FACT FILE: Hep C infections rise with injection drug use in Appalachia

The Centers for Disease Control and Prevention (CDC) released a new report this week outlining a concern about hepatitis C (HCV) infections in Kentucky, Tennessee, Virginia and West Virginia and the link to injection drug use (IDU). IDU is the primary risk factor for HCV infection.

Background: HCV is a chronic viral infection. Treatment typically includes a specific course of prescription drugs that often have undesirable side effects, but more recently, new prescription drugs have hit the market that promise a cure in a shorter amount of time with fewer side effects. The newer drugs are quite costly, reaching as much as $80,000 for a full course of treatment. However, advanced hepatitis C infections can lead to liver failure neccessitating a liver transplant, and death.

What the CDC reported: Between 2006 to 2012, significant increases in HCV infection were found in the four states. During the same period, the proportion of treatment admissions for opioid dependency increased 21.1 percent, with a significant increase in the proportion of persons admitted who identified injecting as their main route of drug administration (an increase of 12.6 percent). In addition, increases of 16.8 percent and 7.4 percent were observed in the proportion of prescription opioid admissions and heroin admissions, respectively.  Taken together, these increases indicate a geographic intersection among opioid abuse, drug injecting, and HCV infection in central Appalachia.

Why this is important: Although the prevalence of HIV among young persons who inject drugs in central Appalachia is currently low, the regional increase in cases of acute HCV infection described in the report raises concerns about the potential for an increase in HIV infections because IDU is a risk factor for both HCV and HIV infection. CDC says the findings underscore the need for integrated health services in substance abuse treatment settings to prevent HCV infection and ensure that those who are infected receive medical care.

Recommendations: The agency specifically recommends that people who inject drugs are engaged with addiction treatment and tested for HCV.