Eyes on potential HIV, Hepatitis C outbreak, experts say

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Editor’s note: The original article said illicit drug use is a risk factor for Hepatitis A. While this is factually correct, people under the influence of any drug, even alcohol, are susceptible to the disease as it is transmitted through poor hand washing. The article has been modified to correct that statement. 

Public health experts say an outbreak of infectious diseases spread by needle use could be on the horizon for our region. 

Dr. David Kirschke, the state deputy epidemiologist for the Tennessee Department of Health, said that Hepatitis C has been on the rise for about six years.  This, he said, is due to the continuing opioid crisis ravaging our region as more and more drug users turn to injection.

“We know we have a lot of Hepatitis C related to injection drugs in Northeast Tennessee,” he said. “So far, we haven’t seen a huge increase in HIV associated with that, but it’s only a matter of time before we get an outbreak of something like HIV.” 

The Centers for Disease Control reported in 2015 that rates of Hepatitis C increased by 100 percent between 2011 and 2015. Kirschke said these numbers have been steadily increasing for years. 

Hepatitis C affects the liver. There’s no vaccine, but Kirschke said it’s treatable. The problem is many drug users don’t get tested, so they don’t know they have Hepatitis C until they are suffering from cirrhosis or liver cancer.

It’s one of the indicators the health department uses to gauge drug use in the community, he added.

“Now we have high Hepatitis C rates in this area, which correlate with injection drug use, we know there’s a lot of injection drug use going on,” he said.

While Kirschke said our region hasn’t seen an increase in HIV yet, he said that’s always on the health department’s radar.

Community outreach is one way the health department and East Tennessee State University are attempting to curb the spread of infectious diseases. Kirschke said it’s been difficult reaching the drug user community with preventative programs like PReP for HIV. 

Kirschke said opioid use is also fueling a current Hepatitis A outbreak. While the Hepatitis A virus isn’t transmitted through needles, drug use and homelessness are two of the biggest risk factors for contracting it. 

“We’ve been doing mass vaccination campaigns, so we’ve been vaccinating, trying to target those groups for vaccination at homeless shelters, drug treatment clinics, the jails, just trying to get some prevention, but we’re still seeing a fair amount of cases of Hepatitis A,” he said.

ETSU launched the Syringe Trade and Education Program about a year ago, where drug users can trade used needles for sterile ones. Dr. Sarah Melton, a professor of pharmacy practice at Bill Gatton College of Pharmacy, said this is just one way drug users can seek help in the community. 

The program offers sterile needles, but it’s another way for drug users to obtain Naloxone, a drug used to treat opioid overdoses. Participants in needle exchange programs are also more likely to get long-term help, Melton added. 

“I think in most areas, we see pushback from law enforcement because they see that as enabling people to use the syringes and inject,” Melton said. “Really they’re going to be using anyway, that’s the nature of addiction, so we want them to do so safely and decrease the transmission of diseases.

“What we know is that really in a hotbed of risk, so southwest Virginia, northeast Tennessee, we’re at a really high risk of an epidemic of HIV or Hepatitis C breaking out because of people using the syringes in close proximity to one another.”

More information on ETSU’s STEP program may be accessed online at STEPTN.org. or by calling 423-930-8337.

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