1295. Risks for Increasing Hepatitis C Infections among Young Adults —Massachusetts, 2010
Session: Poster Abstract Session: Viral Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • Tohme IDSA 2011 POSTER_final.pdf (1.2 MB)
  • Background: 

    Hepatitis C virus (HCV) infection is a major cause of liver disease in the United States.  Rates of newly reported HCV infection to the Massachusetts disease surveillance system from 2002−2009 among cases aged 15−24 years increased from 65 to 113 cases per 100,000 population.  To better understand the increase in HCV infection in youth, we investigated a subset of reported cases for detailed demographic, clinical, and risk characteristics, and use of healthcare services.

    Methods: 

    Of the 394 hepatitis C cases aged 18-24 years reported between July 1−December 31, 2010, we contacted 193 to request an interview. We also interviewed 5 persons with hepatitis C diagnosed in a correctional facility but not yet reported to the surveillance system. Blood specimens were tested for evidence of hepatitis B and C. Genotyping and phylogenetic testing were performed when feasible.

    Results: 

    A total of 28 young persons participated. Of these, 18% reported symptoms of acute hepatitis at the time of testing, and 40% were either tested before enrollment in a drug treatment program (DTP) or during incarceration. Notably, 25% first knew about their infection when they came for the interview.  Drug use, mainly injection drug use (IDU), was likely the principal mode of transmission of HCV infection; of 26 persons who ever-used drugs, 92% reported ever injecting drugs. Oxycodone/oxycontin abuse was almost universal and was the second most commonly injected drug after heroin during the preceding 6 months. The majority (70%) reported sharing syringes and drug paraphernalia with others.  Multiple enrollments in DTPs and incarceration were prevalent. Of 13 respondents who provided blood specimens, 77% had anti-HBs≥ 10mIU/mL. Viral isolates from 9 persons showed 4 genotype 1a, 3 genotype 3a, and 2 genotype 2b.   A 95% nucleotide identity was found among all genotype 3a cases.

    Conclusion: 

    The emerging problem of opioid abuse in the US and its role as a gateway drug to IDU is fueling the increase in HCV infections in young adults. Health care providers should ask about ever-IDU and screen for HCV in high-risk populations at an early age. Enhanced and expanded prevention services are indicated for young people who use drugs. Venues for this age group could include DTPs and correctional facilities.


    Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

    Rania A. Tohme, MD, MPH1,2, Norma Harris, PhD, MSPH1, Dan Church, MPH3, Stephen Liu, MPH1, Kerri Barton, MPH3, Franny Elson, MS3, Dale Hu, MD, MPH4, Yury Khudyakov, PhD1, Jan Drobeniuc, MD, PhD1 and Alfred DeMaria Jr., MD3, (1)Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, (2)Epidemic Intelligence Service , Centers for Disease Control and Prevention, Atlanta, GA, (3)Massachusetts Department of Public Health, Jamaica Plain, MA, (4)Division of Viral Hepatitis, CDC, Atlanta, GA

    Disclosures:

    R. A. Tohme, None

    N. Harris, None

    D. Church, None

    S. Liu, None

    K. Barton, None

    F. Elson, None

    D. Hu, None

    Y. Khudyakov, None

    J. Drobeniuc, None

    A. DeMaria Jr., None

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