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. 2018 Feb;108(2):175-181.
doi: 10.2105/AJPH.2017.304132. Epub 2017 Dec 21.

Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014

Jon E Zibbell  1 , Alice K Asher  1 , Rajiv C Patel  1 , Ben Kupronis  1 , Kashif Iqbal  1 , John W Ward  1 , Deborah Holtzman  1
Affiliations

Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014

Jon E Zibbell et al. Am J Public Health. 2018 Feb.

Abstract

Objectives: To compare US trends in rates of injection drug use (IDU), specifically opioid injection, with national trends in the incidence of acute HCV infection to assess whether these events correlated over time.

Methods: We calculated the annual incidence rate and demographic and risk characteristics of reported cases of acute HCV infection using surveillance data from 2004 to 2014 and the annual percentage of admissions to substance use disorder treatment facilities reporting IDU for the same time period by type of drug injected and demographic characteristics. We then tested for trends.

Results: The annual incidence rate of acute HCV infection increased more than 2-fold (from 0.3 to 0.7 cases/100 000) from 2004 to 2014, with significant increases among select demographic subgroups. Admissions for substance use disorder attributed to injection of heroin and prescription opioid analgesics increased significantly, with an almost 4-fold increase in prescription opioid analgesic injection. Significant increases in opioid injection mirrored those for reported cases of acute HCV infection among demographic subgroups.

Conclusions: These findings strongly suggest that the national increase in acute HCV infection is related to the country's opioid epidemic and associated increases in IDU.

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Figures

FIGURE 1—
FIGURE 1—
Reported Cases of Acute HCV Infection by Year: National Notifiable Disease Surveillance System, United States, 2004–2014
FIGURE 2—
FIGURE 2—
Percentage of All Admissions to Substance Use Disorder Treatment Facilities Attributed to the Injection of Any Opioid, Prescription Opioid Analgesic, Heroin, and All Other Drugs, by Year: Treatment Episode Data Set-Admissions, United States, 2004–2014 Note. POA = prescription opioid analgesic.
FIGURE 3—
FIGURE 3—
Percentage of State Admissions to Substance Use Disorder Treatment Facilities Reporting Any Opioid Injection by State Rate of Acute HCV Infection in (a) 2004, (b) 2009, and (c) 2014: National Notifiable Disease Surveillance System and Treatment Episode Data Set-Admissions, Selected US States Note. The number of states that reported cases of acute HCV infection to the National Notifiable Disease Surveillance System was 39 in 2004, 40 in 2009, and 37 in 2014.
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