Study Finds Rising Incidence of HCV in Young, Non-Urban Injection Drug Users
New data indicate a rising incidence of hepatitis C infection among young, primarily white, non-urban people who inject drugs, according to CDC researchers.
“A comprehensive approach is needed to address the increases in HCV infection among young persons,” the researchers wrote in Clinical Infectious Diseases. “Both CDC and the United States Preventive Services Task Force recommend HCV testing for persons with a history of [injection drug use]. The majority of young persons with recent HCV infection in supplemental case follow-up interacted with clinical providers, drug or alcohol rehabilitation, or prison systems — venues where HCV testing and prevention can be focused.”
The researchers used national surveillance data from 2006 to 2012 to examine HCV trends among people aged 30 years or younger. From 2011-2012, health departments in five states and one city received supplemental funding to investigate newly reported infections in young people. The researchers also used this follow-up data in their analysis.
From 2006 to 2012, there were 7,169 cases of acute hepatitis C reported to the CDC. Among the 7,077 cases with a documented age, 44% were young people. In 2012, 49% of the cases were young people, whereas in 2006, 36% were young people. The majority of the cases were white and non-Hispanic, and the cases were equally among men and women.
Thirty states of 34 that report to the CDC had a higher incidence of acute hepatitis C in young people in 2012 compared with 2006. Among the young people, 31% resided in non-urban counties and 67% in urban counties. The reported incidence of acute hepatitis C in young people in non-urban counties increased 13% per year, for an overall increase of 170% from 2006 to 2012. In urban counties, the increase of acute hepatitis C in young people was 5% a year.
Among the 1,202 cases with follow-up or case interviews in 2011-2012, 77% reported ever injecting drugs. Among patients with interviews, 84% reported ever using drugs recreationally, and 97% of those began before age 20 years. After marijuana and alcohol, the most common abused drug was prescription opioids, reported by 76%.
“A Health and Human Services multi-agency technical consultation was convened in 2013 to address the emerging epidemic of HCV infection among young persons, especially those residing in non-urban areas, and the concurrent problem of prescription opioid abuse with transition to injection drug use,” the researchers wrote. “Reducing HCV incidence among young persons is achievable, but requires a comprehensive, integrative strategy in response to this emerging threat.”
Disclosure: The researchers report no relevant financial disclosures.