Case-reporting of acute hepatitis B and C among injection drug users
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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.
- Contoreggi C, Rexroad VE, Lange WR. Current management of infectious disease complications in the injecting drug user. J Subst Abuse Treat. 1998;15:95–106. CrossRef
- Hagan H. Hepatitis C transmission dynamics in injection drug users. Subst Use Misuse. 1998;33:1197–1212. CrossRef
- Chamot E, de Saussure P, Hirschel B, et al. Incidence of hepatitis C, hepatitis B, and HIV infections among drug users in a methadone maintenance programme. AIDS. 1992; 6:431–432.
- an Ameijden EJC, van den Hoek JAR, Mientjes GHC, et al. A longitudinal study on the incidence and transmission patterns of HIV, HBV and HCV infection among drug users in Amsterdam. Eur J Epidemiol. 1993;9:255–262. CrossRef
- Hagan H, McGough JP, Thiede H, et al. Syringe exchange and risk of infection with hepatitis B and C viruses. Am J Epidemiol. 1999;149:203–213.
- Crofts N, Aitken CR. Incidence of blood-borne virus infection and risk behaviors in a cohort of injecting drug users in Victoria, 1990–1995, Med J Aust. 1997;167;17–20.
- Alter MJ, Moyer LA. The importance of preventing hepatitis C virus infection among injection drug users in the United States. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(suppl 1):S6-S10.
- Moyer LA, Mast EE, Hepatitis B: Virology, epidemiology, disease, and prevention, and an overview of viral hepatitis. Am J Prev Med. 1994;10:45–55.
- Heptonstall J. Strategies to ensure delivery of hepatitis B vaccine to injecting drug users. Commun Dis Public Health. 1999;2:174–177.
- Margolis HS, Alter MJ, Hadler SC. Viral hepatitis. In: Evans AS, Kaslow RA, eds. Viral Infections of Humans—Epidemiology and Control. New York: Plenum; 1997:363–418.
- Robinson WS. Hepatitis B virus and hepatitis D virus. In: Mandel GE, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases, 5th ed. Philadelphia, PA: Churchill Livingstone; 2000:1652–1685.
- Seeff LB. Natural history of hepatitis C. Hepatology. 1997;26(suppl 1):21S-28S. CrossRef
- Chang G, Kosten TR. Detoxification. In: Lowinson JH, Ruiz P, Millman RB, Langrod JG, Eds. Substance Abuse: a Comprebensive Textbook. Baltimore, MD: Williams and Wilkins; 1997:377–381.
- Hagan H, Thiede H, McGough JP, Alexander ER. Hepatitis B vaccination among research participants, Seattle, Washington. Am J Public Health. November 2002. In press.
- Hagan H, Thiede H. Changes in injection risk behavior associated with participation in the Seattle needle exchange. J Urban Health. 2000;3:365–378.
- Hagan H, Thiede H, Weiss NS, et al. Sharing of drug preparation equipment as a risk factor for hepatitis C virus incidence. Am J Public Health. 2001;91:42–46. CrossRef
- Thiede H, Hagan H, Murrill CS. Methadone treatment and HIV and hepatitis B and C risk reduction among injectors in the Seattle area. J Urban Health. 2000;77:331–345. CrossRef
- Hanley JA, Lippman-Hand A. If nothing goes wrong, is everything all right? Interpreting zero numerators. JAMA. 1983;249:1743–1745. CrossRef
- Washington State Department of Health. Annual Communicable Disease Report. Olympia, WA: Washington State Department of Social and Health Services; 1998.
- Centers for Disease Control and Prevention. Summary of notifiable diseases, 1998. MMWR Morb Mortal Wkly Rep. 1999;47:4–7.
- Gretch DR. Diagnostic tests for hepatitis C. Hepatology. 1997;26 (suppl 1):43S-47S. CrossRef
- Schroter M, Feucht HH, Schafer P, Zollner B, Polywka S, Laufs R. Definition of falsepositive reactions in screening for hepatitis C virus antibodies. J Clin Microbiol. 1999; 37:233–234.
- Alter MJ, Mares A, Hadler SC, et al. The effect of underreporting on the apparent incidence and epidemiology of acute viral hepatitis. Am J Epidemiol. 1987;125:133–139.
- Crofts N, Jolley D, Kaldor J, et al. Epidemiology of hepatitis C virus infection among injecting drug users in Australia. J Epidemiol Community Health. 1997;1:692–697. CrossRef
- Case-reporting of acute hepatitis B and C among injection drug users
Journal of Urban Health
Volume 79, Issue 4 , pp 579-585
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Hepatitis B
- Hepatitis C
- Substance use
- Author Affiliations
- 1. University of Washington, Seattle, Washington
- 2. Public Health-Seattle and King County, Seattle, Washington
- 3. Center for Drug Use and HIV Research, National Development and Research Institutes, 71 West 23rd Street, 10010, New York, NY