Opioid epidemic and liver disease
Elizabeth C Verna1, Aaron Schluger2, Robert S Brown1,3
1Center for Liver Disease and Transplantation, Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
JHEP Reports : Innovation in Hepatology
|February 11, 2020
Summary
The opioid epidemic significantly impacts liver disease, increasing hepatitis C virus infections in younger demographics and women. It also affects organ donation, necessitating better strategies for managing disease transmission risks.
Area of Science:
- Hepatology
- Epidemiology
- Public Health
Background:
- Opioid use has reached epidemic levels globally, causing increased mortality and altering liver disease patterns.
- The crisis has shifted hepatitis C virus (HCV) incidence towards younger populations and women, impacting screening guidelines.
- Potential direct/indirect opioid hepatotoxicity and rising rates of hepatitis B virus (HBV) and alcohol abuse are concerns.
Purpose of the Study:
- To review the multifaceted impact of the opioid epidemic on liver disease.
- To examine the effects on liver transplantation and organ donor characteristics.
- To highlight the need for enhanced understanding and intervention strategies.
Main Methods:
- Literature review focusing on the epidemiological and clinical consequences of the opioid crisis on liver health.
- Analysis of shifts in viral hepatitis incidence and trends in organ donation.
- Synthesis of current knowledge on opioid-related hepatotoxicity and co-occurring substance use disorders.
Main Results:
- Significant increase in hepatitis C virus infections among younger individuals and women.
- Rise in the proportion of organ donors deceased from overdose, increasing donor pool but posing transmission risks.
- Emerging concerns regarding opioid hepatotoxicity and increased incidence of hepatitis B and alcohol-related liver disease.
Conclusions:
- The opioid epidemic necessitates targeted public health interventions for liver disease prevention and treatment.
- Further research into opioid hepatotoxicity and co-infections is crucial for managing this high-risk population.
- Optimizing the use of organs from donors with overdose history requires careful risk assessment for disease transmission, particularly hepatitis C.
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