The United States commemorates National Hepatitis Awareness Month each May. Viral hepatitis still persists as a major public health threat despite availability of preventive measures such as vaccines and therapies, including a curative treatment for hepatitis C virus (HCV) infection. New cases of hepatitis B virus (HBV) and HCV infections are on the rise, largely among persons who inject drugs, with some attributed to the current U.S. opioid epidemic. Most children born after 1998 have been immunized against HBV, however, at risk adults (HBV can be transmitted sexually or via contaminated injection equipment) need to consider this vaccine which is widely available.
Recent hepatitis A outbreaks have also occurred among unvaccinated injection drug users and homeless persons. Since August 2016, CDC has responded to hepatitis A outbreaks with high HBV/HCV co-infection, hospitalization, and mortality rates in multiple states (California, Indiana, Kentucky, Michigan, Utah and West Virginia).
Two and a half thousand hepatitis A cases have been reported nationally so far, with approximately a 66% hospitalization rate and 52 deaths; of these 570 were in Kentucky. Hepatitis A is transmitted from person to person by the fecal-oral route or through contaminated food. A very effective vaccine is available for all who wish to prevent this disease.
Hepatitis C infection is usually silent for decades whilst damaging the liver. People using drugs, either by huffing or injecting should be tested and treated because HCV infection affects more than the liver and infected individuals have a shortened life expectancy as well as poor overall health. There is no vaccine available, however, a 12 week course of antiviral treatment can be curative.
Christine Weyman, MD, PhD, FAAP
Lake Cumberland District Health Department