Evidence map›Paper›PMID 39852668›Full record

ArticleTropical medicine and infectious disease2025

Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?

Thomas J Stopka, Robin M Nance, L Sarah Mixson, Hunter Spencer, Judith I Tsui, Judith M Leahy, Mai T Pho, Jean DeJace, Judith Feinberg, April M Young and 10 more

Abstract read
In one paragraph

Article in Tropical medicine and infectious disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. An Update on Syndemics: Editorial Comments.Tropical medicine and infectious disease · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Thomas J StopkaDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA.ORCID 0000-0003-2314-8924
Robin M NanceDepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA.
L Sarah MixsonDepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA.ORCID 0009-0006-5149-8859
Hunter SpencerDepartment of Medicine, Oregon Health & Science University, Portland, OR 97239, USA.ORCID 0000-0002-5710-1836
Judith I TsuiDepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA.
Judith M LeahySOR Harm Reduction and Public Health Strategist, Behavioral Health Division, Oregon Health Authority, Portland, OR 97232, USA.
Mai T PhoDepartment of Medicine, Section of Infectious Diseases & Global Health, University of Chicago, Chicago, IL 60637, USA.
Jean DeJaceDivision of Infectious Disease, Department of Medicine, University of Vermont, Burlington, VT 05401, USA.
Judith FeinbergDepartments of Behavioral Medicine and Psychiatry & Medicine/Infectious Diseases, West Virginia University School of Medicine, Morgantown, WV 26505, USA.
April M YoungDepartment of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY 40536, USA.
Wei-Teng YangDivision of Infectious Diseases, Perelman School of Medicine, Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA 19104, USA.
Amelia BaltesDepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.ORCID 0000-0002-0416-9810
Eric RomoDepartment of Family Medicine, Boston Medical Center, Boston, MA 02118, USA.ORCID 0000-0002-5804-9136
Randall T BrownDepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
Kerry NolteDepartment of Nursing, University of New Hampshire, Durham, NH 03824, USA.ORCID 0000-0002-7226-3948
William C MillerDepartment of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC 27514, USA.
William A ZuleDivision of Behavioral Health and Criminal Justice Research, RTI International, Research Triangle Park, NC 27709, USA.
Wiley D JenkinsDepartment of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
Joseph A DelaneyDepartment of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA.
Peter D FriedmannOffice of Research and Department of Healthcare Delivery & Population Sciences, University of Massachusetts Chan Medical School-Baystate and Baystate Health, Springfield, MA 01107, USA.ORCID 0000-0003-3585-3604

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
Oregon Clinical and Translational Research Institute KL2 SupplementKL2TR002370 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Catherine Lee Hough · 2017 to 2026
$10.1M
Ending transmission of HIV, HCV, and STDs and overdose in rural communities of people who inject drugs (ETHIC)UH3DA044829 · NIDA · UNIVERSITY OF CHICAGO · PI JENKINS, WILEY, PHO, MAI TUYET · 2019 to 2022
$5.2M
Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)UH3DA044798 · NIDA · UNIVERSITY OF KENTUCKY · PI COOPER, HANNAH LF, YOUNG, APRIL MARIE · 2019 to 2022
$4.4M
Oregon HIV/Hepatitis and Opioid Prevention and Engagement (OR-HOPE) Study Cost ExtensionUH3DA044831 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI KORTHUIS, PHILIP TODD · 2019 to 2022
$4.0M
Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE)UH3DA044830 · NIDA · BAYSTATE MEDICAL CENTER, INC. · PI FRIEDMANN, PETER D, STOPKA, THOMAS J · 2019 to 2022
$3.9M
Rural Comorbidity and HIV consequences of Opioid use Research and Treatment Initiative (Rural cohort)U24DA048538 · NIDA · UNIVERSITY OF WASHINGTON · PI CRANE, HEIDI M., TSUI, JUDITH · 2019 to 2023
$3.7M
Next-Generation Sequencing Center for GHOSTing Hepatitis C Virus: Transforming Community Based Molecular Surveillance and Outbreak InvestigationU24DA044801 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI ALLEN, TODD M · 2017 to 2022
$3.3M
Community-based, client-centered prevention homes to address the rural opioid epidemicUH3DA044826 · NIDA · UNIVERSITY OF WISCONSIN-MADISON · PI SEAL, DAVID W, WESTERGAARD, RYAN PATRICK · 2019 to 2022
$2.6M
Learning from the COVID-19 pandemic to improve emergency management planning for harm reduction services in rural OhioUH3DA044822 · NIDA · OHIO STATE UNIVERSITY · PI GO, VIVIAN F., MILLER, WILLIAM C · 2019 to 2022
$2.5M
Mitigating the Outcomes Associated with the Injection Drug Use Epidemic in Southern AppalachiaUH3DA044823 · NIDA · RESEARCH TRIANGLE INSTITUTE · PI ZULE, WILLIAM A · 2019 to 2021
$2.4M
Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE)UG3DA044830 · NIDA · BAYSTATE MEDICAL CENTER, INC. · PI FRIEDMANN, PETER D · 2017 to 2018
$1.6M
NCATS NIH HHS KL2 TR002370NIAID NIH HHS P30 AI027757NIDA NIH HHS U24 DA044801NIDA NIH HHS U24 DA048538NIDA NIH HHS UG3 DA044798NIDA NIH HHS UG3 DA044823NIDA NIH HHS UG3 DA044825NIDA NIH HHS UG3 DA044826NIDA NIH HHS UG3 DA044829NIDA NIH HHS UG3 DA044830NIDA NIH HHS UG3 DA044831NIDA NIH HHS UH3 DA044798NIDA NIH HHS UH3 DA044822NIDA NIH HHS UH3 DA044823NIDA NIH HHS UH3 DA044826NIDA NIH HHS UH3 DA044829NIDA NIH HHS UH3 DA044830NIDA NIH HHS UH3 DA044831NIH HHS Primary data collection was supported by grants UG3DA044829/UH3DA044829, G3DA044798/UH3DA044798, UG3DA044830/UH3DA044830, UG3DA044823/UH3DA044823, UH3DA044822/UH3DA044822, UG3DA044831/UH3DA044831, UG3DA044825, UG3DA044826/UH3DA044826, and U24DA044801 co-f
6 · The paper itself

Abstract

Limited research has examined the possible synergistic interrelationships between serious bacterial infections (SBIs) of the heart (i.e., endocarditis), bone, spine, brain, or joints (e.g., osteomylelitis) and hepatitis C virus (HCV) infections. We examined whether syndemic interactions existed between SBI, HCV, and substance-use-related factors in rural communities, hypothesizing that injection-mediated risks elevated the likelihood for both SBIs and HCV infections, which could be exacerbated by synergistic biological-biological or biological and social interactions. We calculated the prevalence ratios (PRs) of past-year SBI associated with each risk factor in separate models. Effect modification among significant risk factors was assessed using multiplicative interaction. Among 1936 participants, 57% were male and 85% White, with a mean age of 36 years. Eighty-nine participants (5%) reported hospitalization for an SBI in the year prior to the survey. More than half tested HCV-antibody-positive (58%); 62 (5.6%) of the participants with a positive HCV antibody result reported past-year hospitalization with an SBI. Injection behaviors were correlated with other SBI risk factors, including multiple injections in the same injection event (MIPIE), injection equipment sharing, and fentanyl use. In adjusted models, MIPIE (PR: 1.79; 95% confidence interval [CI]: 1.03, 3.11) and fentanyl use (PR: 1.68; 95% CI: 1.04, 2.73) were significantly associated with past-year SBI. Our analyses pointed to co-occurring epidemics of SBI and HCV, related to the cumulative health effects of fentanyl use contributing to frequent injections and MIPIE. Both the SBI and HCV epidemics present public health challenges and merit tailored interventions.

Indexed as

hepatitis C viruspeople who inject drugsruralserious bacterial infectionssyndemic

Identifiers

PMID39852668
PMCPMC11769247

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.