![[ Visit Client Website ]](images/banner.png)
BACKGROUND: Recent trends have demonstrated an increasing incidence of hepatitis C virus (HCV) infection among young adults in the United States. Arkansas established a registry in January 2013 to track chronic HCV in young Arkansans.
METHODS: Starting in 2013, HCV notifiable disease reports received by the Arkansas Department of Health were entered into the National Electronic Disease Surveillance System for individuals aged <30 years. The provider listed for each newly reported suspect case was asked to complete a questionnaire detailing symptoms, reasons for testing, HCV laboratory results, diagnosis dates, and risk factors. Surveillance data for cases aged 13–29 years were analyzed using SAS 9.3.
RESULTS: A total of 441 persons aged 13–29 years with chronic HCV were reported from January 1–June 30, 2013; median age was 26 years and 56.2% were male. At the time of testing, 41.7% of persons were living in a correctional facility. Among those reported, 123 persons were newly diagnosed with chronic HCV in 2013. An additional 228 persons were thought to be newly diagnosed with chronic HCV in 2013 but data were insufficient to discriminate whether the diagnosis was new. Among the 441 cases, 379 identified the ordering physician, who was asked to complete the HCV follow-up questionnaire. A total of 298 (78.6%) questionnaires were returned; 187 (62.8%) persons had ever injected drugs; 4 (1.3%) were coinfected with human immunodeficiency virus (HIV). Among 120 reports from injection drug users (IDU), 94 (78.3%) injected methamphetamine and 50 (41.7%) injected any opioid (heroin, oxycodone, hydromorphone, morphine, methadone, or unspecified opioids). At least 26 (52%) opioid users injected prescription opioids. Among 264 HCV antibody positive cases with a completed questionnaire, 41.9% were further tested for HCV ribonucleic acid (RNA).
CONCLUSIONS: Follow-up of chronic HCV cases revealed that more than 40% were incarcerated at the time of testing. Most cases reported IDU. The most commonly injected substance was methamphetamine followed by opioids, which may reflect nationwide trends in the abuse of prescription narcotics and heroin. The initiation of Arkansas’ prescription drug monitoring program in 2013 may discourage the abuse of prescription opioids; however, the injection of Schedule I substances will likely remain a challenge in HCV control. Physicians in Arkansas ordered follow-up HCV RNA testing after a positive HCV antibody screen in less than half of cases. Education regarding testing recommendations should be improved to ensure physicians follow recent screening guidelines to differentiate past and present infections.