May 5, 2011 -- Hepatitis C infections are rising among adolescents and young adults in Massachusetts, apparently in part due to needle sharing that spreads the virus, the CDC says in a new report.
There is reason to believe, the researchers write, that this trend may be occurring in other states.
The CDC in collaboration with other state and local health departments is examining hepatitis C virus surveillance data in order to determine whether similar trends are occurring in other areas.
In Massachusetts, a rise in cases in the 15- to 24-year-old age group from 2007 to 2009 occurred most frequently among white people, the CDC says. And the increase was divided about equally among males and females.
Injection drug use was the most common risk factor for transmission. The increase apparently represents an epidemic of hepatitis C related to sharing of needles and a history of drug use via nasal passages, according to the CDC.
The study is published in the CDC’s Morbidity and Mortality Weekly Report for May 6.
Monitoring Hepatitis C
The Massachusetts Department of Public Health uses an electronic data system for disease surveillance. All positive laboratory results indicating hepatitis C infection are reported to the department.
Though an overall decline in rates of newly reported hepatitis C infections was detected between 2002 and 2006, an increase was noted among people 15 to 24. Starting in 2007, Massachusetts state health officials sent hepatitis C infection case report forms to reporting clinicians in an attempt to gather data on new cases among young people 15 to 24.
Between 2002 and 2009, rates of newly reported cases in the 15-24 group rose from 65 to 113 cases per 100,000 people, the CDC says.
Between 2007 and 2009, the Massachusetts Department of Public Health received 1,925 reports of new cases among the young people, 53% of which were confirmed, with the rest classified as probable.
Analysis of data showed that the most common risk was injection drug use. The researchers say that of 1,196 cases with a reported risk history, 860 (72%) were in people who reported current or past use of injectable drugs. And of those, 719 or 84% reported injecting drugs during the previous 12-month period.
In addition, 445 new cases reported history of drug use via nasal passages.
The hepatitis C virus also was likely spread via other types of exposures, including tattooing. And a history of incarceration also seemed to be a factor.
The researchers say their findings strongly indicate a need for greater surveillance of the spread of hepatitis C, and that education efforts need to target adolescents and young adults.
Who’s Getting Hepatitis C
The Massachusetts data indicate an increase in hepatitis C infections in people 15-24 during the 2002-2009 period, and that “appears to represent an epidemic” that is related to injection drug use in this age group.
The cases studied were mostly of non-Hispanic whites who lived in urban, suburban, and rural areas. Findings suggest that most people 15-24 with a hepatitis C infection contracted it within a few years of being tested.
The researchers express concern that even though an increase in HIV infections were not identified in the 15-24 age group, the hepatitis C findings “might be a harbinger” of increases in injection-linked HIV.
During the same period in which hepatitis C infections were observed, Massachusetts officials also noticed an increase in heroin use among young adults and adolescents.
The authors of the report say the “recent epidemic in reported cases among adolescents and young adults and its apparent association with increases in drug injection and sharing of injection equipment in this population is a disturbing trend.”
They say young people may be more likely to share drug equipment because of the nature of their social networks, which are characterized by trust and sharing. Educational materials targeting these young people ought to be developed to put a damper on risky behaviors, according to the researchers.