The Rise in Acute Hepatitis B Infection in the U.S.
In light of the ongoing opioid epidemic in the U.S., it is becoming increasingly important to raise awareness about the risk of contracting infectious diseases such as hepatitis B (HBV), hepatitis C (HCV), and/or HIV through injection drug use.
To help address the link between the opioid crisis and the spread of infectious diseases, state and local health departments, health care providers, and community organizations are working to coordinate treatment and services for substance use disorders with HCV and HIV prevention and care. However, even among public health workers and advocates, there remains a lack of awareness and action around the rise in acute hepatitis B infection.
Hepatitis B education and outreach often focuses on its most common global mode of transmission – from an infected mother to her baby during childbirth – but among the other modes of hepatitis B transmission, injection drug use is a growing concern. In 2015, the acute hepatitis B infection rate in the U.S. increased by 20.7%, rising for the first time since 2006. The sharpest increases in new hepatitis B cases are occurring largely in states that have been impacted the most by the opioid epidemic.
- From 2009 to 2013, the incidence of acute hepatitis B infection increased by 114% in Kentucky, Tennessee, and West Virginia, while remaining stable in the U.S. overall.
- In North Carolina, new cases of hepatitis B increased by 56% between 2014 and 2016.
- The Massachusetts Department of Public Health recently issued an advisory about the alarming rise in HBV outbreaks associated with injection drug use in their state, citing a 78% increase in acute hepatitis B cases in 2017.
New cases of hepatitis B that are linked to injection drug use are particularly prevalent among adults aged 30 to 49 who were not vaccinated as children. Unfortunately, newly infected young women may be unaware of their status and may pass the virus on perinatally to their children, along with a significantly higher risk of chronic infection and liver cancer.
But hepatitis B is completely preventable. All pregnant women in the U.S. are screened for hepatitis B, and if infected, appropriate steps can be taken to prevent mother-to-child transmission. A safe and highly effective vaccine to prevent hepatitis B infection has also been available for over 30 years and is recommended in the U.S. for all infants and children under 18 and for adults with high risk of infection.
While the hepatitis B vaccine offers lifelong protection, data from 2013 found that only 32.6% of adults between 19 and 49 years old were fully covered by the three-dose series. Coverage is estimated to be even lower among people who inject drugs, who are at higher risk of contracting and/or transmitting hepatitis B to their partners, children, and other close contacts.
Together, these factors – low rates of hepatitis B vaccination coverage among adults over 30 years of age and increasing rates of injection drug use – are fueling the recent rise in acute hepatitis B infections in the U.S. To combat these barriers to eliminating hepatitis B, we must continue to raise awareness about who is at risk and how to prevent transmission, while promoting dialogue about the seriousness of hepatitis B and its deadly link to cirrhosis, liver failure, and liver cancer.
The Hepatitis B Foundation encourages everyone at risk to get tested for hepatitis B. If you test negative, talk to your doctor about being vaccinated to prevent you from a future infection. If you have hepatitis B, there are healthy lifestyle and treatment options that can slow down the virus and prevent liver damage. Knowing your status and getting linked to care can save your life!
To learn more about hepatitis B and injection drug use, download our fact sheets:
Additional resources about hepatitis B transmission, risk factors, prevention, treatment, and more are available at www.hepb.org.
About the Hepatitis B Foundation: The Hepatitis B Foundation is the nation’s leading nonprofit organization solely dedicated to finding a cure for hepatitis B and improving the quality of life for those affected worldwide through research, education and patient advocacy.
About Hep B United: Hep B United is a national coalition dedicated to reducing the health disparities associated with hepatitis B by increasing awareness, screening, vaccination, and linkage to care for high-risk communities across the United States. Hep B United was co-founded and is co-chaired by the Hepatitis B Foundation and the Association of Asian Pacific Community Health Organizations (AAPCHO).
The number of reported cases of acute #HBV infection across the country is rising. Learn about the link between the #opioidcrisis and #hepB via @HepBFoundation @HepBUnited @HHS_ViralHep: https://go.usa.gov/xnMKG