As prescription drug abuse leads more Americans on a path to heroin, new cases of hep C are rising among young people in non-urban areas of the eastern United States. Analyzing Centers for Disease Control and Prevention (CDC) surveillance reports covering 2006 to 2012, researchers found that, out of 7,077 total hep C cases for which there was information about age, 44 percent were 30 years old or younger. This proportion was just 36 percent in 2006 and rose to 49 percent by 2012.

The number of new annual hep C cases, also known as incidence, among young people in non-urban counties increased by 13 percent annually, compared with 5 percent in urban counties. Thirty out of 34 states, or 88 percent, that reported hep C cases saw a higher hep C incidence in 2012 than in 2006, especially in non-urban counties east of the Mississippi River.

Looking at data from 635 young people diagnosed with hep C between 2011 and 2012, the researchers found that three-quarters reported injection drug use. Out of that group, 75 percent had previously abused prescription opioids an average of two years before using heroin.

Saying he was “deeply concerned” by the study’s findings, Scott D. Holmberg, MD, MPH, chief of the epidemiology and surveillance branch of the Division of Viral Hepatitis at the CDC, suggested that the higher hep C incidence in non-urban settings was partially a consequence of the fact that programs to treat drug use, to treat hep C and to provide clean drug injection equipment are often “nonexistent or far distant” for people in these areas.