Immune activation (IA), a well-defined surrogate of poor clinical outcome that is elevated in people who inject drugs (PWID), can regress to normal levels in former intravenous drug users who are hepatitis C (HCV)-aviremic, a recent study found. Researchers evaluated 4 groups of study volunteers: Group 1) active PWID, Group 2) individuals who ceased injecting drugs for 1 to 2 months, Group 3) individuals who ceased injecting drugs for 3 to 4 months, and Group 4) healthy volunteers. They found:

• HCV-viremic PWID have elevated levels of IA when compared to healthy volunteers.

• Cessation of intravenous drug use results in a decline of IA in the absence of HCV viremia, while HCV-viremic, former intravenous drug users continue to harbor elevated levels of IA.

It is suggested that enhanced harm reduction efforts should incorporate aggressive treatment of HCV infection.

Citation: Markowitz M, Deren S, Cleland C, et al. Chronic hepatitis C infection and the pro-inflammatory effects of injection drug use. [Published online ahead of print August 11, 2016]. J Infect Dis. doi:10.1093/infdis/jiw373.