HCV increases among younger IDUs in Appalachia

The report was released on the heels of a major HIV outbreak in Indiana, which was traced in large part to injection drug use (IDU) of Opana (oxymorphone, Endo Pharmaceuticals).

“State surveillance reports from the period 2006-2012 reveal a nationwide increase in reported cases of acute HCV infection … particularly among states in central Appalachia,” Jon E. Zibbell, PhD, health scientist at the CDC, and colleagues wrote. “Demographic and behavioral data accompanying these reports show young persons from nonurban areas contributed to the majority of cases, with about 73% citing IDU as a principal risk factor.”

Jon E. Zibbell, PhD

Jon E. Zibbell

Surveillance data from the four states showed a 364% increase in acute HCV infection for those aged younger than 30 years. While significant increases in HCV infections in both urban and nonurban areas were found, more than double the rate of cases occurred in nonurban areas, the researchers wrote.

Those aged younger than 30 years accounted for 44.8% of acute HCV cases from 2006 to 2012, the researchers wrote. About 80% of these cases involved whites, and approximately half were women. The proportion of people aged younger than 30 years admitted for opioid use treatment in the four states increased 21.1%, and admissions related to any opioid injection climbed 12.6%.

“Taken together, these increases indicate a geographic intersection among opioid abuse, drug injecting, and HCV infection in central Appalachia,” Zibbell and colleagues wrote.

Although the rate of HIV infection among those studied is relatively low, the researchers expressed concern that the increase in acute HCV infections may point to a possible increase in HIV infections since both are linked to IDU.

“Integrated health care services are needed to treat substance abuse and prevent and treat blood-borne infections deriving from illicit drug use behaviors,” the researchers wrote. “Because persons who inject drugs underutilize health services, additional efforts are urgently needed to enlist them into substance abuse treatment, ensure they are tested for HCV, and link those with HCV infection into care to receive appropriate treatment.” – by David Jwanier

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