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

  • I.T. W
  • B.P. B
  • W. K
 et al. 
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Abstract

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., METHODS: We 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. Incidence and frequency of reported risk factors were the main outcome measures., RESULTS: Of 2075 patients identified, the median age was 31 years, 91.5% had ALT values greater than 7xULN, 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., CONCLUSIONS: 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. 2011 American Medical Association. All rights reserved.

Author-supplied keywords

  • *Hepatitis C/ep [Epidemiology]
  • *hepatitis C/ep [Epidemiology]
  • 80 and over
  • Acute Disease
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alanine Transaminase
  • Aspartate Aminotransferases
  • Child
  • Cross-Sectional Studies
  • Female
  • Hepatitis C virus
  • Hepatitis C/di [Diagnosis]
  • Hepatitis C/tm [Transmission]
  • Humans
  • Incidence
  • Infant
  • Intravenous/co [Complications]
  • Intravenous/ep [Epidemiology]
  • Intravenous/rh [Rehabilitation]
  • Male
  • Middle Aged
  • Occupational Diseases/di [Diagnosis]
  • Occupational Diseases/ep [Epidemiology]
  • Preschool
  • Risk Factors
  • Sentinel Surveillance
  • Sex Factors
  • Substance Abuse
  • Substance Abuse Treatment Centers
  • United States
  • Young Adult
  • adolescent
  • adult
  • aged
  • alanine aminotransferase/ec [Endogenous Compound]
  • article
  • child
  • female
  • health survey
  • human
  • incidence
  • infant
  • injection
  • jaundice
  • major clinical study
  • male
  • newborn
  • nonhuman
  • priority journal
  • risk factor
  • virus RNA
  • virus transmission

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Authors

  • Williams I.T.

  • Bell B.P.

  • Kuhnert W.

  • Alter M.J.

  • Ian T Williams

  • Beth P Bell

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