An outbreak of HIV infection among people who inject drugs linked to injection of propofol in Taiwan

Yu Ching Huang, Yen Fang Huang, Min Hau Lin, Jyh Yuan Yang, Yu Hsin Liao, Hsiu Yun Lo, Carl A Latkin, Kenrad Edwin Nelson

Research output: Contribution to journalArticle

Abstract

Introduction: The aim of this study was to report an HIV outbreak related to propofol-injection and the impact of regulating propofol on the HIV epidemic among people who inject drugs (PWID). Methods: A retrospective cohort study of 252 PWID who were diagnosed with an HIV infection between 2014 and 2017 in Taiwan. The propofol information was collected by routine epidemic surveillance and interviews. We linked several national databases to collect other related factors, including methadone maintenance treatment (MMT) attendance and incarceration. The serums were tested for recent infection by the LAg-avidity EIA assay and relationship of the trains by the Phylogenetic tree analysis. Analyses were conducted using the R Surveillance package for retrospective modeling for outbreak detection. A multiple logistic regression was used to evaluate the association between propofol-injection and other related factors. Results: There were 28 cases reported with propofol-injection, all of which were reported in Central Taiwan. A total of 11 (50%) cases among 22 propofol-injectors with serums were recent infections, which were higher than that 33 (23.4%) of non-propofol group. The phylogenetic tree indicated that 6 propofol-injectors were grouped together with the same cluster in circular. The HIV epidemic curve among PWID revealed an outbreak of 82 in 2015, which then decreased to 43 in 2016 after propofol began to be regulated as a Schedule 4 controlled drug in August 2015. In a multiple logistic regression, attendance at methadone clinics was associated with a significantly higher risk for propofol-injection (adjusted OR = 2.43, 95% CI = 0.98-5.98), and HIV reported in the year 2015 was associated with an increased risk of propofol-injection (adjusted OR = 4, 95% CI = 1.08-14.86). Conclusions: Our data indicate that the government regulation of propofol as a controlled drug strategy was associated with significant reduction in the spread of HIV among PWID. authors and do not necessarily represent the official views of Taiwan Centers for Disease Control.

Original languageEnglish (US)
Article numbere0210210
JournalPloS one
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

HIV infections
Propofol
Taiwan
HIV Infections
Disease Outbreaks
injection
drugs
Injections
Pharmaceutical Preparations
methadone
injectors
HIV
Methadone
monitoring
phylogeny
cohort studies
infection
Logistics
laws and regulations
interviews

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

An outbreak of HIV infection among people who inject drugs linked to injection of propofol in Taiwan. / Huang, Yu Ching; Huang, Yen Fang; Lin, Min Hau; Yang, Jyh Yuan; Liao, Yu Hsin; Lo, Hsiu Yun; Latkin, Carl A; Nelson, Kenrad Edwin.

In: PloS one, Vol. 14, No. 2, e0210210, 01.02.2019.

Research output: Contribution to journalArticle

Huang, Yu Ching ; Huang, Yen Fang ; Lin, Min Hau ; Yang, Jyh Yuan ; Liao, Yu Hsin ; Lo, Hsiu Yun ; Latkin, Carl A ; Nelson, Kenrad Edwin. / An outbreak of HIV infection among people who inject drugs linked to injection of propofol in Taiwan. In: PloS one. 2019 ; Vol. 14, No. 2.
@article{b264c19b3788415abc7ddf7d3e694aa6,
title = "An outbreak of HIV infection among people who inject drugs linked to injection of propofol in Taiwan",
abstract = "Introduction: The aim of this study was to report an HIV outbreak related to propofol-injection and the impact of regulating propofol on the HIV epidemic among people who inject drugs (PWID). Methods: A retrospective cohort study of 252 PWID who were diagnosed with an HIV infection between 2014 and 2017 in Taiwan. The propofol information was collected by routine epidemic surveillance and interviews. We linked several national databases to collect other related factors, including methadone maintenance treatment (MMT) attendance and incarceration. The serums were tested for recent infection by the LAg-avidity EIA assay and relationship of the trains by the Phylogenetic tree analysis. Analyses were conducted using the R Surveillance package for retrospective modeling for outbreak detection. A multiple logistic regression was used to evaluate the association between propofol-injection and other related factors. Results: There were 28 cases reported with propofol-injection, all of which were reported in Central Taiwan. A total of 11 (50{\%}) cases among 22 propofol-injectors with serums were recent infections, which were higher than that 33 (23.4{\%}) of non-propofol group. The phylogenetic tree indicated that 6 propofol-injectors were grouped together with the same cluster in circular. The HIV epidemic curve among PWID revealed an outbreak of 82 in 2015, which then decreased to 43 in 2016 after propofol began to be regulated as a Schedule 4 controlled drug in August 2015. In a multiple logistic regression, attendance at methadone clinics was associated with a significantly higher risk for propofol-injection (adjusted OR = 2.43, 95{\%} CI = 0.98-5.98), and HIV reported in the year 2015 was associated with an increased risk of propofol-injection (adjusted OR = 4, 95{\%} CI = 1.08-14.86). Conclusions: Our data indicate that the government regulation of propofol as a controlled drug strategy was associated with significant reduction in the spread of HIV among PWID. authors and do not necessarily represent the official views of Taiwan Centers for Disease Control.",
author = "Huang, {Yu Ching} and Huang, {Yen Fang} and Lin, {Min Hau} and Yang, {Jyh Yuan} and Liao, {Yu Hsin} and Lo, {Hsiu Yun} and Latkin, {Carl A} and Nelson, {Kenrad Edwin}",
year = "2019",
month = "2",
day = "1",
doi = "10.1371/journal.pone.0210210",
language = "English (US)",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

}

TY - JOUR

T1 - An outbreak of HIV infection among people who inject drugs linked to injection of propofol in Taiwan

AU - Huang, Yu Ching

AU - Huang, Yen Fang

AU - Lin, Min Hau

AU - Yang, Jyh Yuan

AU - Liao, Yu Hsin

AU - Lo, Hsiu Yun

AU - Latkin, Carl A

AU - Nelson, Kenrad Edwin

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Introduction: The aim of this study was to report an HIV outbreak related to propofol-injection and the impact of regulating propofol on the HIV epidemic among people who inject drugs (PWID). Methods: A retrospective cohort study of 252 PWID who were diagnosed with an HIV infection between 2014 and 2017 in Taiwan. The propofol information was collected by routine epidemic surveillance and interviews. We linked several national databases to collect other related factors, including methadone maintenance treatment (MMT) attendance and incarceration. The serums were tested for recent infection by the LAg-avidity EIA assay and relationship of the trains by the Phylogenetic tree analysis. Analyses were conducted using the R Surveillance package for retrospective modeling for outbreak detection. A multiple logistic regression was used to evaluate the association between propofol-injection and other related factors. Results: There were 28 cases reported with propofol-injection, all of which were reported in Central Taiwan. A total of 11 (50%) cases among 22 propofol-injectors with serums were recent infections, which were higher than that 33 (23.4%) of non-propofol group. The phylogenetic tree indicated that 6 propofol-injectors were grouped together with the same cluster in circular. The HIV epidemic curve among PWID revealed an outbreak of 82 in 2015, which then decreased to 43 in 2016 after propofol began to be regulated as a Schedule 4 controlled drug in August 2015. In a multiple logistic regression, attendance at methadone clinics was associated with a significantly higher risk for propofol-injection (adjusted OR = 2.43, 95% CI = 0.98-5.98), and HIV reported in the year 2015 was associated with an increased risk of propofol-injection (adjusted OR = 4, 95% CI = 1.08-14.86). Conclusions: Our data indicate that the government regulation of propofol as a controlled drug strategy was associated with significant reduction in the spread of HIV among PWID. authors and do not necessarily represent the official views of Taiwan Centers for Disease Control.

AB - Introduction: The aim of this study was to report an HIV outbreak related to propofol-injection and the impact of regulating propofol on the HIV epidemic among people who inject drugs (PWID). Methods: A retrospective cohort study of 252 PWID who were diagnosed with an HIV infection between 2014 and 2017 in Taiwan. The propofol information was collected by routine epidemic surveillance and interviews. We linked several national databases to collect other related factors, including methadone maintenance treatment (MMT) attendance and incarceration. The serums were tested for recent infection by the LAg-avidity EIA assay and relationship of the trains by the Phylogenetic tree analysis. Analyses were conducted using the R Surveillance package for retrospective modeling for outbreak detection. A multiple logistic regression was used to evaluate the association between propofol-injection and other related factors. Results: There were 28 cases reported with propofol-injection, all of which were reported in Central Taiwan. A total of 11 (50%) cases among 22 propofol-injectors with serums were recent infections, which were higher than that 33 (23.4%) of non-propofol group. The phylogenetic tree indicated that 6 propofol-injectors were grouped together with the same cluster in circular. The HIV epidemic curve among PWID revealed an outbreak of 82 in 2015, which then decreased to 43 in 2016 after propofol began to be regulated as a Schedule 4 controlled drug in August 2015. In a multiple logistic regression, attendance at methadone clinics was associated with a significantly higher risk for propofol-injection (adjusted OR = 2.43, 95% CI = 0.98-5.98), and HIV reported in the year 2015 was associated with an increased risk of propofol-injection (adjusted OR = 4, 95% CI = 1.08-14.86). Conclusions: Our data indicate that the government regulation of propofol as a controlled drug strategy was associated with significant reduction in the spread of HIV among PWID. authors and do not necessarily represent the official views of Taiwan Centers for Disease Control.

UR - http://www.scopus.com/inward/record.url?scp=85061260485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061260485&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0210210

DO - 10.1371/journal.pone.0210210

M3 - Article

C2 - 30735511

AN - SCOPUS:85061260485

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 2

M1 - e0210210

ER -