Drug Injections Fuel Hepatitis C Increase

A rise in injection drug use is creating more new acute Hepatitis C incidents and East Tennessee is seeing higher rates of the disease than other parts of the state.

"People don't just take opiates by mouth. It started that way, but they start injecting because it gives them a faster high," Dr. Martha Buchanan, the Knox County Health Department Director, said.

Since Hepatitis C is transmitted through blood, sharing needles and straws can spread the disease.

However, Dr. Buchanan says drug use is not the only behavior that puts people at an increased risk. People who received donated blood or had an organ transplant before blood screening started in 1992 could also have been exposed.

Acute Hepatitis C is a short-term illness that typically occurs within six months after a person is exposed to the Hepatitis C virus.

The CDC says as many as 80 percent of people with acute Hepatitis C have no symptoms, and without blood work, the illness goes undetected.

Of those with acute Hepatitis C, the CDC says 75 to 85 percent will develop chronic Hepatitis C, which can lead to long-term health problems such a liver damage, liver cancer or death.

"We've got to address our opiate epidemic. If we can address that and decrease the number of people that are injecting drugs, that's going to help us reduce our rates over time," Dr. Buchanan said.

A grant provided to the Knox County Health Department has allowed the department to test more people and help them get treatment. Dr. Buchanan said about 10,000 people have been tested and around 12 percent of tests have come back positive.

"If we don't treat these folks, the cost of taking care of the problem later when they're in end-stage liver disease, or they have liver cancer is much more expensive than treating it up front," she said.

She says modern treatment is more effective and manageable than treatment regimens in the past, but the cost can be prohibitive without assistance from grants.

"You can actually get your viral load - the number of viruses in your system - down to zero," she said. "The problem is its really expensive so it's not very accessible and those people, if they don't have lifestyle changes, could be reinfected if they go back to using IV drugs."

In May, Gov. Bill Haslam signed legislation into law allowing nonprofit organizations to run syringe-exchange programs. Buchanan says once the programs are up and running, it should create a noticeable impact on decreasing new infections.

"In places around the world where there are syringe exchange programs, drug use doesn't go up, but infections go down," Dr. Buchanan said.

Although drug use is recognized as a factor in the more recent increase in Hepatitis C, she says drugs users aren't the only ones who should be tested.

The CDC says Baby Boomers are five times more likely than other adults to have Hepatitis C and recommends anyone born between 1945 and 1965 be tested.

"I think people need to know their risks, and the people that know their risks need to be tested," she said. "Some folks who get the acute phases, they don't even go to the doctor. They're not that sick, they just have some vomiting, diarrhea, fever, they stay home and they never know they have the disease until later in life."

Hepatitis C testing at the Knox County Health Department is free and results are confidential.

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