At-Risk Youth Are Not Getting Hep C Testing Despite the Opioid Crisis

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At-Risk Youth Are Not Getting Hep C Testing Despite the Opioid Crisis

Intravenous drug use is a major risk factor for the disease, but few teens and young adults are screened.

Teens and young adults who develop an opioid dependence and inject the drugs may also be exposed to hepatitis C infection, warn health officials who are calling for hepatitis C testing of high-risk opioid users.

The first study to closely examine the link between opioid dependence and hepatitis C risk was presented today at IDWeek 2018, the joint annual meeting of the Infectious Diseases Society of America (IDSA) and several other medical organizations, in San Francisco.

Hepatitis C is an infection of the liver that, if left untreated, can eventually cause cirrhosis (scarring of the liver), liver cancer, or death. More than 18,153 deaths related to hepatitis C virus were reported to the Centers for Disease Control and Prevention (CDC) in 2016.

Intravenous drug use and needle sharing is a major risk factor for contracting hepatitis C, but few teens and young adults are screened for the disease, said the lead author of the study, Rachel L. Epstein, MD, a postgraduate research fellow in infectious diseases at Boston Medical Center.

Though less common, it’s also possible to become infected by having unprotected sex with someone who has the virus or by using personal care items like razors or toothbrushes that come in contact with infected blood.

How the Study Was Conducted

The study consisted of an analysis of 269,124 teens and young adults, ages 13 to 21, who visited federally qualified health centers (FQHCs), which provide healthcare to underserved communities across 19 states, between 2012 and 2017.

Among 875 people who had a diagnosis of opioid dependence, only 36 percent were tested for hepatitis C. The testing found 11 percent had been exposed to hepatitis C, and 6.8 percent had evidence of chronic hepatitis C infection.

Healthcare providers may overlook the risk of hepatitis C in young people who abuse opioids because many users start out taking pills. But Dr. Epstein says some of those users eventually begin to inject opioids.

“In the midst of this current opioid crisis, where young people are most likely to transmit [infection], we need to be testing in order to diagnose and find cases and link them to care and treatment — and in the case of hepatitis C — cure them,” she said at a news conference. “We are probably underestimating the burden of youth with a known risk factor.”

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