scholarly journals A Systematic Review and Meta-Analysis of Studies Evaluating the Effect of Medication Treatment for Opioid Use Disorder on Infectious Disease Outcomes

2021 ◽  
Author(s):  
Katelyn F McNamara ◽  
Breanne E Biondi ◽  
Raúl U Hernández-Ramírez ◽  
Noor Taweh ◽  
Alyssa A Grimshaw ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Sustained Virologic Response ◽  
Viral Suppression ◽  
Meta Analysis ◽  
Virologic Response ◽  
Opioid Use Disorder ◽  
Art Adherence ◽  
Opioid Use ◽  
Disease Outcomes ◽  
Hiv Viral Suppression

Abstract The opioid epidemic has fueled infectious disease epidemics. We determined the impact of medications for opioid use disorder (OUD; MOUD) on treatment outcomes of OUD-associated infectious diseases: antiretroviral therapy (ART) adherence, HIV viral suppression, hepatitis C (HCV) sustained virologic response, HCV re-infection, new HBV infections, and infectious endocarditis-related outcomes. Manuscripts reporting on these infectious disease outcomes in adults with OUD receiving MOUD compared with those with OUD not receiving MOUD were included. Initial search yielded 8,169 papers; 9 were included in the final review. The meta-analysis revealed that MOUD was associated with greater ART adherence (OR=1.55; 95%CI=1.12-2.15) and HIV viral suppression (2.19; 1.88-2.56). One study suggested a positive association between MOUD and HCV sustained virologic response. There is significant support for integrating MOUD with HIV treatment to improve viral suppression among persons with HIV (PWH) and OUD. Treatment of OUD among PWH should be a priority in order to combat the opioid and HIV epidemics.

scholarly journals Development of an Interdisciplinary Telehealth Model of Provider Training and Comprehensive Care for Hepatitis C and Opioid Use Disorder in a High-Burden Region

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S354-S364 ◽  
Author(s):  
Jacqueline E Sherbuk ◽  
Terry Kemp Knick ◽  
Chelsea Canan ◽  
Patrice Ross ◽  
Bailey Helbert ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Sustained Virologic Response ◽  
Virologic Response ◽  
Opioid Use Disorder ◽  
Support Staff ◽  
World Population ◽  
Opioid Use ◽  
Provider Training ◽  
Financial Barriers ◽  
Efficient Treatment

Abstract Background Hepatitis C virus (HCV) and the opioid epidemic disproportionately affect the Appalachian region. Geographic and financial barriers prevent access to specialty care. Interventions are needed to address the HCV-opioid syndemic in this region. Methods We developed an innovative, collaborative telehealth model in Southwest Virginia featuring bidirectional referrals from and to comprehensive harm reduction (CHR) programs and office-based opioid therapy (OBOT), as well as workforce development through local provider training in HCV management. We aimed to (1) describe the implementation process of provider training and (2) assess the effectiveness of the telehealth model by monitoring patient outcomes in the first year. Results The provider training model moved from a graduated autonomy model with direct specialist supervision to a 1-day workshop with parallel tracks for providers and support staff followed by monthly case conferences. Forty-four providers and support staff attended training. Eight providers have begun treating independently. For the telehealth component, 123 people were referred, with 62% referred from partner OBOT or CHR sites; 103 (84%) attended a visit, 93 (76%) completed the treatment course, and 61 (50%) have achieved sustained virologic response. Rates of sustained virologic response did not differ by receipt of treatment for opioid use disorder. Conclusions Providers demonstrated a preference for an in-person training workshop, though further investigation is needed to determine why only a minority of those trained have begun treating HCV independently. The interdisciplinary nature of this program led to efficient treatment of hepatitis C in a real-world population with a majority of patients referred from OBOTs and CHR programs.

scholarly journals Prevalence of childhood maltreatment among people with opioid use disorder: A systematic review and meta-analysis

2021 ◽  
Vol 219 ◽  
pp. 108459
Author(s):  
Thomas Santo ◽  
Gabrielle Campbell ◽  
Natasa Gisev ◽  
Lucy Thi Tran ◽  
Samantha Colledge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Childhood Maltreatment ◽  
Meta Analysis ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals On the diverse and opposing effects of nutrition on pathogen virulence

2019 ◽  
Vol 286 (1906) ◽  
pp. 20191220 ◽  
Author(s):  
Victoria L. Pike ◽  
Katrina A. Lythgoe ◽  
Kayla C. King
Keyword(s):  
Infectious Disease ◽  
Immune System ◽  
Meta Analysis ◽  
Anthropogenic Factors ◽  
Anthropogenic Activity ◽  
Pathogen Virulence ◽  
Disease Outcomes ◽  
Host Nutrition ◽  
Opposing Effects ◽  
The Impact

Climate change and anthropogenic activity are currently driving large changes in nutritional availability across ecosystems, with consequences for infectious disease. An increase in host nutrition could lead to more resources for hosts to expend on the immune system or for pathogens to exploit. In this paper, we report a meta-analysis of studies on host–pathogen systems across the tree of life, to examine the impact of host nutritional quality and quantity on pathogen virulence. We did not find broad support across studies for a one-way effect of nutrient availability on pathogen virulence. We thus discuss a hypothesis that there is a balance between the effect of host nutrition on the immune system and on pathogen resources, with the pivot point of the balance differing for vertebrate and invertebrate hosts. Our results suggest that variation in nutrition, caused by natural or anthropogenic factors, can have diverse effects on infectious disease outcomes across species.

scholarly journals Integrating Responses to the Opioid Use Disorder and Infectious Disease Epidemics

JAMA ◽  
2020 ◽  
Vol 324 (1) ◽  
pp. 37 ◽  
Author(s):  
Sandra A. Springer ◽  
Andrew P. Merluzzi ◽  
Carlos del Rio
Keyword(s):  
Infectious Disease ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Disease Epidemics

Association Between Food Insecurity and HIV Viral Suppression: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 21 (3) ◽  
pp. 754-765 ◽  
Author(s):  
Wusiman Aibibula ◽  
Joseph Cox ◽  
Anne-Marie Hamelin ◽  
Taylor McLinden ◽  
Marina B. Klein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Food Insecurity ◽  
Viral Suppression ◽  
Meta Analysis ◽  
Hiv Viral Suppression

scholarly journals Beyond Antibiotics: A Practical Guide for the Infectious Disease Physician to Treat Opioid Use Disorder in the Setting of Associated Infectious Diseases

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Nikhil Seval ◽  
Ellen Eaton ◽  
Sandra A Springer
Keyword(s):  
Infectious Disease ◽  
Extended Release ◽  
Hospital Admissions ◽  
Opioid Use Disorder ◽  
Evidence Based ◽  
Opioid Use ◽  
Patient Centered ◽  
Infectious Disease Physician ◽  
Centered Care ◽  
Acute Injection

Abstract Infections are a common cause of hospitalization for patients with opioid use disorder (OUD), and hospital admissions are rising in the context of the worsening US opioid crisis. Infectious disease (ID) physicians are frequently the first point of medical contact for these patients. In this article, we discuss the integration of evidence-based management of OUD and patient-centered care of hospitalized persons with acute injection-related infections. We describe the following components of a comprehensive approach for OUD with inpatient ID consultations: (1) how to screen for OUD; (2) how to initiate the 3 US Food and Drug Administration-approved medications for OUD (buprenorphine, methadone, and extended-release naltrexone); (3) how to manage acute pain and opioid-related conditions; and (4) how to link and integrate ID and OUD treatment after hospital discharge. These strategies reduce unplanned discharges and increase completion of recommended antimicrobial regimens.

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