An analysis of U.S. Centers for Disease Control and Prevention (CDC) data on hepatitis C (HCV) incidence reported in Clinical Infectious Diseases showed a significant increase in HCV incidence among those under 30 in non-urban settings, especially among intravenous drug users (IDUs). The data analyzed had been reported to the CDC by 34 U.S. states and territories, 30 of which said that the incidence of acute HCV was higher in 2012 than it had been in 2006. In 15 states and territories, the number of new HCV cases more than doubled during that time.
From 2006 to 2012, the HCV incidence among young people (<= 30 years) increased by 170% in non-urban jurisdictions (P =.003), from 36% of all HCV infections in 2006 to 49% in 2012. Non-urban settings recorded an average of 1.22 new HCV infections per 100,000 population in 2012, while urban areas had 0.55 cases per 100,000. Counties east of the Mississippi, especially in or near Appalachia, were affected the most, with the highest number of new HCV infections reported in Kentucky, Tennessee, Georgia, Indiana and Florida.
More than three quarters (77%) of young people with acute HCV infection reported ever injecting drugs, with almost as many (75%) having been treated for alcohol or drug abuse. The demographic profile of the 1,202 people for whom such data were available during 2011-2012 shows an overwhelmingly white (85%), mostly non-urban (56%) and female (52%) population, almost half (44%) of whom were in their early 20s.
The study authors concluded that "reducing HCV incidence among young persons is achievable, but requires a comprehensive, integrative strategy in response to this emergent threat."