TY - JOUR
T1 - Heroin use is associated with liver fibrosis in the Miami Adult Studies on HIV (MASH) cohort
AU - Baum, Marianna K.
AU - Tamargo, Javier A.
AU - Ehman, Richard L.
AU - Sherman, Kenneth E.
AU - Chen, Jun
AU - Liu, Qingyun
AU - Mandler, Raul N.
AU - Teeman, Colby
AU - Martinez, Sabrina S.
AU - Campa, Adriana
N1 - Funding Information:
This work was supported by the National Institute on Drug Abuse at the National Institutes of Health under grant U01-DA040381 and partially supported by the National Institute of Biomedical Imaging and Bioengineering under grant R37-EB001982. The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy or position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies.
Funding Information:
This work was supported by the National Institute on Drug Abuse at the National Institutes of Health under grant U01-DA040381 and partially supported by the National Institute of Biomedical Imaging and Bioengineering under grant R37-EB001982 . The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy or position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies.
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Background: People who use opioids and people living with HIV (PLWH) are at increased risk for liver-related morbidity and mortality. Although animal models suggest that chronic opioid use may cause liver damage, research in humans is limited. We aimed to determine whether opioid use, particularly heroin, was associated with liver fibrosis. Methods: Cross-sectional analysis of 679 participants (295 HIV/HCV uninfected, 218 HIV mono-infected, 87 HCV mono-infected, 79 HIV/HCV coinfected) from the Miami Adult Studies on HIV (MASH) cohort. Liver fibrosis was assessed via magnetic resonance elastography (MRE) on a 3 T Siemens MAGNETOM Prisma scanner. Results: A total of 120 (17.7 %) participants used opioids. Liver fibrosis was present in 99 (14.6 %) participants and advanced liver fibrosis in 31 (4.6 %). Heroin use (N = 46, 6.8 %) was associated with HCV-seropositivity, smoking, misuse of prescription opioids, and polysubstance use. The use of heroin, but not misuse of prescription opioids, was significantly associated with liver fibrosis (OR = 2.77, 95 % CI: 1.18―6.50) compared to heroin non-users, after adjustment for confounders including excessive alcohol consumption, polysubstance use and HIV and HCV infections. Both HIV and HCV infections were associated with liver fibrosis, whether virally suppressed/undetectable or viremic. Conclusions: Heroin use was independently associated with increased risk for liver fibrosis irrespective of the use of other substances and HIV or HCV infections. Both HIV and HCV were associated with higher risk for liver fibrosis, even among those with suppressed or undetectable viral loads. The exact mechanisms for opioid-induced liver fibrosis remain to be fully elucidated.
AB - Background: People who use opioids and people living with HIV (PLWH) are at increased risk for liver-related morbidity and mortality. Although animal models suggest that chronic opioid use may cause liver damage, research in humans is limited. We aimed to determine whether opioid use, particularly heroin, was associated with liver fibrosis. Methods: Cross-sectional analysis of 679 participants (295 HIV/HCV uninfected, 218 HIV mono-infected, 87 HCV mono-infected, 79 HIV/HCV coinfected) from the Miami Adult Studies on HIV (MASH) cohort. Liver fibrosis was assessed via magnetic resonance elastography (MRE) on a 3 T Siemens MAGNETOM Prisma scanner. Results: A total of 120 (17.7 %) participants used opioids. Liver fibrosis was present in 99 (14.6 %) participants and advanced liver fibrosis in 31 (4.6 %). Heroin use (N = 46, 6.8 %) was associated with HCV-seropositivity, smoking, misuse of prescription opioids, and polysubstance use. The use of heroin, but not misuse of prescription opioids, was significantly associated with liver fibrosis (OR = 2.77, 95 % CI: 1.18―6.50) compared to heroin non-users, after adjustment for confounders including excessive alcohol consumption, polysubstance use and HIV and HCV infections. Both HIV and HCV infections were associated with liver fibrosis, whether virally suppressed/undetectable or viremic. Conclusions: Heroin use was independently associated with increased risk for liver fibrosis irrespective of the use of other substances and HIV or HCV infections. Both HIV and HCV were associated with higher risk for liver fibrosis, even among those with suppressed or undetectable viral loads. The exact mechanisms for opioid-induced liver fibrosis remain to be fully elucidated.
KW - HIV
KW - Hepatitis C
KW - Liver diseases
KW - Opioids
KW - Substance abuse
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U2 - 10.1016/j.drugalcdep.2021.108531
DO - 10.1016/j.drugalcdep.2021.108531
M3 - Article
C2 - 33508691
AN - SCOPUS:85099823440
SN - 0376-8716
VL - 220
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 108531
ER -