Opioid Drug Abuse Linked to Increase in Hepatitis C Rate

The rate of hepatitis C infection is on the rise in New York City as a result of a jump in the illicit use of opioid drugs, according to a January report from the New York City Department of Health and Mental Hygiene.

In the report, which is based on 2014 statistics, researchers concluded that 1.2% of all New Yorkers, including 2.4% of New Yorkers over age 20, were infected with the virus. Furthermore, HCV is rampant in city prisons, with 814.4 cases per 100,000 inmates.

The hardest hit borough is that of Staten Island, with a rate of 34.7 cases per 100,000 people under the age of 29. That compares to a city average of 24.8 cases per 100,000.

About half these patients are covered by Medicaid. Those prescribed medications for their infections are mostly getting direct acting antivirals, with sofosbuvir (Solvadi/Gilead) accounting for nearly 80% of prescriptions as of 2014.

Sofosbuvir/ledipasvir (Harvoni/Gilead) was available for only 3 months of 2014 and more recent prescribing statistics were not included in the report. Before 2014, nearly all medications prescribed contained interferon, a drug that is often less effective and comes with severe side effects that can lead patients to stop using it.

Overall, the researchers found most new NYC cases (52.7%) were in the baby boomer generation, defined as those born between 1945 and 1965. Much testing remains to be done, the report noted.

Overall, 41% of New Yorkers surveyed by the health department said they had never been tested, and among baby boomers that percentage dropped to 36%. Deaths in the city from hepatitis C increased 46% from 1999 to 2013, with 62.8% occurring in people under age 65 (412 deaths).

Liver cancer (hepatocellular carcinoma) incidence and mortality rates have also climbed. In 1976, there were about 3 cases and 6 deaths per 100,000 people in the city. By 2012, there were 16.8 cases per 100,000 men and 9.6 deaths per 100,000 men.

That year there were 4.7 cases per 100,000 women and 2.8 deaths per 100,000 women. Patients in NYC who died of liver cancer from hepatitis C lived a median of 13.1 months after diagnosis.