Hepatitis C Infection Increasing Among Adolescents, Young Adults

By: SHARON WORCESTER
Family Practice News Digital Network
03/13/12

ATLANTA – The incidence of hepatitis C infection is increasing among adolescents and young adults in Pennsylvania, just as it has in other areas in the United States, according to surveillance data for 2003 through 2010.

During that 7-year period, the number of reports of newly recognized confirmed or probable cases of hepatitis C past or present infection among those aged 15-34 years increased from 1,384 to 2,393, representing a near doubling of the rate of cases (from 43 to 72) per 100,000 population, Dr. Sameh W. Boktor reported in a poster at the International Conference on Emerging Infectious Diseases.
The rates in other age groups, however, declined during this time period.

For example, the overall rate of newly reported cases for all age groups combined declined from 85 to 72 per 100,000 population, and the rate of cases among those aged 45-64 years declined from 185 to 142 per 100,000 population, said Dr. Boktor of the Pennsylvania Department of Health, Harrisburg.
The increases in the adolescent and young adult age groups are likely caused by high-risk behaviors, such as intravenous drug use and unprotected sex between men – and, to a lesser degree – unprotected heterosexual sex.

"We know high-risk behaviors are common in this age group," Dr. Boktor said, noting that evidence suggests such high-risk behaviors are increasing among residents in rural areas, and the increases in cases of hepatitis C among adolescents and young adults in this study were greater in rural areas, compared with two large urban centers.

This finding, however, should be interpreted with caution because of the small population in rural counties; targeted studies may shed more light on this apparent trend.
The data for this study were derived mainly from laboratories via electronic reporting. Age-specific rates of reported cases were calculated and compared over time, as were demographic and spatial characteristic, Dr. Boktor said.

The findings, which are similar to those from Massachusetts and other areas, are of concern, because hepatitis C infection is the leading cause of advanced liver cirrhosis and liver cancer in the United States. They indicate a need for increased attention to prevention in the adolescent and young adult population.

"We need to work more on characterizing risk factors, and we need to work more on developing effective prevention strategies in this very productive age group," Dr. Boktor said.
He noted that these findings "almost certainly underestimate the real impact of viral hepatitis," because they reflect only those patients with access to testing, and whose results are reported.
Dr. Boktor said he had no relevant financial disclosures.
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