Cecillia Y Wong1, Weiming Zhu2, Gerard P Aurigemma3, Nathan Furukawa2, Eyasu H Teshale4, Ya-Lin A Huang2, Philip J Peters2, Karen W Hoover2. 1. Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 2. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 3. Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 4. Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
BACKGROUND: Infective endocarditis (IE) is a life-threatening bacterial infection of the heart valves, most often diagnosed in older persons and persons with prior cardiac surgery. It is also associated with injection drug use, a behavior that has increased in recent years along with the US opioid crisis. METHODS: We conducted a retrospective cohort analysis of commercial and Medicaid health insurance databases to estimate incident cases of IE in the United States in 2017, stratified by persons living with human immunodeficiency virus (HIV), hepatitis C virus (HCV), and opioid use disorder (OUD). We also estimated annual percentage changes (EAPCs) in IE from 2007-2017 among persons with commercial insurance. RESULTS: The weighted incidence rate of IE was 13.8 cases per 100 000 persons among persons with commercial insurance, and 78.7 among those with Medicaid. The incidence rate of IE among commercially insured persons increased slightly from 2007-2017 (EAPC, 1.0%). It decreased among commercially insured persons living with HIV, from 148.0 in 2007 to 112.1 in 2017 (EAPC, -4.3%), and increased among those with HCV infection, from 172.4 in 2007 to 238.6 in 2017 (EAPC, 3.2%). Among persons aged 18-29 years with HCV infection, IE increased from 322.3 in 2007 to 1007.1 in 2017 (EAPC, 16.3%), and among those with OUD it increased from 156.4 in 2007 to 642.9 in 2017 (EAPC, 14.8%). CONCLUSIONS: The incidence rate of IE increased markedly among young persons with HCV infections or OUD. This increase appears to parallel the ongoing national opioid crisis. Harm reduction with syringe services programs, medications for opioid use disorder, and safe injection practices can prevent the spread of HIV, HCV, and IE. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
BACKGROUND:Infective endocarditis (IE) is a life-threatening bacterial infection of the heart valves, most often diagnosed in older persons and persons with prior cardiac surgery. It is also associated with injection drug use, a behavior that has increased in recent years along with the US opioid crisis. METHODS: We conducted a retrospective cohort analysis of commercial and Medicaid health insurance databases to estimate incident cases of IE in the United States in 2017, stratified by persons living with human immunodeficiency virus (HIV), hepatitis C virus (HCV), and opioid use disorder (OUD). We also estimated annual percentage changes (EAPCs) in IE from 2007-2017 among persons with commercial insurance. RESULTS: The weighted incidence rate of IE was 13.8 cases per 100 000 persons among persons with commercial insurance, and 78.7 among those with Medicaid. The incidence rate of IE among commercially insured persons increased slightly from 2007-2017 (EAPC, 1.0%). It decreased among commercially insured persons living with HIV, from 148.0 in 2007 to 112.1 in 2017 (EAPC, -4.3%), and increased among those with HCV infection, from 172.4 in 2007 to 238.6 in 2017 (EAPC, 3.2%). Among persons aged 18-29 years with HCV infection, IE increased from 322.3 in 2007 to 1007.1 in 2017 (EAPC, 16.3%), and among those with OUD it increased from 156.4 in 2007 to 642.9 in 2017 (EAPC, 14.8%). CONCLUSIONS: The incidence rate of IE increased markedly among young persons with HCV infections or OUD. This increase appears to parallel the ongoing national opioid crisis. Harm reduction with syringe services programs, medications for opioid use disorder, and safe injection practices can prevent the spread of HIV, HCV, and IE. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
Entities:
Keywords:
HIV; hepatitis C; infective endocarditis; opioid use disorder
Authors: Magdalena Cerdá; Noa Krawczyk; Leah Hamilton; Kara E Rudolph; Samuel R Friedman; Katherine M Keyes Journal: Annu Rev Public Health Date: 2021-11-30 Impact factor: 21.981
Authors: Khawaja M Talha; Mark J Dayer; Martin H Thornhill; Wajeeha Tariq; Verda Arshad; Imad M Tleyjeh; Kent R Bailey; Raj Palraj; Nandan S Anavekar; M Rizwan Sohail; Daniel C DeSimone; Larry M Baddour Journal: Open Forum Infect Dis Date: 2021-09-25 Impact factor: 4.423
Authors: David P Serota; Hansel E Tookes; Belén Hervera; Babley M Gayle; Cara R Roeck; Edward Suarez; David W Forrest; Michael A Kolber; Tyler S Bartholomew; Allan E Rodriguez; Susanne Doblecki-Lewis Journal: Ann Med Date: 2021-12 Impact factor: 5.348