Hepatitic C prevention efforts targeting adolescents and young adults are urgently needed, according to CDC officials, who called injection drug-use related increases in HCV infections among Massachusetts residents aged 15 to 24 years “a disturbing trend.”
Massachusetts Department of Public Health surveillance data indicate the number of HCV cases in this age group increased from 65 to 113 per 100,000 population from 2002 to 2009.
Between 2007 and 2009 alone, the state received 1,925 new reports of HCV among those aged 15 to 24, according to data published in Morbidity and Mortality Weekly Report.
Risk history was available for 1,196 patients, 72% of whom reported current or past injection drug use – making it the most common HCV risk factor.
Additional commonly reported potential HCV exposures included tattoos (23%), history of incarceration (20%) and “other” blood exposures (24%), the majority of which were injection drug related, according to the researchers.
Among the 1,357 case report forms with race and ethnicity information available, 78% were white, 3% were black and 2% were Asian.
Health officials believe these HCV trends reflect larger patterns of drug use in the U.S., as law enforcement data indicates that the number of new heroine users increased from 100,000 in 2002 to 180,000 in 2009.
“Health-care providers need to be encouraged to ask about risks for HCV infection, especially injection drug use, and to screen patients at risk,” the researchers wrote, noting that although18 to 24 year-olds are the group most commonly tested for HIV, HCV testing is lowest among this age group.
Based on recommendations from the Institutes of Medicine that say multicomponent comprehensive risk reduction programs are best to prevent HCV transmission among elicit drug users, the researchers suggested the following strategies:
Syringe exchange services to ensure access to sterile syringes and drug preparation equipment
- Expanded viral hepatitis prevention messages in school-based education programs
- Expanded harm reduction programs for young drug users
- Improved access to comprehensive health services that provide HCV testing and care
- Improved drug treatment for young injection drug users.
Currently, the CDC is collaborating with local health departments to determine if this same trend is occurring in other surveillance areas in the U.S. and is conducting additional studies to determine the causes of HCV transmission in adolescents and young adults in Massachusetts to improve prevention measures.