Acute Hepatitis C on the Rise Among Young People

An emerging epidemic of acute hepatitis C threatens the country’s younger population, which experienced a significant hike in the number of cases during a recent 6-year period, according to a compound study that looked at trends of the disease among youth.

Researchers examined national surveillance data submitted to the Centers for Disease Control and Prevention (CDC) from 2006 to 2012 to identify infection trends and characteristics among people who were 30 years or younger, according to Anil Suryaprasad, lead author of the CDC-sponsored study that appears in the August issue of Clinical Infectious Diseases. To better detect shifts in trends, researches limited analyses to states that reported data in both 2006 and 2012.

Supplemental follow up of newly reported cases in 6 jurisdictions from 2011 to 2012 aided in additional analysis of socio-demographic and risk factors among young people infected with the hepatitis C virus (HCV).

While cases of acute HCV dropped rapidly from 1992 to 2003, the number has increased since 2006, especially among younger people who inject drugs, according to the national surveillance data. The increase coincided with numerous outbreaks of the virus among drug injection users in nonurban areas, frequently associated with injection or prior misuse of prescriptions opioids, according to the article.

The study found that a larger portion of young people with acute HCV were urban dwellers — 67% lived in urban counties and 31% resided in non-urban counties, according to the CDC study. And while both experienced a significant increase from 2006 to 2012, non-urban communities recorded a steeper hike in cases per year at 13% compared to 5% in urban counties.

Hepatitis C virus is spread through exposure to infectious blood and can damage the liver and cause cirrhosis or liver cancer. Chronic infection of the virus is the leading indication of liver transplants in the country, according to the CDC.

Health officials estimate that there are about 3 million people in the US with chronic HCV, including many who don’t know they have it because they lack symptoms. Some people who become infected with hepatitis C can clear the virus with their own immune system but about 75% of those who get it will become chronically infected if left untreated.

Much public attention has recently focused on the older population of so called baby boomers who, according to the CDC, have the highest prevalence of hepatitis C infection. Most were likely infected more than 2 decades ago before HCV was identified and testing of blood supplies was less rigorous.

Nowadays, spread of HCV is rising among the nation’s young generation and that increase is being fueled by “early prescription opioid abuse and addiction, followed by initiation” to injectable drugs, especially in non-urban settings in or nearby Appalachia, write the authors. Injection drug use is currently the most common means of transmission of the virus in the United States, according to the CDC.

Results from the study showed that out of 34 states reporting data to the CDC, 30 or 88% observed higher incidence of acute hepatitis C among young people in 2012 compared to 2006, most noticeably in non-urban counties that lay east of the Mississippi River. In 2012, Kentucky topped the list of 5 states with the most cases at 85, followed by Tennessee at 60, Georgia at 58 and Florida at 47.

Of 1202 cases of newly infected young people reviewed for the study, 52% were female and 85% were white. Injection drug use was reported among 75% of 635 respondents interviewed. Among those who reported drug abuse, 75% had abused prescription opioids.

“These data indicate an emerging U.S. epidemic of HCV infection among young non-urban persons of predominantly white race,” concluded the study authors. They noted that prescription opioids are commonly abused at an early age and warrant medical and public health intervention.