Hepatitis C virus (HCV) infection rates among teenagers and young adults are rising significantly in Massachusetts, according to a new CDC report. Experts say it is principally due to needle sharing by illicit drug users. Other states appear to have witnessed a similar trend, the authors added.

The majority of the increase in Massachusetts is occurring among non-Hispanic Caucasian young people. Rates are increasing equally among males and females.

Authorities are describing the increase as a hepatitis C epidemic linked to the sharing of needles.

Between 2002 and 2006 there was a drop in newly reported cases of hepatitis C infections among all age groups. The problem is among individuals aged 15 to 24, the authors explain. In 2002 there were 65 newly reported cases per 100,000 people aged 15 to 24, rising to 113 in 2009. 1,925 new cases in young people were reported to the Massachusetts Department of Public Health (MDPH), 53% were confirmed and the rest were probable.

Researchers found that:
  • There were 1,196 cases with a reported risk history (of injection drug use)
  • 860 (72%) of them were either using injectable drugs at the time or had done in the past
  • 719 (84%) of them admitted to injecting drugs at some time during the previous 12 months - 615 with heroin and 220 with cocaine (there was some overlap)
  • 445 new cases had a history of taking drugs via the nasal passages
The authors added that other types of exposure, such as tattooing, probably added to the numbers.

Having been in prison was also found to be a risk factor for HCV infection.

The authors say their report strongly indicates a need for better and more intensified HCV prevention efforts, focusing on teenagers and young adults. According to the Institute of Medicine, for a strategy to be successful it has to include a range of comprehensive risk reduction programs that effectively address HCV infection prevention needs of individuals who use illegal drugs.

Providing sterile syringes and drug preparation equipment via syringe exchange services has been shown to reduce infection rates, as have school-based education programs. Drug treatments for young injection drug users need to be widely available.

Hepatitis C

Hepatitis C is an infection that affects the liver and is caused by HCV (hepatitis C virus). Initially the infected individual typically has no symptoms. However, once established, infection can become chronic (long-term) and fibrosis (scarring of the liver) can occur. Eventually this will develop to cirrhosis (advanced scarring), which can lead to liver failure or liver cancer.

People become infected by blood-to-blood contact. In about 85% of infections the virus persists in the liver. The standard medication for persistent infection is peginterferon and ribavirin. Over half of all treated patients are cured. If cirrhosis of the liver develops the patient may need a liver transplant - the virus recurs after transplantation.

Approximately 300 million people around the world have hepatitis C. There is no vaccine to protect against HPC virus infection. There are five known hepatitis viruses, A, B, C, D, and E.

"Hepatitis C Virus Infection Among Adolescents and Young Adults - Massachusetts, 2002--2009"
MMWR May 6, 2011 / 60(17);537-541
Centers for Disease Control and Prevention

Written by Christian Nordqvist