Routinely providing hepatitis C screening to pregnant women who are undergoing treatment for opioid use disorder can help steer them to effective treatments to eradicate the infection, University of New Mexico researchers have found.
In a new study published in the journal Maternal and Child Health(and highlighted in the director’s report of the National Institute on Drug Abuse), the researchers found that a high percentage of women with opioid addictions enrolled in UNM’s Milagro Program, which provides prenatal care for women with substance abuse disorders, tested positive for hepatitis C virus (HCV).
The virus is transmitted in blood, typically through intravenous drug use. It causes damage slowly and with few outward symptoms over a period of decades, but over the long term the infection can result in liver cancer.
Results of a recent study showed a significant correlation between the increase of acute hepatitis C cases in the U.S. and the country’s current opioid epidemic. Acute HCV and admissions for opioid injection drug use increased significantly among individuals aged 18 years to 39 years, both men and women, and specific ethnicities.
“Substantial increases in the number of persons with opioid use disorders who inject drugs have the potential to thwart the nation’s efforts to control morbidity and mortality associated with HCV infection, consequently undermining the National Academies of Sciences, Engineering, and Medicine’s national strategy for the elimination of hepatitis B and C,” Jon E. Zibbell, PhD, from the Behavioral and Urban Health Program, Georgia, and colleagues wrote. “It also challenges the Centers for Disease Control and Prevention’s Viral Hepatitis Strategic Plan for 2016 to 2020, which underscores reductions in HCV infections caused by [injection drug use] behaviors as a priority area.”
Zibbell and colleagues analyzed Treatment Episode Data Set (TEDS) admissions from the Substance Abuse and Mental Health Services Administration (SAMHSA) and laboratory-confirmed cases of acute HCV with associated demographic and risk factors from the National Notifiable Disease Surveillance System.
A jump in acute hepatitis C infection (HCV) in the US dovetails with a similar increase in injection of opioids, with young adults hit hardest by the combined health threats, new analysis shows.
Research from the US Centers for Disease Control and Prevention (CDC) found that acute HCV cases rose 133% from 2004 to 2014, while admissions to substance use disorder (SUD) treatment facilities for opioid injections climbed 93%.
Injection drug use (IDU) is the primary risk factor for HCV transmission and the leading cause of incidence in the US, according to the research published in the February 2018 issue of the American Journal of Public Health.
The American epidemic of opioid abuse is finally getting the attention it warrants. While policy solutions continue to be inadequate, the decision by President Trump to declare a national opioid emergency has helped to increase discussion about the problem and how the country can solve it. But the conversation also needs to address a dangerous – and largely ignored – interconnected public health crisis wreaking havoc among young Americans.
The problem is that more Americans than ever are injecting opioids and inadvertently infecting themselves with hepatitis C. Shared needles mean shared blood-borne infections – and that’s how the opioid crisis has created a new generation of hepatitis C patients. The number of reported hepatitis C infections nearly tripled from 2010 to 2015, with the virus is spreading at an unprecedented rate among young people under 30 – who are now, for the first time, the most at-risk population for contracting and transmitting hepatitis C.
In the United States, an estimated 3.5 million people, and likely more, are currently living with hepatitis C. The virus kills nearly 20,000 Americans each year – more than HIV and all other infectious diseases combined.
WASHINGTON — During a session focused on the connection between the hepatitis and opioid epidemics at The Liver Meeting 2017, Jerome M. Adams, MD, MPH,Surgeon General of the U.S., advised physicians in attendance that hepatitis C elimination will require nontraditional partnerships and innovative strategies for education, prevention and screening.
“I want to ask you all a question that I hope all of you know the answer to,” Adams said to the audience. “How do you eat an elephant? One bite at a time. If you take one bite at a time, if you help all of our partners see which part of that elephant they can take a bite of, we will be able to consume that elephant that is the opioid
“But there’s another way to eat the elephant that is the hepatitis epidemic: because any one of you eating an elephant one bite at a time is still going to take the rest of your lives to eat that elephant,” Adams continued. “If everyone in this room decides we’re going to eat an elephant, we’ll have it eaten before you know it. We need to get through it one bite at a time, but we also have to do it together.”
PROVIDENCE, R.I. [Brown University] — As public health officials worry that the increase of opioid use among young adults has helped to spread the hepatitis C virus to a new generation, a study in Rhode Island finds that while screening is common, the follow-up measures needed to stop the spread of the virus are significantly less so.
Hepatitis C virus (HCV) can linger for decades before causing any symptoms, but eventually it can severely damage the liver, leading to death without treatment.
“Many young people who are at risk for hepatitis C may acquire the infection and then not know it, and then through drug injection practices may transmit it to others,” said Brandon Marshall, associate professor of epidemiology in the Brown University School of Public Health and corresponding author of the new study in the Journal of Adolescent Health. “For this reason, we need to not only be screening, but also providing care to young people who test positive for hepatitis C.”
The nation’s opioid epidemic has unleashed a secondary outbreak: The rampant spread of hepatitis C.
New cases of the liver disease have nearly tripled nationwide in just a few years, driven largely by the use of needles among drug users in their 20s and 30s, spawning a new generation of hepatitis C patients. Because a treatment that cures the disease costs tens of thousands of dollars, is limited by insurance and Medicaid, and is mostly unavailable to people who are still using illicit drugs, there likely will be financial and public health ramifications for decades to come.
Here in West Virginia, which has the nation’s highest rates of overdose deaths and new hepatitis C and hepatitis B infections, public health officials are attempting to identify as many new hepatitis carriers as possible – and are girding for decades of repercussions.