May 20, 2011
Amid an overall decline in new hepatitis C virus infections in Massachusetts during 2002-06, an increase in cases was seen among those ages 15-24, health officials recently reported. HCV cases overall fell from 181 per 100,000 population to 128 during that period; however, confirmed and probable HCV infections among persons ages 15-24 rose from 65 per 100,000 to 102. In 2009, the figure jumped again, to 113 HCV reports per 100,000 residents ages 15-24.
"I feel like I'm watching this epidemic unfold, and we aren't really doing a lot in terms of prevention," said Dr. Alfred DeMaria Jr., state epidemiologist with the Department of Public Health. "Many of the things that might work are difficult to do in this population," he said. "The increase of [HCV] in younger people is dramatic and had not been projected."
The uptick was found in rural, urban and suburban areas statewide, according to an analysis by DeMaria and colleagues. Of case reports documented by medical professionals, there was a higher frequency among white males and females with a history of IV drug use.
"The current hypothesis that we're testing ... is that many of these cases are in people who start with prescription drugs like OxyContin, oxycodone and then progress to injecting either those drugs or heroin, and using injection drug equipment that they share with other people," DeMaria said. "These [younger] individuals are coming along with their peer group, not with experienced injectors" who might know sterile injection techniques, he said.
There is a point at which heroin becomes a cheaper option than prescription drugs, said Mary Ann Foose, director of nurses at High Point Treatment Center, which has facilities in New Bedford, Plymouth, and Brockton. The majority of the center's teen heroin patients "started with prescription drugs," she said.
The report, "Hepatitis C Virus Infection Among Adolescents and Young Adults -- Massachusetts, 2002-2009," was published in Morbidity and Mortality Weekly Report (2011;60(17):537-541).