Holly Hagan

Co-Director, CDUHR

1 212 998 5221

433 First Avenue
Room 752
New York, NY 10010
United States

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Professional overview

Dr. Holly Hagan is a Professor at Rory Meyers College of Nursing and Co-Director of the NIH Center for Drug Use and HIV Research at NYU. She received her doctorate in Epidemiology from the University of Washington School of Public Health and Community Medicine. Dr. Hagan’s research has principally focused on the infectious disease consequences of substance use, and her main interest is in reducing the burden of hepatitis C virus infection in people who inject drugs. She is the Principal Investigator on an NIH RO1 that uses the methods of implementation science to optimize HCV control strategies in the United States at the national, regional and local level. She is a member of the WHO Global Burden of Disease Study Diseases and Injuries Group, and she served on the Institute of Medicine Committee on the Prevention and Control of Viral Hepatitis in the United States. Dr. Hagan has been an advisor to the US Department of Health and Human Services, the CDC, and the Canadian Institutes of Health on national programs to detect, diagnose and treat HCV infections.

Dr. Hagan teaches research methods to students in the Florence S. Downs PhD Program in Nursing Research and Theory Development.

PhD in Epidemiology - University of Washington
MPH in Epidemiology - University of Massachusetts at Amherst
RN - Seattle Central College
BA in Russian Studies - Evergreen State College
Honors and awards
President’s Award for Leadership in the Control of Viral Hepatitis in the United States, The White House (2014)
Substance use
Infectious disease
Vulnerable & marginalized populations
Research methods
Professional membership
Society for Epidemiologic Research

HSV-2 Infection as a Cause of Female/Male and Racial/Ethnic Disparities in HIV Infection.

Des Jarlais, D. C., Arasteh, K., McKnight, C., Perlman, D. C., Cooper, H. L., & Hagan, H. (2013). PloS one 8, (e66874). 10.1371/journal.pone.0066874

To examine the potential contribution of herpes simplex virus 2 (HSV-2) infection to female/male and racial/ethnic disparities in HIV among non-injecting heroin and cocaine drug users. HSV-2 infection increases susceptibility to HIV infection by a factor of two to three.

Meta-analysis of hepatitis C seroconversion in relation to shared syringes and drug preparation equipment.

Pouget, E. R., Hagan, H., & Des Jarlais, D. C. (2012). Addiction (Abingdon, England) 107, (1057-65). 10.1111/j.1360-0443.2011.03765.x

We conducted a systematic review of studies reporting seroincidence of hepatitis C infection (HCV) in relation to shared syringes and drug preparation equipment among injection drug users (IDUs). We identified published and unpublished studies that met inclusion criteria.

A systematic review and meta-analysis of interventions to prevent hepatitis C virus infection in people who inject drugs.

Hagan, H., Pouget, E. R., & Des Jarlais, D. C. (2011). The Journal of infectious diseases 204, (74-83). 10.1093/infdis/jir196

High rates of hepatitis C virus (HCV) transmission are found in samples of people who inject drugs (PWID) throughout the world. The objective of this paper was to meta-analyze the effects of risk-reduction interventions on HCV seroconversion and identify the most effective intervention types.

Agent, host, and environment: hepatitis C virus in people who inject drugs.

Hagan, H. (2011). The Journal of infectious diseases 204, (1819-21). 10.1093/infdis/jir654

Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews

Nelson, P.K., Mathers, B.M., Cowie, B., Hagan, H., Des Jarlais, D., Horyniak, D., & Degenhardt, L. (2011). The Lancet 378, (571-583). 10.1016/s0140-6736(11)61097-0 Elsevier BV.

Attribution of hepatitis C virus seroconversion risk in young injection drug users in 5 US cities.

Hagan, H., Pouget, E. R., Williams, I. T., Garfein, R. L., Strathdee, S. A., Hudson, S. M., … Ouellet, L. J. (2010). The Journal of infectious diseases 201, (378-85). 10.1086/649783

BACKGROUND. In studies of hepatitis C virus (HCV) seroconversion in injection drug users (IDUs), some have questioned whether underreporting of syringe sharing, a stigmatized behavior, has led to misattribution of HCV risk to other injection-related behaviors. METHODS. IDUs aged 15-30 years who were seronegative for human immunodeficiency virus and HCV antibodies were recruited into a prospective study in 5 US cities. Behavioral data were collected via computer-assisted self-interviewing to reduce socially desirable reporting. Hazard ratios (HRs) were estimated to assess associations between behavior and HCV seroconversion. Because the shared use of cookers, cottons, and rinse water was highly correlated, a summary variable was created to represent drug preparation equipment sharing. RESULTS. Among 483 IDUs who injected during the period covered by the follow-up assessments, the incidence of HCV infection was 17.2 cases per 100 person years; no HIV seroconversions occurred. Adjusting for confounders, the shared use of drug preparation equipment was significantly associated with HCV seroconversion (adjusted HR, 2.66; 95% confidence interval, 1.03-23.92), but syringe sharing was not (adjusted HR, 0.91). We estimated that 37% of HCV seroconversions in IDUs were due to the sharing of drug preparation equipment. CONCLUSIONS. Associations between sharing drug preparation equipment and HCV seroconversion are not attributable to underascertainment of syringe sharing. Avoiding HCV infection will require substantial reductions in exposure to all sources of contaminated blood.

Herpes simplex virus type 2 associated with HIV infection among New York heterosexuals living in high-risk areas.

Hagan, H., Jenness, S. M., Wendel, T., Murrill, C. R., Neaigus, A., & Gelpi-Acosta, C. (2010). International journal of STD & AIDS 21, (580-3). 10.1258/ijsa.2010.010137

Herpes simplex virus type 2 (HSV-2) has been shown to increase the risk of sexual human immunodeficiency virus (HIV) transmission. A matched case-control design was used to examine the association between HSV-2 and HIV infection among heterosexuals in 'high-risk areas' (HRAs) in New York City (NYC). We identified NYC HRAs using HIV surveillance data on heterosexual-related adult HIV diagnoses and USA census data on household poverty. Heterosexuals who were socially or geographically linked to an HRA were recruited using respondent-driven sampling. HIV prevalence was 8.6% and HSV-2 prevalence was 80.1%. Only 6% of HIV-positives knew they were infected. HIV-positive cases were matched to HIV-negative controls on gender, race/ethnicity and age, and tested for antibody to HSV-2. In a multivariate model, HIV infection was associated with HSV-2 infection (adjusted odds ratio [AOR] = 3.5, 95% confidence interval 1.1-11.7) and non-HSV-related sexually transmitted infection diagnosis in the previous year (AOR = 2.6, 1.1-6.2). Effective approaches to HIV risk reduction for individuals with HSV-2 remain uncertain, and these are urgently needed in high-risk communities where multiple social, behavioural and biological factors that facilitate HIV infection coexist.

Meta-regression of hepatitis C virus infection in relation to time since onset of illicit drug injection: the influence of time and place.

Hagan, H., Pouget, E. R., Des Jarlais, D. C., & Lelutiu-Weinberger, C. (2008). American journal of epidemiology 168, (1099-109). 10.1093/aje/kwn237

The authors examined the relation between time since onset of illicit drug injection (time at risk) and rates of hepatitis C virus (HCV) infection by using meta-regression. In 72 prevalence studies, median time since onset of injection was 7.24 years and median prevalence was 66.02%. The model showed statistically significant linear and quadratic effects of time at risk on HCV prevalence and significantly higher prevalence in developing and transitional countries and in earlier samples (1985-1995). In developed countries post-1995, mean fitted prevalence was 32.02% (95% confidence interval: 25.31, 39.58) at 1 year of injection and 53.01% (95% confidence interval: 40.69, 65.09) at 5 years. In developing/transitional countries post-1995, mean fitted HCV prevalence was 59.13% (95% confidence interval: 30.39, 82.74) at 1 year of injection. In 10 incidence studies, median time at risk was 5.29 years and median cumulative HCV incidence was 20.69%. Mean fitted cumulative incidence was 27.63% (95% confidence interval: 16.92, 41.70) at 1 year of drug injection. The authors concluded that time to HCV infection in developed countries has lengthened. More rapid onset of HCV infection in drug injectors in developing/transitional countries resembles an earlier era of the HCV epidemic in other regions.

Eligibility for treatment of hepatitis C virus infection among young injection drug users in 3 US cities.

Hagan, H., Latka, M. H., Campbell, J. V., Golub, E. T., Garfein, R. S., Thomas, D. A., … (2006). Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 42, (669-72). 10.1086/499951

Among 404 injection drug users aged 18-35 who tested positive for hepatitis C virus (HCV) RNA, 96% had conditions that are potentially unwarranted contraindications for HCV treatment (e.g., problem drinking, moderate-to-severe depression, and recent drug injection). Restrictive eligibility criteria may deny treatment to a large proportion of patients who could benefit from it.

Extracorporeal circulation as an alternative to open-chest cardiac compression for cardiac resuscitation.

Gazmuri, R. J., Weil, M. H., Terwilliger, K., Shah, D. M., Duggal, C., & Tang, W. (1992). Chest 102, (1846-52).

Open-chest direct cardiac compression represents a more potent but highly invasive option for cardiac resuscitation when conventional techniques of closed-chest cardiac resuscitation fail after prolonged cardiac arrest. We postulated that venoarterial extracorporeal circulation might be a more effective intervention with less trauma. In the setting of human cardiac resuscitation, however, controlled studies would be limited by strategic constraints. Accordingly, the effectiveness of open-chest cardiac compression was compared with that of extracorporeal circulation after a 15-min interval of untreated ventricular fibrillation in a porcine model of cardiac arrest. Sixteen domestic pigs were randomized to resuscitation by either peripheral venoarterial extracorporeal circulation or open-chest direct cardiac compression. During resuscitation, epinephrine was continuously infused into the right atrium, and defibrillation was attempted by transthoracic countershock at 2-min intervals. Systemic blood flows averaged 198 ml.kg-1.min-1 with extracorporeal circulation. This contrasted with direct cardiac compression, in which flows averaged only 40 ml.kg-1.min-1. Coronary perfusion pressure, the major determinant of resuscitability on the basis of earlier studies, was correspondingly lower (94 vs 29 mm Hg). Extracorporeal circulation, in conjunction with transthoracic DC countershock and epinephrine, successfully reestablished spontaneous circulation in each of eight animals after 15 min of untreated ventricular fibrillation. This contrasted with the outcome after open-chest cardiac compression, in which spontaneous circulation was reestablished in only four of eight animals (p = .038). We conclude that extracorporeal circulation is a more effective alternative to direct cardiac compression for cardiac resuscitation after protracted cardiac arrest.

[The osteoprotective effect of ovarian hormones].

Hesch, R. D. (1992). Wiener medizinische Wochenschrift (1946) 142, (127-9).

Osteoporosis is regarded as a disease of the systems controlling bone evolution. Estrogen modulates such a control system; without estrogen 50% of bone is not formed to the peak bone mass or may be lost lateron. Substitution with estrogen can be interpreted as a natural right of the women in our society. Estrogen modulates by dynamic hormonal system the genexpression in bone and determines its three-dimensional architecture. Substitution with estrogen has to consider the individual genetic situation of each women and its biographic and health situation. Individual estrogen substitution is not fully realized yet but estrogen substitution prevents osteoporosis effectively. We question if senile osteoporosis exists at all if there were no estrogen deficiency.