New hepatitis C infections triple due to opioid epidemic

By Susan Scutti, CNN – Read more at CNN

New hepatitis C virus infections in the United States nearly tripled between the years 2010 and 2015.

The number of new nationally reported infections with the virus swelled from 850 in 2010 to 2,436 cases in 2015, with the highest rates among young people, mainly 20- to 29-year-olds, who inject drugs, according to a new report released Thursday by the Centers for Disease Control and Prevention.

However, the CDC estimates the true number is much higher– about 34,000 new infections nationally for 2015 since hepatitis C has few symptoms and most newly infected people do not get diagnosed.
. . .
Ward and his colleagues believe states can reduce the number of people risking a hepatitis C infection by adopting laws and policies that would increase access for IV drug users to services intended to prevent and treat the infection.
For the new report, then, Ward and his colleagues assessed state laws and Medicaid policies that impact IV drug users.
To decide whether a state had comprehensive needle laws, the CDC explored five questions: Did the state explicitly authorize a needle exchange program? Did the state exempt syringes from the definition of drug paraphernalia? Did the state decriminalize possession and distribution of needles for participants of needle exchange programs? Did the state permit a person to disclose possession of a needle to an arresting officer to avoid criminal prosecution? Finally, did the state allow the sale of needles, without prescriptions, to injected drug users?
With regard to Medicaid, the researchers looked at whether a state imposed sobriety requirements on drug users before approving treatment for an infection. Permissive Medicaid treatment policies, as defined by the CDC, would mean states either do not require a period of being sober or only require screening and counseling for a person to receive treatment.
. . .
Between 2009 and 2014, rates of hepatitis C virus infection among US women giving birth doubled, according to a second CDC study published Thursday.
“In 2014, 35 infants a day were exposed to the virus,” said Dr. Stephen W. Patrick, author of the study and assistant professor of pediatrics and health policy at Vanderbilt University School of Medicine. He explained the risk of transmission from mother to infant is estimated to be just about 6%, but research suggests follow-up on infants is poor.
“My worry is that some infants will convert to having hepatitis C without anyone knowing, or treating the infant,” said Patrick.
. . .
With treatment for hepatitis C, there must also be counseling to get these patients into care for their addiction to avoid an “exercise in futility” by treating only “a consequence of the substance use disorder.” according to Chung.
Coordinated effort is needed to get patients plugged into care so they beat their addictions and avoid becoming reinfected with hepatitis C.
Yet there have been several studies performed on rates of reinfection among IV drug users and they range from about 10% to 20%, said Chung. The results are not yet “water-tight,” said Chung, but reinfection rates can be viewed from another angle: “Success can be had — and durable success can be had — in most of these patients.”
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