Injection drug use and opioid epidemic drives hepatitis C infections | McClatchy Washington Bureau

Intravenous drug use related to opioid use helped fuel a 22 percent increase in reported new cases of acute hepatitis C in 2016, nearly doubling the growth rate of infections from 2015, according to the latest surveillance report from the Centers for Disease Control and Prevention.

After increasing just 2.6 percent to 2,194 reported new cases in 2014, acute hepatitis C infections spiked 11 percent to 2,436 cases in 2015 before jumping 21.8 percent to 2,967 new cases in 2016, the CDC reported. That’s about three-and-a-half times the 850 reported cases in 2010.

But the actual number of new cases could be as high as 41,000 in 2016 – nearly 14 times the reported number - because most new hepatitis C infections show no symptoms and go undiagnosed, the CDC reported.

The escalating numbers are more evidence of the collateral public health damage caused by the nation’s growing appetite for heroin and prescription opioid painkillers.

Acute hepatitis C is a contagious liver disease that is transmitted by contact with an infected person’s blood or body fluids. It strikes within six months after exposure and those infected can experience mild symptoms like tiredness and vomiting, but some never show symptoms.

Health advocacy groups have called on Congress to increase funding at CDC for better surveillance, prevention and treatment programs for Hepatitis C and other infectious diseases. In 2017, the CDC’s Division of Viral Hepatitis received $34 million.

“Even a modest increase in funding would help communities that are hard hit by the opioid crisis,” said Tina Broder, acting interim director at the National Viral Hepatitis Roundtable.

Senators Todd Young, R-IN, Edward Markey, D-MA, and Tammy Baldwin, D-WI, have introduced a bill that would give the CDC an additional $40 million annually over four years. A companion bill in the House is awaiting consideration in committee.

The explosion of hepatitis C is an ongoing frustration for health experts because more than 90 percent of cases are curable with an 8- to 12-week pill regimen, according to the CDC. But treatment with drugs like Sovaldi and Harvoni by Gilead can cost more than $84,000.

The CDC estimates roughly 75 percent to 85 percent of acute cases lead to chronic hepatitis C, which can cause long-term liver damage and liver cancer.

Infection from hepatitis C often occurs from sharing intravenous needles and syringes. Among 1,118 case reports on newly reported hepatitis A infections in 2016, 767 - nearly 69 percent – indicated the patients were injection-drug users, the CDC reported.

“We think that providing the appropriate education, resources and supplies to drug users is the best way to prevent the spread of hepatitis C and keep people as healthy as possible,” said Tina Broder, acting interim director at the National Viral Hepatitis Roundtable.

Hepatitis C infections can also occur in babies born to infected mothers and through accidental needle pricks in a hospital or health care setting. Although less common, acute hepatitis C can also be contracted by having sex with an infected person or sharing items like razors and toothbrushes that might have an infected person’s blood.

An estimated 3.5 million Americans are infected with chronic hepatitis C and 75 percent were born between 1945 and 1965, the CDC estimates. For that reason, the CDC recommends that all Baby Boomers, born between 1946 and 1964, get tested for the virus.

But the CDC report found that incidence rates for hepatitis C increased for all age groups in 2016 except people age 19 and under.

In 2016, the CDC found eight states accounted for more than half of newly reported acute cases: Florida, Indiana, Massachusetts, New Jersey, New York, Ohio, Pennsylvania and Tennessee. Massachusetts led all sates with 424 followed by Florida with 236, Pennsylvania with 225 and Ohio with 187.

According to the CDC, “several early investigations of newly acquired infections reveal that most occur among young, white persons who inject drugs and live in non-urban areas,” the report stated, particularly in Appalachian, Midwestern and New England regions of the country. “Trends in these states likely indicate an overall increase in HCV incidence throughout the country.”