Various Topics

Journal of Urban Health

, Volume 79, Issue 4, pp 579-585

First online:

Case-reporting of acute hepatitis B and C among injection drug users

  • Holly HaganAffiliated withUniversity of WashingtonPublic Health-Seattle and King CountyCenter for Drug Use and HIV Research, National Development and Research Institutes Email author 
  • , Nadine SnyderAffiliated withPublic Health-Seattle and King County
  • , Eillen HoughAffiliated withPublic Health-Seattle and King County
  • , Tianji YuAffiliated withPublic Health-Seattle and King County
  • , Shelly McKeirnanAffiliated withPublic Health-Seattle and King County
  • , Janice BoaseAffiliated withPublic Health-Seattle and King County
  • , Jeffrey DuchinAffiliated withPublic Health-Seattle and King CountyUniversity of Washington

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Although public health surveillance system data are widely used to describe the epidemiology of communicable disease, occurrence of hepatitis B and C virus (HBV and HCV, respectively) infections may be misrepresented by under-reporting in injection drug users (IDUs). This study was carried out to examine the relationship between HBV and HCV incidence and case-reporting of hepatitis B and C in Seattle IDUs. Names of participants in a Seattle IDU cohort study who acquired HBV or HCV infection over a 12-month follow-up period were compared to a database of persons with acute bepatitis B and C reported to the bealth department surveillance unit over the same period. Of 2,208 IDUs enrolled in the cohort who completed a follow-up visit, 63/759 acquired HBV infection, 53/317 acquired HCV infection, and 3 subjects acquired both HBV and HCV. Of 113 cohort subjects who acquired HBV or HCV, only 2 (1.5%) cases were reported; both bad acute bepatitis B. The upper 95% confidence limit for case-reporting of bepatitis C in the cohort was 5.7%, and for hepatitis B, it was 7.5%. In this study, reporting of acute bepatitis in IDUs was extremely low, raising questions regarding the use of community surveillance data to estimate underlying incidence in that population group.


Hepatitis B Hepatitis C Substance use Surveillance