Patterns of transmission of hepatitis C

January 01, 0001

Patterns of transmission of hepatitis C

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. These US authors 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 (xULN), negative findings for serologic markers for acute hepatitis A and B, and positive findings for antibody to HCV or HCV RNA.

They found: "Of 2075 patients identified, the median age was 31 years, 91.5% had ALT values greater than 7 x ULN, 77.3% were jaundiced, 22.5% were hospitalized, and 1.2% died. Incidence averaged 7.4 per 100 000 individuals during 1982 to 1989 then declined averaging 0.7 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."

The authors concluded: "The 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."

Hepatitis C is an important risk for injection drug abusers.

For the full abstract, click here.

Arch Intern Med 171(3):242-248, 14 February 2011
© 2011 to the American Medical Association
Incidence and Transmission Patterns of Acute Hepatitis C in the United States, 1982-2006. Ian T. Williams, Beth P. Bell, Wendi Kuhnert, Miriam J. Alter. Correspondence to Dr. Williams:

Category: D. Digestive, Z. Social Problems. Keywords: hepatitis C, transmission, epidemiology, injection drug abuse, observational study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 1 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.