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People who use or inject drugs (PWUD) are at higher risk of viral hepatitis. CDC asks clinicians to talk with all patients — and especially these — about vaccination against hepatitis A and B and testing for hepatitis B and C.
The three viruses
| How it spreads | Why PWUD are at risk | CDC recommends | |
|---|---|---|---|
| Hepatitis A | the fecal-oral route | person-to-person outbreaks across the country, often among PWUD; some cases bring severe complications, hospitalization and death | vaccination for everyone who uses or injects drugs (how to give it) |
| Hepatitis B | blood, and other body fluids | sharing syringes or any other equipment used to prepare and inject drugs | screening for all adults once in a lifetime (2023) and vaccination for all adults aged 19–59 (ACIP, 2022); test and vaccinate (screening, vaccine) |
| Hepatitis C | blood | acute cases have doubled since 2015, and injection drug use was the most commonly reported risk among acute cases in 2023 | one-time screening for all adults, testing for anyone who has ever injected drugs whatever their age, and periodic testing while risk continues (testing) |
Syringe services programs
Syringe services programs (SSPs) are community-based prevention programs that widen access to harm reduction for people who use or inject drugs, or have in the past, and cut infections and other complications of injecting. They offer:
- sterile syringes and safe disposal of used equipment;
- testing and vaccination for infectious diseases;
- links to treatment for infections and for substance use disorder.
SSPs are associated with an estimated 50% reduction in new HIV and hepatitis C infections. Nearly 30 years of research show that comprehensive SSPs are safe, effective and cost-saving, and do not increase drug use or crime. More: CDC on SSPs.
Guidelines
- Prevention of Hepatitis A Virus Infection in the United States — ACIP, 2020
- Screening and Testing for Hepatitis B Virus Infection — CDC, 2023
- Universal Hepatitis B Vaccination in Adults Aged 19–59 Years — ACIP, 2022
- Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection — 2008
- Prevention of Hepatitis B Virus Infection in the United States — ACIP
- CDC Recommendations for Hepatitis C Screening Among Adults — 2020
- Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly
More help
| For | Resource |
|---|---|
| Health departments | CDC's guide to handling HIV and hepatitis C outbreaks among people who inject drugs, and an outbreak management checklist |
| Related CDC topics | how HIV spreads, HIV cluster detection and response, overdose prevention |
| Federal agencies | the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration |
| Other organizations | the American Association for the Treatment of Opioid Dependence, WHO guidance on hepatitis B and C among people who inject drugs, and NACCHO's harm reduction support for local health departments |
| Patients | a pocket hepatitis A and B vaccine card and a hepatitis C fact sheet in English and Spanish |
Sources
Based on "Viral Hepatitis Among People Who Use or Inject Drugs," Centers for Disease Control and Prevention; a work of the United States government in the public domain. The stock photo on the original page is left out.
Licens: CC0 1.0 (offentligt eje) · Bearbejdet efter www.cdc.gov
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