Hepatic in the Heartland

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

The Iowa Department of Public Health (IDPH) issued, this month, the state’s most recent epidemiological profile for Hepatitis C (HCV), and that profile isn’t looking good for people under the age of 30. Between 2010 and 2015, people between the ages of 18-30 have seen a 300% increase in new HCV infections (IDPH, 2017a). New HCV infections amongst all ages saw a 48.70% increase over that same period.

For nearly thirty years, the conventional wisdom has been that HCV is a Baby Boomer disease, and that, outside of the occasional People Who Inject Drugs (PWIDs), there is really no need to screen other groups for infection. What that preconceived notion failed to account for was a resurgence in popularity of heroin as the drug of choice and the resultant increase in Injection Drug Use (IDU). Moreover, the setting of heroin use has largely shifted away from being an urban problem that impacts mostly minority communities to one that’s plaguing suburban and rural areas where access to comprehensive healthcare and recovery services lags behind the more urban settings with which the heroin addiction has historically been associated.

The IDPH report indicates that IDU accounts for 68% of all new HCV infections, and that 55% of Iowans living with HCV live in one of six counties: Polk, Linn, Scott, Woodbury, Pottawattamie, and Black Hawk. Though these counties are among the most populous in Iowa, the state is, itself, relatively rural in comparison to its neighbors. In the IDPH HCV Fact Sheets, the increase in new infections amongst younger Iowans is specifically tied to IDU, indicating that ER visits for opioid and heroin overdoses increased 253% and 2,500%, respectively (IDPH, 2017b).

Randy Mayer, Chief of the IDPH Bureau of HIV, STD, and Hepatitis puts a positive spin on the report:

“These data indicate that Iowans are getting tested and referred to treatment by their medical providers. Everyone born between 1945 and 1965 and anyone who has ever injected non-prescription drugs, even once, should be tested for hepatitis C (Bunge, 2017).”

This is the first report by the IDPH to look at incidences of HCV in Iowa, and Mayer adds that, while this is the first attempt to pull together various data from around the state, the IDPH has been watching similar reports out of Appalachia, and as such paid additional attention to people under 30 (Shotwell, 2017).

This inaugural report from the IDPH does a lot of things “right,” my personal favorite being the use of APA citation, rather than MLA, allowing for in-text citations, rather than footnotes. Writing stylistic approach aside, the report does a fantastic job of indicating which areas Iowan medical professionals need to watch and where interventions most need to be made, as well as indicating that follow-up after treatment is necessary to avoid re-infection.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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