Sample: True or false? Most new hepatitis C virus infections occur among people who inject drugs. Plus 4 more questions on hepatitis C and injection drug use.
Answer: True. About 70% of new HCV infections occur among PWID. The first few years after starting injection drug use can be particularly risky, with rates of HCV infection exceeding 40%. The Infectious Disease Society of Americarecommends annual HCV testing among people who actively inject drugs and have had no past testing or past negative results. More frequent testing may be indicated based on risk factors for HCV transmission.
Question 2. True or false? PWID are NOT at increased risk for HAV, which is spread through contaminated water and not by sharing needles.
Answer: False. PWID are at increased risk for HAV, which can be spread through person-to-person contact as well as the fecal-oral route. In the US, HAV is more often spread from person-to-person. Since 2016, 30 states have reported outbreaks of HAV. Groups at highest risk for HAV include people who use drugs (both injection and non-injection), people who are homeless, men who have sex with men, people who are incarcerated, and people with chronic liver disease.
Answer: True. PWID are at increased risk for HCV, HBV, and HAV. The CDC Advisory Committee on Immunization Practices advises that PWID should receive the HAV and HBV vaccine. The Committee also advises testing PWID for HBV and HCV. No vaccine exists for HCV.
Question 4. True or false? PWID should NOT be treated with DAAs until after they have completed a drug treatment program and have been drug-free for 6 months.
Answer: False. Accumulating evidence suggests high rates of sustained viral response and low rates of reinfection among injection drug-users and are treated with DAAs. However, most studies are short-term (≤24 weeks), and more data is needed about longer-term rates of reinfection. Experts advise surveillance for reinfection after completing treatment among PWID.
Question 5. True or false? Rates of HCV are decreasing among younger Americans as a result of public health efforts to prevent transmission.
Answer: False. A 2018 study found that rates of acute HCV infection increased by >300% from 2004-2014 among Americans aged 18-39 years. Whites and women also experienced dramatic increases in acute HCV. The opioid crisis is thought to be fueling the HCV epidemic in these groups, whose use of injection opioids paralleled the jump in HCV during this time period.
Injection drug use is a common risk factor for hepatitis C virus (HCV) infection and while there are effective treatments available, injection drug-users often cannot afford the high costs. When left untreated, HCV can increase a patient’s risk for mortality. According to the National Institute on Drug Abuse, since 2012 there has been more deaths due to HCV vs 60 of the other reportable infectious disease combined. How much do you know about HCV in people who inject drugs (PWID)? Take our 5-question quiz below to find out.