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In 2016, hepatitis C killed more than 18,000 Americans, making it the most common cause of death from a reportable infectious disease, according to the U.S. Centers for Disease Control and Prevention.
"We're missing an opportunity to identify and treat young people who are at risk for this deadly infection," said Dr. Rachel Epstein, lead author of the new study.
"Screening for [opioid addiction] and other drug use, and then testing for hepatitis C in those at high risk, can help us do a better job of eliminating this serious infection, especially now that very effective hepatitis C medications are approved for teenagers," said Epstein, a postgraduate research fellow at Boston Medical Center.
Her team studied the electronic medical records of more than 269,100 teens and young adults, ages 13 to 21. Between 2012 and 2017, the patients had visited one of 57 federally qualified health centers that provide health care to underserved communities in 19 states.
Of the 875 people with diagnosed opioid addiction, only 36 percent were tested for hepatitis C. Of those, 11 percent had been exposed to hepatitis C and almost 7 percent had evidence of chronic hepatitis C infection, the researchers found.
Overall, 2.5 percent, or more than 6,800 teens and young adults who visited the health centers, were tested for hepatitis C. Of those, 122 tested positive for it. Those most likely to be tested were black, had any substance use disorder, and were ages 19 to 21.
The study was presented Thursday at IDWeek, a meeting of infectious disease specialists, in San Francisco.
Injection drug users who share needles often spread hepatitis C. It's possible that doctors don't test suspected opioid abusers because the drugs are available in pill form, which doesn't increase the risk of hepatitis C. However, studies show many youths who misuse prescription opioid pills eventually begin injecting drugs, the researchers noted.
Current guidelines only recommend hepatitis C testing for known injection drug users.
"The issue is complicated by the fact that not enough at-risk youth are screened for opioid or other drug use for a variety of reasons, including lack of time, comfort level between clinician and patient, and privacy and stigma concerns," Epstein said in a meeting news release.
"And even when drug use is identified, there's a belief that youth are less likely to test positive for hepatitis C, which isn't necessarily the case as we show in our study. Clearly, this is an overlooked group that is at high risk," she concluded.
Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.
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SOURCE: IDWeek, news release, Oct. 4, 2018