People who Inject Drugs and Viral Hepatitis

Drugs in spoon being heated by flame

People who inject drugs (PWID) are at risk for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection through the sharing of needles and any equipment used to prepare and inject drugs. In addition, outbreaks of Hepatitis A infection have been reported among PWIDs; such outbreaks are believed to occur through both percutaneous and fecal-oral routes. There are currently widespread person-to-person outbreaks of hepatitis A affecting PWID across the United States. The Advisory Committee on Immunization Practices recommends that PWIDs get vaccinated against hepatitis A and hepatitis B. Because of higher rates of infection among this population, CDC also recommends testing anyone who has injected drugs for HBV and HCV infection.

Guidelines and Recommendations

Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly: Summary Guidance from CDC and the U.S. Department of Health and Human Services
MMWR 2012;61(RR-5);1-40

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
MMWR 2008;57(RR-8)

Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR 2006;55(RR-7)

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices
MMWR 2018;67(No. RR-1):1–31

Hepatitis C and HIV Outbreak Detection and Response

The opioid misuse epidemic has substantially increased the transmission risk of blood-borne viruses, including hepatitis C virus and HIV, through injection drug use. The following documents provide guidance on how to prepare for, detect, investigate and respond to an HIV or hepatitis C outbreak among people who inject drugs.

Resources

CDC

Federal

Other

Patient Resources