Two people in Penobscot County, Maine, tested positive for both HIV and hepatitis C in the past week, bringing the total number of new local cases to 18 in slightly under a year and a half, reports the Maine Center for Disease Control & Prevention (Maine CDC), a division of the state’s health department.

The Maine CDC first identified the cluster in October 2023. Injection drug use and homelessness were common links among the cases. Specifically, all of the people who tested positive reported injection drug use within a year of their diagnosis, and 16 of the 18 had experienced homelessness within a year of their diagnoses. Of these, 11 were connected to care within 30 days.

In response to the cluster, the Maine CDC said it is working with community partners to:

  • Increase access to HIV and hepatitis C virus (HCV) testing among those at risk;

  • Provide HIV and sexually transmitted infection (STI) prevention services, such as post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and safer sex supplies;

  • Offer syringe services and other harm reduction services; and

  • Link people diagnosed with HIV or HCV to medical care and treatment.

Community groups including Wabanaki Public Health and Wellness and Needlepoint Sanctuary offer harm reduction services, such as clean needles to help reduce the transmission of bloodborne disease, reports the Bangor Daily News.

Both HIV and hepatitis C virus can be transmitted via injection drug use.

Hepatitis refers to inflammation of the liver. When untreated, it can lead to scarring of the liver (cirrhosis), liver cancer, the need for a liver transplant and death. Hepatitis can be caused by several factors, including toxins, excess alcohol use, autoimmune diseases, fat in the liver and viruses, including the three most common ones: hepatitis A, B and C. According to “Hepatitis C Transmission and Risk,” part of Hep magazine’s Basics of Hepatitis, hep C is most easily spread through:

  • Sharing needles and other equipment (paraphernalia) used to inject drugs;

  • Blood transfusions and organ transplants before July 1992;

  • Sexual contact with someone who has hep C;

  • Having a mother who had hep C when you were born.

HIV, in contrast, is a virus that attacks the immune system. Over several years, the immune system becomes depleted, and the body isn’t able to fight infections, leading to an AIDS diagnosis. Although there is no cure for HIV, many safe and effective treatments—often just one pill a day or a long-acting injection—are available. People with HIV who achieve and maintain viral suppression experience slower disease progression, enjoy better overall health and are less likely to develop opportunistic illnesses. What’s more, people with an undetectable viral load don’t transmit HIV to others through sex (dubbed treatment as prevention, or Undetectable Equals Untransmittable, or U=U).

Folks living with HIV are at higher risk for coinfection with viral hepatitis. Effective vaccines are available for hep A and B. What’s more, hep C is curable in most cases (but not HIV and hep B).

Nearly 1.2 million people in the United States are living with HIV, compared with the 2.3 million people with chronic hepatitis C and the 862,000 with hep B. These numbers will likely climb, spurred by the opioid crisis and injection drug use.

For more, see the Basics of HIV/AIDS in POZ.com, a sister publication of HepMag.com, RealHealthMag.com, CancerHealth.com and TuSaludMag.com.