HCV Burden Shifting from Baby Boomers to Millennials

Primary care providers may need to start worrying about a new population infected with the hepatitis C virus (HCV): millennials.

Individuals aged 24 to 39 years have fast become the predominant group affected by the HCV epidemic, according to a poster presented on October 3 at Infectious Disease Week 2019.¹

The study, conducted by John Myers, PhD, MSPH, and colleagues at Norton Healthcare and the University of Louisville in Kentucky, found that the HCV epidemic has shifted from baby boomers (aged 54 to 74 years) to millennials, and particularly young men.

Millennials have been hardest hit by the opioid crisis, which may have something to do with the shift in demographics for HCV. Injection drug use increases the risk for HCV transmission.

Past studies have hinted at this shift, but most have been too small to provide representative data for the US. The new study took place between 2016-2018 at Norton Healthcare in the Appalachia region, an epicenter of the US opioid crisis. Researchers screened 82 243 individuals for HCV infection, and found that 3% (n=2615) had chronic HCV infection.

Importantly, the average age of individuals with HCV decreased from 47.3 years in 2016 to 39.9 years in 2018, a statistically significant decline of about 3.7 years annually (p<.001).

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Researchers also found that the proportion of HCV-infected individuals of millennial age significantly increased between 2016 and 2018:

• 2016      33.6%

• 2017      42.4%

• 2018      51.4% (p<.001)

In contrast, the proportion of HCV infected individuals of baby boomer age significantly decreased between 2016 and 2018:

• 2016      44%  

• 2017      38.8%  

• 2018      29.3% (p<.001)
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Further analyses suggested that the average age of individuals with HCV will continue to decline. Unless public health officials intervene, the average age will plateau at about 28 years over the next 7 years.

Unless public health officials intervene, the average
age will plateau at about 28 years over the next 7 years.

People living with chronic HCV may be more likely to be male and Hispanic. Over the course of the study, HCV infections among men increased from 49.6% to 54.4% (p=0.008). HCV infections among Hispanic individuals increased from 1.6% to 17.7% (p<.001).

The authors conclude “that the opioid crisis has led to a drastic demographic shift, and currently the typical HCV infected individual is a younger male. Without interventions, this trend will continue for over seven years, plateauing near the demarcation of millennials and generation Z [ages 7-23].”  

Source: Ryan N, Prince A, Talbot M, et al. Hepatitis C is now a millennial disease in response to the opioid crisis: a demographic shift in hepatitis C infection. Presented at IDWeek 2019 on October 3, 2019, Washington DC. Session: 041. Poster 293.

(image©pkchai/shutterstock.com)

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