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 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 people who inject drugs 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 hepatitis B and hepatitis C.

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