Injection of New Psychoactive Substance Snow Blow Associated with Recently Acquired HIV Infections among Homeless People Who Inject Drugs in Dublin, Ireland, 2015

In February 2015, an outbreak of recently acquired HIV infections among people who inject drugs (PWID) was identified in Dublin, following similar outbreaks in Greece and Romania in 2011. We compared drug and risk behaviours among 15 HIV cases and 39 controls. Injecting a synthetic cathinone, snow blow, was associated with recent HIV infection (AOR: 49; p = 0.003). Prevention and control efforts are underway among PWID in Dublin, but may also be needed elsewhere in Europe.

In February 2015, the Department of Public Health (DPH), Health Service Executive (HSE) in Dublin, Ireland, identified an unexpected increase in cases of acute HIV infection among people who inject drugs (PWID); three cases were diagnosed p24 antigen-positive in January and February 2015, compared with two cases diagnosed during the whole year in 2014 [1]. Drug treatment clinicians had also identified increased use of a new psychoactive substance (NPS) alpha-pyrrolidinovalerophenone (α-PVP), known as snow blow, which was being used by ‘chaotic’ PWID, and which they suspected might be linked to the increase [2]. Clinicians defined the chaotic group as homeless PWID who, if on opioid substitution treatment (OST), required daily attendance at their treatment programme, due to continued use of a variety of other illicit substances in an intensive or chaotic way. We undertook an epidemiological investigation to identify the likely source of this increase...

Below:  Number of recent HIV infections or diagnoses with epidemiological link to recent infections in PWID in Dublin, by month of first diagnosis, January 2014 to September 2015a (n = 38)

Full article at: http://goo.gl/s5QWLl

By: C Giese ^1 2 , D Igoe ² , Z Gibbons ³ , C Hurley ⁴ , S Stokes ³ , S McNamara ³ , O Ennis ⁴ , K O’Donnell ² , E Keenan ³ , C De Gascun ^5 6 , F Lyons ⁷ , M Ward ⁴ , K Danis ^1 8 , R Glynn ⁴ , A Waters ⁵ , M Fitzgerald ⁴ , on behalf of the outbreak control team ⁹

1. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden

2. HSE Health Protection Surveillance Centre, Dublin, Ireland

3. HSE National Drug Treatment Centre, Dublin, Ireland

4. Department of Public Health, Dublin, Ireland

5. National Virus Reference Laboratory, University College Dublin, Dublin, Ireland

6. School of Medicine, University College Dublin, Dublin, Ireland

7. St. James’s Hospital, Dublin, Ireland

8. French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Paris, France

9. The members of the team are listed at the end of the article

  

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