HIV cases skyrocket among US painkiller abusers (Update)

HIV, the AIDS virus (yellow), infecting a human immune cell. Credit: Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health.
Cases of HIV have skyrocketed among injection drug users in a rural community in the midwestern state of Indiana where 142 people have been diagnosed since the beginning of the year, officials said Friday.

Pregnant women, grandparents, their adult children and grandchildren are among the new cases of HIV linked to abuse of oxymorphone, a potent prescription painkiller that drug users crush, liquefy and inject into their veins.

Indiana State Health Commissioner Jerome Adams described the current outbreak as "unprecedented," noting that HIV used to be quite rare in Scott County, a community of 4,200 people and just one doctor in southeastern Indiana.

Only three new cases of HIV were recorded there from 2009 to 2013.

"We literally have new cases being reported every day, literally on an hourly basis," Adams told reporters.

A public health emergency was declared in Scott County on March 26 by Governor Mike Pence.

The US Centers for Disease Control and Prevention issued a nationwide alert to health care providers to be on the lookout for the possibility of outbreaks of human immunodeficiency virus—and hepatitis C, which often accompanies it—among injection drug users elsewhere in the country.

"At this point, there is no sign that infections are increasing on a national level among people who are injecting drugs," said Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

But, he added that the situation in Indiana "should serve as a warning that we cannot let down our guard against these deadly infections."

In the late 1980s, when heroin use was driving the HIV/AIDS epidemic among needle-sharers, there were about 35,000 new cases annually in that group.

Now, there are about 3,900 new HIV infections per year in the United States linked to injection drug use.

Heroin is less popular these days but prescription painkiller abuse is on the rise in the United States, where opioid poisoning deaths have nearly quadrupled from 2009 to 2011.

'Community activity'

Injecting painkillers may prove even more dangerous than heroin because opioid addicts tend to shoot up more frequently, as often as every few hours, experts said.

Also, since the pills can be difficult to crush into powder, they use bigger needles than heroin users typically do, raising their risk of exposure to HIV.

Scott County has an unemployment rate of 8.9 percent, while 21.3 percent of adults have not completed high school and 19 percent of the population lives in poverty, according to the CDC's Morbidity and Mortality Weekly report on the crisis.

Four out of five of those diagnosed with HIV have admitted to injecting drugs, health authorities explained during a conference call with reporters.

Their drug of choice is a painkiller known by the brand name Opana, which comes in a pill that they crush and dissolve, even though it is sold in an abuse-deterrent form.

The problem of painkiller addiction in the area began more than a decade ago.

"Many family members will use drugs together," said Joan Duwve, chief medical consultant for the Indiana State Department of Health.

"There are children and parents and grandparents who live in the same house who are injecting drugs together, sort of as a community activity."

The age range of those infected so far is 18-57. Just over half are men. Seven percent of the female patients have identified themselves as commercial sex workers, the CDC said.

Each drug user in the HIV cluster has reported sharing needles with an average of nine other people.

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24 new HIV cases reported in Indiana outbreak, 130 total

© 2015 AFP

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