Viral Hepatitis Among People Who Use or Inject Drugs

Key points

• Talk to all your patients, especially those who use or inject drugs, about getting vaccinated against hepatitis A and hepatitis B and getting tested for hepatitis B and hepatitis C.
• Syringe services programs (SSPs) play an important role in reducing the transmission of viral hepatitis, human immunodeficiency virus (HIV), and other infections among people who use drugs (PWUD).

Risks

Certain populations, including people who use or inject drugs, have an increased risk for contracting viral hepatitis.

Injection drug use and hepatitis A

Hepatitis A is transmitted through the fecal-oral route. While hepatitis A can affect anyone, certain groups are at greater risk for infection. Recent person-to-person transmission of hepatitis A has occurred across the country, and frequently among PWUD. In some cases, people can experience severe complications, hospitalization, and even death. CDC recommends that people who use or inject drugs be vaccinated against hepatitis A.

Vaccinate for hepatitis A

Talk to your patients about getting vaccinated against hepatitis A.Hepatitis A Vaccine Administration

Injection drug use and hepatitis B

Hepatitis B virus (HBV) is a bloodborne pathogen and can also be transmitted through exposure to other body fluids. PWUD are at risk for HBV infection through the sharing of syringes and/or any other equipment used to prepare and inject drugs.

CDC published updated recommendations

The updated recommendations include hepatitis B screening for all adults once in their lifetime and hepatitis B vaccination for all adults aged 19-59 years.

Learn more about hepatitis B clinical screening and testing.

Vaccinate for hepatitis B

Talk to your patients about getting tested for and vaccinated against hepatitis B.Hepatitis B Vaccine Administration

Injection drug use and hepatitis C

Hepatitis C virus (HCV) is also a bloodborne pathogen. The number of acute hepatitis C cases has doubled since 2015. Among risk behaviors and exposures identified for reported cases of acute HCV infection in 2023, injection drug use was most commonly reported. CDC recommends one-time screening for all adults, testing for anyone who has ever injected drugs, regardless of age, and periodic testing if risk persists.

Learn more about hepatitis C clinical screening and testing.

Harm reduction

SSPs are community-based prevention programs. Their purpose is to:

• Increase access to harm reduction services for people who use or inject drugs or have a history of injecting drugs.
• Reduce the incidence of infectious disease and other complications of using injection drugs.

These organizations provide a range of harm reduction services including:

• Access to sterile syringes and disposal of used injection equipment.
• Testing and vaccination for infectious diseases.
• Linkage to treatment for infectious diseases.
• Linkage to treatment for substance use disorder.

SSPs are associated with an estimated 50% reduction in HIV and HCV incidence.

Nearly 30 years of research show that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV, and other infections.

Learn more about SSPs.

Resources

These resources from CDC and other national organizations can help clinicians learn more about preventing and treating viral hepatitis among people who use or inject drugs.

Scientific guidelines and recommendations

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020

MMWR. Recommendations and Reports / Vol. 69 / No. 5 / P. 1–38

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023

MMWR. Recommendations and Reports / Vol. 72 / No. 1 / P. 1–25

Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022

MMWR. Morbidity and Mortality Weekly Report / Vol. 71 / No. 13 / P. 477–483

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection, 2008

MMWR. Morbidity and Mortality Weekly Report / Vol. 57 / No. 08 / P. 1–20

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

MMWR. Recommendations and Reports / Vol. 67 / No. 1 / P. 1–31

CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020

MMWR. Recommendations and Reports / Vol. 69 / No. 2 / P. 1–17

Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly

MMWR. Recommendations and Reports / 61(RR05);1-40

CDC resources

Syringe Services Programs (SSPs)

Information on The Safety and Effectiveness of Syringe Services Programs (SSPs)

How HIV Spreads

CDC provides an overview of HIV prevention among PWID.

HIV Cluster Detection and Response

CDC summarizes HIV cluster detection and response (CDR), which identifies communities affected by rapid HIV transmission.

Overdose Prevention

This collection of resources from CDC summarizes prevention of opioid overdoses.

Downloadable resources

• A PDF providing comprehensive recommendations for state and local health departments for handling HIV and hepatitis C outbreaks.
• A PDF checklist for state and local health departments outlining considerations for HIV and hepatitis C outbreak management.

Federal resources

National Institute on Drug Abuse (NIDA)

NIDA advances science on drug use and addiction to improve individual and public health.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA is the agency within the United States Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.

Other organizations’ resources

American Association for the Treatment of Opioid Dependence (AATOD)

AATO is a national nonprofit that works to expand access to quality opioid use disorder treatment services.

World Health Organization (WHO)

WHO provides guidance on hepatitis B and hepatitis C prevention among PWID.

The National Association of County and City Health Officials (NACCHO)

NACCHO supports local health departments in harm reduction programs.

Communication resources

These resources from CDC can help clinicians talk to their patients about preventing and treating viral hepatitis.

Posters, digital tools, and social media

For more, see all posters for PWUD.

Resources for PWUD

Hepatitis A Outbreaks Linked to Person-to-Person Contact

Details about the ongoing person-to-person hepatitis A outbreak in the US.

Vaccine Card: Get vaccinated for hepatitis A and hepatitis B | CDC

Find pocket vaccine cards for hepatitis A and hepatitis B. Protect your liver and get vaccinated.

Aug 19, 2020 Download

Download

FactSheet-PWID.pdf

FactSheet-PWID.pdf

Jan 11, 2024 Download

Download

FactSheet-PWID_sp.pdf

FactSheet-PWID_sp.pdf

Jan 11, 2024 Download

Download

Where this page came from

This page was imported from Centers for Disease Control and Prevention. Material produced by the Centers for Disease Control and Prevention is a work of the United States government and is in the public domain.

Nobody has written it yet — it is the source material at a new address, which is why search engines are asked to skip it and why no one earns from it. It is up for grabs: take it on, and it is yours to rewrite and to earn from.