A new report in the October issue of Hepatology underlines the importance of vaccinating injection drug users (IDUs) for hepatitis B. Health officials from the Centers for Disease Control and health departments in Montana and New Mexico report on a series of acute hepatitis B infections in IDUs that resulted in fatal fulminant hepatitis.
Fulminant means sudden and severe; fulminant hepatitis is characterized by massive and rapid killing of liver cells. Fulminant hepatitis is rare, but generally fatal in adults. About 1% of new hepatitis B infections result in fulminant hepatitis and death. Fulminant hepatitis has also been reported in a small number of people chronically infected with hepatitis C who become infected with hepatitis A. Drugs and medications have also been linked to fulminant hepatitis.
The Hepatology paper identified 10 cases of fulminant hepatitis B among IDUs, all of whom died from liver failure. Comparison with people with acute hepatitis B infections that did not result in fulminant hepatitis suggests that use of alcohol, methamphetamine, and acetaminophen (an ingredient in Tylenol and some other pain relievers) may have contributed to the incidence of fulminant hepatitis.
The authors conclude that "[i]mproved vaccination coverage among IDUs has the potential to prevent similar outbreaks in the future."
Full abstract follows: