Viral Hepatitis C, 2003

In 2003, 23 cases of acute hepatitis C virus (HCV) infection were reported. Sixteen (70%) of these case-patients had clinical symptoms, and seven were asymptomatic seroconversions. Seventeen (74%) case-patients resided in Greater Minnesota. The median age was 28 years (range, 19 to 55 years). Sixteen (70%) case-patients were female. Fifteen (65%) case patients were white; seven (30%) were American Indian; and one (4%) was black. Incidence rates were higher among American Indians (8.6 per 100,000 population) and blacks (0.5 per 100,000 population) than among whites (0.3 per 100,000 population).

Among the 23 case-patients, 13 (57%) reported using needles to inject drugs, two of whom also had HCV-positive sex partners; two (9%) case-patients had sexual contact with a known anti- HCV-positive partner within 6 months prior to onset of symptoms; one (4%) case-patient had a needle stick occupational exposure; and one (4%) had a recent tattoo. No risk factor could be determined for the remaining six (26%) cases, three of whom were plasma donors with documented seroconversions who could not be reached for interview.

MDH received more than 2,400 reports of newly identified anti-HCV-positive persons in 2003, the vast majority of whom are chronically infected. The 23 acute cases represent less than 1% of those recently diagnosed. Since 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 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; health care, 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 infection and immunized appropriately.

• For up to date information see>> Hepatitis C
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003