Viral Hepatitis C, 2009

In 2009, 15 cases of symptomatic acute hepatitis C virus (HCV) infection (0.3 per 100,000) were reported. In addition to the 15 cases, 11 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.

Eight (53%) of the 15 cases resided in Greater Minnesota. The median age was 44 years (range, 32 to 61 years). Ten (67%) cases were male. Eight (53%) were white, 3 (20%) were black, and 1 (7%) was American Indian; race was unknown for 3 (20%) cases.

MDH attempts to ascertain risk factor information for the 6 months prior to onset of symptoms by collecting information reported by the case to his/her health care provider and by interviewing the case, if possible. A case may report more than one risk factor, and may report different information to his/her health care provider than to MDH. Among the 15 cases, 1 (7%) used injection drugs; 1 (7%) had sexual contact with a known HCV-infected partner; 1 (7%) had a needle stick, 1 (7%) had multiple sexual partners, and 2 (13%) had one sexual partner. No risk factor was identified for 9 cases.

MDH received 1,798 reports of newly identified anti-HCV positive persons in 2009, the vast majority of whom are chronically infected. A total of 33,359 persons are assumed to be alive and living in Minnesota with past or present HCV infection. The median age of these cases is 53. 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