Incidence and transmission patterns of acute hepatitis C in the United States, 1982-2006

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Source: Arch Intern Med | Posted 6 days ago

Incidence and transmission patterns of acute hepatitis C in the United States,

1982-2006;

IT, Bell BP, Kuhnert W, Alter MJ; Archives of Internal Medicine 171

(3), 242-8 (Feb 2011)

BACKGROUND Monitoring disease incidence and transmission patterns is important

to characterize groups at risk for hepatitis C virus (HCV) infection. Clinical

cases generally represent about 20% to 30% of all newly acquired infections.

METHODSWe used sentinel surveillance to determine incidence and transmission

patterns for acute hepatitis C in the United States using data from 25 years of

population-based surveillance in the general community. Acute cases of hepatitis

C were identified from 1982 through 2006 by a stimulated passive surveillance

system in 4 to 6 US counties. Cases were defined by a discrete onset of

symptoms, alanine aminotransferase (ALT) levels greater than 2.5 times the upper

limit of normal (×ULN), negative findings for serologic markers for acute

hepatitis A and B, and positive findings for antibody to HCV or HCV RNA.

Incidence and frequency of reported risk factors were the main outcome measures.

RESULTSOf 2075 patients identified, the median age was 31 years, 91.5% had ALT

values greater than 7 × ULN, 77.3% were jaundiced, 22.5% were hospitalized, and

1.2% died. Incidence averaged 7.4 per 100 000 individuals (95% confidence

interval [CI], 6.4-8.5 per 100 000) during 1982 to 1989 then declined averaging

0.7 per 100 000 (95% CI, 0.5-1.0 per 100 000) during 1994 to 2006. Among 1748

patients interviewed (84.2%), injection drug use (IDU) was the most commonly

reported risk factor. The average number of IDU-related cases declined

paralleling the decline in incidence, but the proportion of IDU-related cases

rose from 31.8% (402 of 1266) during 1982 to 1989 to 45.6% (103 of 226) during

1994 to 2006. Among IDU-related cases reported during 1994 to 2006, 56 of 61

individuals (91.8%) had been in a drug treatment program and/or incarcerated.

CONCLUSIONSThe incidence of acute HCV declined substantially over the 25 years

of population-based surveillance. Despite declines, IDU is the most common risk

factor for new HCV infection.

[Guest guest]

Source: Arch Intern Med | Posted 6 days ago

Incidence and transmission patterns of acute hepatitis C in the United States,

1982-2006;

IT, Bell BP, Kuhnert W, Alter MJ; Archives of Internal Medicine 171

(3), 242-8 (Feb 2011)

BACKGROUND Monitoring disease incidence and transmission patterns is important

to characterize groups at risk for hepatitis C virus (HCV) infection. Clinical

cases generally represent about 20% to 30% of all newly acquired infections.

METHODSWe used sentinel surveillance to determine incidence and transmission

patterns for acute hepatitis C in the United States using data from 25 years of

population-based surveillance in the general community. Acute cases of hepatitis

C were identified from 1982 through 2006 by a stimulated passive surveillance

system in 4 to 6 US counties. Cases were defined by a discrete onset of

symptoms, alanine aminotransferase (ALT) levels greater than 2.5 times the upper

limit of normal (×ULN), negative findings for serologic markers for acute

hepatitis A and B, and positive findings for antibody to HCV or HCV RNA.

Incidence and frequency of reported risk factors were the main outcome measures.

RESULTSOf 2075 patients identified, the median age was 31 years, 91.5% had ALT

values greater than 7 × ULN, 77.3% were jaundiced, 22.5% were hospitalized, and

1.2% died. Incidence averaged 7.4 per 100 000 individuals (95% confidence

interval [CI], 6.4-8.5 per 100 000) during 1982 to 1989 then declined averaging

0.7 per 100 000 (95% CI, 0.5-1.0 per 100 000) during 1994 to 2006. Among 1748

patients interviewed (84.2%), injection drug use (IDU) was the most commonly

reported risk factor. The average number of IDU-related cases declined

paralleling the decline in incidence, but the proportion of IDU-related cases

rose from 31.8% (402 of 1266) during 1982 to 1989 to 45.6% (103 of 226) during

1994 to 2006. Among IDU-related cases reported during 1994 to 2006, 56 of 61

individuals (91.8%) had been in a drug treatment program and/or incarcerated.

CONCLUSIONSThe incidence of acute HCV declined substantially over the 25 years

of population-based surveillance. Despite declines, IDU is the most common risk

factor for new HCV infection.