As the nonprescription use of opioids has surged among young people in particular, health care providers are missing the opportunity to screen for hepatitis C virus (HCV) among youth with opioid use disorder.

Researchers analyzed the electronic medical records of nearly 270,000 U.S. residents between 13 and 21 years old who attended one of 57 federally qualified health centers in 19 states between 2012 and 2017.

A total of 875 of these young people were diagnosed with opioid use disorder; of these, just 36 percent were tested for hep C. Of those who were screened, 11 percent tested positive for HCV antibodies and 6.8 percent tested positive for antibodies and the presence of the virus, indicating a chronic infection.

A total of 6,812 (2.5 percent) of all the young people included in the analysis were tested for HCV. Of this group, 122 (1.8 percent) tested positive for the virus.

“It is critical that pediatricians and other physicians seeing adolescents and young adults first take time to screen for opioid and other substance use and risk factors that may lead to substance use disorders,” says study author Rachel Epstein, MD, MA, a pediatrician at Boston Medical Center.

“Second, once substance use is recognized, clinicians must appropriately screen for both hepatitis C virus and HIV and link diagnosed individuals to [medical] care. Third, treating opioid and other substance use disorders is essential to curb all three epidemics.”

“Additionally,” Epstein says, “expanded HCV screening recommendations that do not rely on identification or disclosure of risk factors could also expand HCV testing significantly, as multiple studies note no identified risk factor in over half of individuals newly diagnosed with HCV.”