Comparison of persons who died of drug overdoses with and without evidence of hepatitis C, United States, 2019-2024.

Abstract

Injection drug use is the most common risk factor for hepatitis C virus (HCV) infection. Despite decreases in injection drug use among overdose decedents during 2020-2022, reported cases of newly-acquired hepatitis C remained relatively stable. This analysis compares sociodemographic characteristics and circumstances among overdose decedents with and without evidence of hepatitis C to inform prevention. CDC's State Unintentional Drug Overdose Reporting System (SUDORS) collects data on unintentional and undetermined intent drug overdose deaths, including HCV infection information. Percentages of overdose deaths during July 2019-December 2024 with sociodemographic characteristics, drugs involved, and circumstances were calculated by hepatitis C evidence (48 jurisdictions). To assess trends, the percentage of overdose deaths with hepatitis C evidence was calculated by 6-month period from July 2019 to December 2024 (30 consistently reporting jurisdictions). Among 328,754 decedents, compared to those without hepatitis C evidence (94.6%), those with hepatitis C evidence (5.4%) more often were aged ≥ 55 years (36.0% vs. 24.7%) and non-Hispanic White (75.9% vs. 63.9%), and had ≥ 1 recent touchpoint or potential intervention opportunity (e.g., mental health treatment, nonfatal overdose; 40.3% vs. 23.9%). The percentage with hepatitis C evidence increased from 5.3% during July-December 2019 to 7.2% during July-December 2024. Implementing community-based services to prevent infectious disease spread and overdose, accessible hepatitis C testing, linkage to substance use disorder treatment and curative hepatitis C treatment, and robust public health surveillance to identify populations for tailored prevention efforts might help address hepatitis C and drug use epidemics.