Viral Hepatitis C, 2008

In 2008, 22 cases of symptomatic acute hepatitis C virus (HCV) infection were reported. In addition to the 22 cases, 13 individuals with asymptomatic, laboratory-confirmed acute HCV infection were reported. Prior to 2006, both symptomatic and asymptomatic acute infections were counted as incident cases. This change in case counting criteria should be considered when examining case incidence trends.

Fifteen (68%) of the 22 case-patients resided in Greater Minnesota. The median age was 28 years (range, 18 to 55 years). Twelve (55%) case-patients were male. Seventeen (77%) were white, three (14%) were American Indian, and one (5%) was black; race was unknown for two (9%) cases.

MDH attempts to ascertain risk factor information for the 6 months prior to onset of symptoms by collecting information reported by the case-patient to his/her health care provider and by interviewing the case-patient, if possible. A case-patient may report more than one risk factor, and may report different information to his/her health care provider than to MDH. Among the 22 case-patients, six (27%) used injection drugs; five (23%) used intranasal drugs; two (9%) had sexual contact with a known HCV-infected partner; two (9%) had multiple sexual partners; one (5%) had sexual contact with an injection drug user; one (5%) shared home tattoo equipment; and one (5%) had an occupational exposure. No risk factor was identified for 10 (45%) cases.

MDH received 2,014 reports of newly identified anti-HCV positive persons in 2008, the vast majority of whom are chronically infected. Because most cases are asymptomatic, medical providers are encouraged to consider each patient’s risk for HCV infection to determine the need for testing. Patients for whom testing is indicated include: persons with past or present injection 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. Infants born to HCV-infected mothers should be tested at 12 to 18 months of age, as earlier testing tends to reflect maternal antibody status. Persons who test positive for HCV should be screened for susceptibility to hepatitis A and B virus infections and immunized appropriately.

Updated Friday, November 19, 2010 at 03:16PM