Viral Hepatitis C, 2002
In 2002, 14 cases of acute hepatitis C virus (HCV) infection were reported to MDH. Ten (71%) of these cases had clinical symptoms, and four (29%) were asymptomatic seroconversions. Twelve (86%) case-patients resided in Greater Minnesota. The median age of case-patients was 32 years (range, 20 to 95 years). Eight (57%) case patients were female. Eight (57%) case-patients were American Indian, and six (43%) were white. One (7%) case-patient was of Hispanic ethnicity. Incidence rates were higher among American Indians (9.9 per 100,000 population) than among whites (0.1 per 100,000).
Among the 14 case-patients, five (36%) reported using needles to inject drugs, two of whom also had HCV positive sex partners. Two (14%) case-patients had sexual contact with a known anti-HCV-positive partner within 6 months prior to onset of symptoms. One (7%) case-patient had a history of intranasal cocaine use. No risk factor could be determined for the remaining six (43%) cases, three of whom were plasma donors with documented seroconversions and could not be located for an interview.
MDH received more than 2,293 reports of newly identified anti-HCV-positive persons in 2002, the vast majority of whom are chronically infected. The 14 acute cases represent less than 1% of those recently diagnosed. Since most cases are asymptomatic, medical providers are encouraged to review each patient's risk factor(s) for HCV infection to determine the need for testing. (Patients for whom testing is indicated include: persons with past or present injecting drug use; recipients of transfusions or organ transplants before July 1992; recipients of clotting factor concentrates produced before 1987; persons on chronic hemodialysis; persons with persistently abnormal alanine aminotransferase levels; healthcare, emergency medical, and public safety workers after needle sticks, sharps or mucosal exposures to HCV-positive blood; and children born to HCV-positive women). Persons who test positive for HCV should be screened for susceptibility to hepatitis A and B virus infection and immunized appropriately.
Twenty percent of isolates tested were resistant to both ampicillin and trimethoprim-sulfamethoxazole.