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Friedman JR, Abramovitz D, Skaathun B, Rangel G, Harvey-Vera A, Vera CF, Artamonova I, Muñoz S, Martin NK, Eger WH, Bailey K, Go BS, Bourgois P, Strathdee SA. Illicit Fentanyl Use and Hepatitis C Virus Seroconversion Among People Who Inject Drugs in Tijuana and San Diego: Results From a Binational Cohort Study. Clin Infect Dis 2024:ciae372. [PMID: 39078273 DOI: 10.1093/cid/ciae372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Illicitly manufactured fentanyl (IMF) increases overdose mortality, but its role in infectious disease transmission is unknown. We examined whether IMF use predicts hepatitis C virus (HCV) and human immunodeficiency virus (HIV) incidence among a cohort of people who inject drugs (PWID) in San Diego, California and Tijuana, Mexico. METHODS PWID were recruited during 2020-2022, undergoing semi-annual interviewer-administered surveys and HIV and HCV serological rapid tests through 2024. Cox regression was conducted to examine predictors of seroconversion considering self-reported IMF use as a 6-month lagged, time-dependent covariate. RESULTS Of 398 PWID at baseline, 67% resided in San Diego, 70% were male, median age was 43 years, 42% reported receptive needle sharing, and 25% reported using IMF. HCV incidence was 14.26 per 100 person-years (95% confidence interval [CI]: 11.49-17.02), and HIV incidence was 1.29 (95% CI: .49-2.10). IMF was associated with HCV seroconversion, with a univariable hazard ratio (HR) of 1.64 (95% CI: 1.09-2.40), and multivariable HR of 1.57 (95% CI: 1.03-2.40). The direction of the relationship with HIV was similar, albeit not significant (HR 2.39; 95% CI: .66-8.64). CONCLUSIONS We document a novel association between IMF and HCV seroconversion among PWID in Tijuana-San Diego. Few HIV seroconversions (n = 10) precluded our ability to assess if a similar relationship held for HIV. IMF's short half-life may destabilize PWID-increasing the need for repeat dosing and sharing smoking materials and syringes. New preventive care approaches may reduce HCV transmission in the fentanyl era.
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Affiliation(s)
| | | | - Britt Skaathun
- Department of Medicine, University of California, San Diego
| | - Gudelia Rangel
- Department of Population Studies, Colegio de la Frontera Norte
- Sección mexicana, Comisión de Salud Fronteriza México-Estados Unidos
| | | | - Carlos F Vera
- Department of Medicine, University of California, San Diego
- Sección mexicana, Comisión de Salud Fronteriza México-Estados Unidos
| | | | - Sheryl Muñoz
- Sección mexicana, Comisión de Salud Fronteriza México-Estados Unidos
- Escuela de Medicina, Universidad Xochicalco, Campus Tijuana, Mexico
| | | | - William H Eger
- Department of Medicine, University of California, San Diego
- School of Social Work, San Diego State University, California
| | - Katie Bailey
- Department of Medicine, University of California, San Diego
| | - Bo-Shan Go
- School of Medicine, University of Amsterdam, The Netherlands
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Ratshisusu L, Simani OE, Blackard JT, Selabe SG. The Impact of Drugs and Substance Abuse on Viral Pathogenesis-A South African Perspective. Viruses 2024; 16:971. [PMID: 38932263 PMCID: PMC11209167 DOI: 10.3390/v16060971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Illicit drug and alcohol abuse have significant negative consequences for individuals who inject drugs/use drugs (PWID/UDs), including decreased immune system function and increased viral pathogenesis. PWID/UDs are at high risk of contracting or transmitting viral illnesses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). In South Africa, a dangerous drug-taking method known as "Bluetoothing" has emerged among nyaope users, whereby the users of this drug, after injecting, withdraw blood from their veins and then reinject it into another user. Hence, the transmission of blood-borne viruses (BBVs) is exacerbated by this "Bluetooth" practice among nyaope users. Moreover, several substances of abuse promote HIV, HBV, and HCV replication. With a specific focus on the nyaope drug, viral replication, and transmission, we address the important influence of abused addictive substances and polysubstance use in this review.
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Affiliation(s)
- Lufuno Ratshisusu
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (O.E.S.); (J.T.B.); (S.G.S.)
| | - Omphile E. Simani
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (O.E.S.); (J.T.B.); (S.G.S.)
| | - Jason T. Blackard
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (O.E.S.); (J.T.B.); (S.G.S.)
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0595, USA
| | - Selokela G. Selabe
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (O.E.S.); (J.T.B.); (S.G.S.)
- National Health Laboratory Service, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
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Madhuravasal Krishnan J, Kong L, Karns R, Medvedovic M, Sherman KE, Blackard JT. The Synthetic Opioid Fentanyl Increases HIV Replication and Chemokine Co-Receptor Expression in Lymphocyte Cell Lines. Viruses 2023; 15:1027. [PMID: 37113007 PMCID: PMC10145664 DOI: 10.3390/v15041027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In the United States, the illicit use of synthetic opioids such as fentanyl has led to a serious public health crisis. Synthetic opioids are known to enhance viral replication and to suppress immunologic responses, but their effects on HIV pathogenesis remain unclear. Thus, we examined the impact of fentanyl on HIV-susceptible and HIV-infected cell types. METHODS TZM-bl and HIV-infected lymphocyte cells were incubated with fentanyl at varying concentrations. Expression levels of the CXCR4 and CCR5 chemokine receptors and HIV p24 antigen were quantified with ELISA. HIV proviral DNA was quantified using SYBR RT-PCR. Cell viability was detected with the MTT assay. RNAseq was performed to characterize cellular gene regulation in the presence of fentanyl. RESULTS Fentanyl enhanced expression of both chemokine receptor levels in a dose-dependent manner in HIV-susceptible and infected cell lines. Similarly, fentanyl induced viral expression in HIV-exposed TZM-bl cells and in HIV-infected lymphocyte cell lines. Multiple genes associated with apoptosis, antiviral/interferon response, chemokine signaling, and NFκB signaling were differentially regulated. CONCLUSIONS Synthetic opioid fentanyl impacts HIV replication and chemokine co-receptor expression. Increased virus levels suggest that opioid use may increase the likelihood of transmission and accelerate disease progression.
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Affiliation(s)
- Janani Madhuravasal Krishnan
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (J.M.K.)
| | - Ling Kong
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (J.M.K.)
| | - Rebekah Karns
- Digestive Health Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Mario Medvedovic
- Department of Environmental & Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Kenneth E. Sherman
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (J.M.K.)
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Jason T. Blackard
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (J.M.K.)
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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Bodnar RJ. Endogenous opiates and behavior: 2021. Peptides 2023; 164:171004. [PMID: 36990387 DOI: 10.1016/j.peptides.2023.171004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
This paper is the forty-fourth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2021 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonizts and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, CUNY, 65-30 Kissena Blvd., Flushing, NY 11367, USA.
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Kong L, Shata MTM, Brown JL, Lyons MS, Sherman KE, Blackard JT. The synthetic opioid fentanyl increases HIV replication and chemokine co-receptor expression in vitro. J Neurovirol 2022; 28:583-594. [PMID: 35976538 PMCID: PMC11135282 DOI: 10.1007/s13365-022-01090-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 01/13/2023]
Abstract
The US is experiencing a major public health crisis that is fueled by the illicit use of synthetic opioids including fentanyl. While several drugs of abuse can enhance viral replication and/or antagonize immune responses, the impact of specific synthetic opioids on HIV pathogenesis is poorly understood. Thus, we evaluated the effects of fentanyl on HIV replication in vitro. HIV-susceptible or HIV-expressing cell lines were incubated with fentanyl. HIV p24 synthesis and chemokine receptor levels were quantified by ELISA in culture supernatants and cell lysates, respectively. Addition of fentanyl resulted in a dose-dependent increase in HIV replication. Fentanyl enhanced expression of the HIV chemokine co-receptors CXCR4 and CCR5 and caused a dose-dependent decrease in cell viability. The opioid antagonist naltrexone blocked the effect of fentanyl on HIV replication and CCR5 receptor levels but not CXCR4 receptor levels. TLR9 expression was induced by HIV; however, fentanyl inhibited TLR9 expression in a dose-dependent manner. These data demonstrate that the synthetic opioid fentanyl can promote HIV replication in vitro. As increased HIV levels are associated with accelerated disease progression and higher likelihood of transmission, additional research is required to enhance the understanding of opioid-virus interactions and to develop new and/or optimized treatment strategies for persons with HIV and opioid use disorder.
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Affiliation(s)
- Ling Kong
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, ML 0595, 231 Albert Sabin Way, Cincinnati, OH, 45267-0595, USA
| | - Mohamed Tarek M Shata
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, ML 0595, 231 Albert Sabin Way, Cincinnati, OH, 45267-0595, USA
| | - Jennifer L Brown
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael S Lyons
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kenneth E Sherman
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, ML 0595, 231 Albert Sabin Way, Cincinnati, OH, 45267-0595, USA
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jason T Blackard
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, ML 0595, 231 Albert Sabin Way, Cincinnati, OH, 45267-0595, USA.
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Yan J, Nie DH, Bai CS, Rehman A, Yang A, Mou XL, Zhang YQ, Xu YQ, Xiang QQ, Ren YT, Xu JL, Wang MR, Feng Y, Chen XP, Xiong Y, Hu HT, Xiong HR, Hou W. Fentanyl enhances HIV infection in vitro. Virology 2022; 577:43-50. [PMID: 36279602 DOI: 10.1016/j.virol.2022.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Acquired immunodeficiency syndrome (AIDS) caused by Human immunodeficiency virus type 1 (HIV-1) has a high tendency among illicit drug abusers. Recently, it is reported that abuse of fentanyl, a potent synthetic μ receptor-stimulating opioid, is an independent risk factor for HIV-1 infection. However, the mechanism of action in augmenting HIV-1 infection still remains elusive. In this study, we found that fentanyl enhanced infection of HIV-1 in MT2 cells, primary macrophages and Jurkat C11 cells. Fentanyl up-regulated CXCR4 and CCR5 receptor expression, which facilitated the entry of virion into host cells. In addition, it down-regulated interferon-β (IFN-β) and interferon-stimulated genes (APOBEC3F, APOBEC3G and MxB) expression in MT2 cells. Our findings identify an essential role of fentanyl in the positive regulation of HIV-1 infection via the upregulation of co-receptors (CXCR4/CCR5) and downregulation of IFN-β and ISGs, and it may have an important role in HIV-1 immunopathogenesis.
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Affiliation(s)
- Jie Yan
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Dong-Hang Nie
- Blood Center of Wuhan, Wuhan, 430030, Hubei Province, China
| | - Cheng-Si Bai
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Abdul Rehman
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - An Yang
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Xiao-Li Mou
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Yu-Qing Zhang
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Ying-Qi Xu
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Qing-Qing Xiang
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Yu-Ting Ren
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Jia-le Xu
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Mei-Rong Wang
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Yong Feng
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Xiao-Ping Chen
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Yong Xiong
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Hai-Tao Hu
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Hai-Rong Xiong
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China.
| | - Wei Hou
- State Key Laboratory of Virology, Institute of Medical Virology/ Department of Infectious Diseases, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hubei Province, China; Wuhan University Shenzhen Research Institute, South Keyuan Road, Scien&Tech Garden, Nanshan District, Shenzhen, Guangdong, China.
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Drugs of Abuse and Their Impact on Viral Pathogenesis. Viruses 2021; 13:v13122387. [PMID: 34960656 PMCID: PMC8707190 DOI: 10.3390/v13122387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/23/2021] [Accepted: 11/27/2021] [Indexed: 02/07/2023] Open
Abstract
Commonly misused substances such as alcohol, cocaine, heroin, methamphetamine, and opioids suppress immune responses and may impact viral pathogenesis. In recent years, illicit use of opioids has fueled outbreaks of several viral pathogens, including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). This review focuses on the myriad of mechanisms by which drugs of abuse impact viral replication and disease progression. Virus–drug interactions can accelerate viral disease progression and lead to increased risk of virus transmission.
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