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Hepatitis in young persons who inject drugs (PWID)

The highest reported age-specific incidence of acute hepatitis C in the United States is now among persons aged 20–29 years.  Prior to 2001, most U.S. reports of acute hepatitis C occurred among persons aged 30–49 years. In recent years, there has been an emerging epidemic of HCV infection among young PWIDs (see more here), the subject of a 2013 HHS Technical Consultation [PDF - 32 pages]. Public health practitioners should be mindful of the growing prevalence of hepatitis C particularly among young persons in suburban and rural communities, who are typically are harder to reach for prevention efforts.

CDC recommends that PWIDs get tested for HBV and HCV infection and vaccinated against Hepatitis A and Hepatitis B because of the higher rates of infection in this population. PWIDs are identified as a priority population in the National Viral Hepatitis Action Plan [PDF - 84 pages].

During 2011–2012, CDC awarded funds to five state and one city health department to investigate risk factors and understand drug use behaviors associated with HCV transmission among adolescents and young adults.  The investigations described in the links below shed light on a growing burden of hepatitis C in rural and suburban areas as well as larger cities, and describe a transition among users from misuse of prescription opioid drugs to injection of prescription opioids, heroin, or both.


Suryaprasad A, White JZ, Xu F, et al. Emerging Epidemic of Hepatitis C Virus Infections Among Young Non-Urban Persons who Inject Drugs in the United States, 2006–2012. Clin Infect Dis e-pub ahead of print.

Notes from the Field : Hepatitis C Virus Infections Among Young Adults — Rural Wisconsin, 2010

Hepatitis C Virus Infection Among Adolescents and Young Adults --- Massachusetts, 2002—2009

Notes from the Field: Risk Factors for Hepatitis C Virus Infections Among Young Adults --- Massachusetts, 2010

Use of Enhanced Surveillance for Hepatitis C Virus Infection to Detect a Cluster Among Young Injection-Drug Users --- New York, November 2004--April 2007