BACKGROUND: In Florida, the rate of reported chronic hepatitis C declined from 2008–2010 except in young adults (age 18−30), where the rate nearly doubled from 74 cases per 100,00 to 138 cases per 100,00. As a result, the Florida Department of Health (Department) began comprehensive interviews of young adults reported with hepatitis C infections. The aim of this investigation is to describe the burden of disease in this cohort and the risks identified through the comprehensive interviews.
METHODS: Case data were extracted from all reported chronic hepatitis C cases among young adults in 10 participating counties from November 1, 2012, through October 31, 2015. Frequency of self-reported risk factors from the comprehensive questionnaire were analyzed based on education, living situation, incarceration, drug use and rehabilitation. Method of drug use including information on needle, cooker or other works sharing was also requested during the interview.
RESULTS: A total of 6,287 cases of hepatitis C were reported among young adults and 1,562 (25%) completed the comprehensive interview. Among interviewed cases, injection drug use (71%), tattoo (66%), piercing (43%), diagnosed with a sexually transmitted disease (18%) and incarcerated over 24 hours (14%) were the most frequently identified risks. Among self-reported illicit drug users (n=1,249), marijuana (80%), powder cocaine (68%), heroin (60%) and tranquilizers or barbiturates (55%) were the top used drugs. Among those reporting injection drug use (n=1,110) nearly 61% (n=764) of those interviewed reported using a needle or syringe that was previously used by someone else; 69% (n=863) reported reusing their own needles; and 55% (n=684) admitted to lending someone else a needle or syringe that was previously used. Only 47% (n=582) admitted to using a cooker with or right after someone and 44% (n=546) admitted to sharing a filter or cotton with or after someone else. More than 61% (n=762) of interviewees acknowledged having ever been in a drug rehabilitation facility.
CONCLUSIONS: The highest risk factor for 18−30 year olds infected with chronic hepatitis C is drug use. Injection drug use has become a major concern not only for hepatitis C transmission but also for other blood-borne pathogens including HIV. The Department is continuing to examine the risks for hepatitis C among young adults and will be exploring means to break disease transmission among high-risk groups.