NEW YORK (AP) — U.S. health officials say the heroin epidemic is driving up cases of hepatitis C.

The number of reported infections nearly tripled in five years to about 2,400 in 2015. The Centers for Disease Control and Prevention said Thursday that the increase coincided with a surge in heroin use. The virus is mostly spread by sharing needles to inject drugs.

Hepatitis C can lead to cirrhosis or liver cancer and other problems. Most people don’t get sick for many years after they are infected. So the CDC thinks the reported cases are only a fraction of actual infections. The health agency estimates new infections for 2015 at 34,000.

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