The US is in the midst of a major epidemic of opioid addiction and related comorbidities.
People with opioid use disorder (OUD) are at significant risk for transmission of several
blood-borne pathogens including the human immunodeficiency virus (HIV), hepatitis B virus
(HBV), and hepatitis C virus (HCV). Commonly abused opioids and their receptors promote viral
replication and virus-mediated pathology. However, most studies demonstrating an adverse effect of
drugs of abuse have been conducted in vitro, the specific effects of synthetic opioids on viral replication
have been poorly characterized, and the evaluation of opioid-virus interactions in clinically
relevant populations is rare. Rigorous characterization of the interactions among synthetic opioids,
host cells, and common injection-associated viral infections will require an interdisciplinary research
approach and translational studies conducted on humans. Such research promises to improve clinical
management paradigms for difficult-to-treat populations, facilitate rational public health policies
given severely strained resources, and reveal additional pathways for novel target-specific therapeutic
interventions. This mini-review examines the published literature on the effects of opioids on
HIV, HBV, and HCV pathogenesis and proposes a series of scientific questions and considerations
to establish a translational research agenda focused on opioid-virus interactions.