Digestive Diseases and Sciences

, Volume 48, Issue 4, pp 815–820 | Cite as

Risk Factors for Hepatitis C Virus Infection Among Patients Receiving Health Care in a Department of Veterans Affairs Hospital

  • Girish Mishra
  • C. Sninsky
  • Robert Roswell
  • S. Fitzwilliam
  • Kenneth C. Hyams
Article

Abstract

A cross-sectional, seroepidemiological study was conducted to determine the prevalence and risk factors for hepatitis C virus (HCV) infection among veterans receiving health care from the VA. Among 274 evaluated outpatients, anti-HCV was found in 27 (9.9%). The prevalence of anti-HCV was 3.7% among 190 individuals who reported no illicit drug use compared to 24.7% among 81 subjects who had used drugs (P < 0.001). The prevalence of anti-HCV was 4.8% among 208 veterans who had never been incarcerated compared to 27.9% among 61 veterans who had been incarcerated (P < 0.001). A multivariate model found the following factors to be independently associated with anti-HCV: having used illicit drugs [odds ratio (OR) = 3.7, 95% CI 1.3–11.8; P = 0.001), having been incarcerated ( OR = 4.4, 95% CI 1.7–10.9; P = 0.001), and a yearly income less than US $10,000 ( OR = 3.5, 95% CI 1.3–9.4; P = 0.002). Because HCV infection was most strongly associated with illicit drug use, incarceration, and low income, these risk factors should be utilized to develop screening strategies among VA patients.

hepatitis C viral hepatitis Veterans Affairs hospital epidemiology military medicine 

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References

  1. 1.
    Alter HJ, Purcell RH, Shih JW, Melpolder JC, Houghton M, Choo QL, Kuo G: Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis N Engl J Med 321:1494-1500, 1989Google Scholar
  2. 2.
    Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao F, Moyer LA, Kaslow RA, Margolis HS: The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med 341:556-562, 1999Google Scholar
  3. 3.
    McQuillan GM, Alter MJ, Moyer LA: A population based-based serologic study of hepatitis C virus infection in the United States. In Viral Hepatitis and Liver Disease. M Rizzetto, RH Purecll, JL Gerin, G Verme (eds). Turin, Italy: Edizioni Minerva Medica; 1997, pp 267-270Google Scholar
  4. 4.
    Pham DQ, Walse D, Montgomery J, Buskell-Bales Z, Collier K, Lokken G, Claggett J, Wilson L, Biswas R, Gibert C, Seef LB: Seroepidemiology of hepatitis C and B in an urban VA medical center. Hepatology 326A, 1994Google Scholar
  5. 5.
    Kizer KW: Under Secretary for Health's Information Letter—Hepatitis C: Standards for Provider Evaluation and Testing. Washington, DC, Department of Veterans Affairs, Veterans Health Administration, June 11, 1998 (IL 10-98-013)Google Scholar
  6. 6.
    Late M: Action urged to stem hepatitis C. US Med 34:3,42,43, 1998Google Scholar
  7. 7.
    Roselle GA, Mendenhall CL, Danko LH: A four-year review of patients with hepatitis C antibody in Department of Veterans Affairs facilities. Mil Med 162:711-714, 1997Google Scholar
  8. 8.
    Malone JD, Hyams KC, Hawkins RE, Sharp TW, Daniell FD: Risk factors for sexually-trasmitted diseases among deployed military personnel. J STD 20:294-298, 1993Google Scholar
  9. 9.
    Long GE, Rickman LS: Infectious complications of tattoos. Clin Infect Dis 18:610-619, 1994Google Scholar
  10. 10.
    Samantha S, Tweeten M, Rickman LS: Infectious complications of body piercing: Clin Infect Dis 26:735-740, 1998Google Scholar
  11. 11.
    Dodd RY: Infectious risk of plasma donations: relationship to safety of intravenous immune globulins. Clin Exp Immunol 104:31-34, 1996Google Scholar
  12. 12.
    Hyams KC, Riddle J, Rubertone M, Trump D, Alter MJ, Cruess DF, Han X, Nainam OV, Seeff LB, Mazzuchi JF, Bailey S: The risk of hepatitis C virus infection in the US military: A serosurvey of 21,000 troops. Am J Epidemiol 153:764-770, 2001Google Scholar
  13. 13.
    Bukh J, Purcell RH, Miller RH: Importance of primer selection for the detection of hepatitis C virus RNA with the polymerase chain reaction assay. Proc Natl Acad Sci USA 89:187-191, 1992Google Scholar
  14. 14.
    Urdea MS, Horn T, Fultz TJ, Anderson M, Running JA, Hamren S, Ahle D, Chang CA: Branched DNA amplication for the sensitive, direct detection of human hepatitis viruses. Nuclere Acids Res Symp Ser 24:197-200, 1991Google Scholar
  15. 15.
    Austin E, Jensen B, Leete J, De L'Aune W, Bhatnagar J, Racine M, Braun JE: Prevalence of hepatitis C virus seropositivity among hospitalized veterans. Am J Med Sci 319:353-359, 2000Google Scholar
  16. 16.
    Cheung RC: Epidemiology of hepatitis C virus infection in American veterans. Am J Gastroenterol 95:740-747, 2000Google Scholar
  17. 17.
    Briggs ME, Baker C, Hall R, Gaziano MJ, Gagnon D, Bzowej N, Wright TL: Prevalence and risk factors for hepatitis C virus infection at an urban veterans administration medical center. Hepatology 34:1200-1205, 2001Google Scholar
  18. 18.
    Brau N, Bini EJ, Shahidi A, Aytarnan A, Xiao P, Stancic S, Eng R, Brown ST, Paronetto F: Prevalence of Hepatitis C and Coinfection with HIV among United States Veterans in the New York City Metropolitan Area. Am J Gastroenterol 97:2071-2078, 2002Google Scholar
  19. 19.
    van Doornum GJJ, Hooykaas C, Cuypers MT, van der Linden MM, Coutinho RA: Prevalence of hepatitis C virus infections among heterosexuals with multiple partners. J Med Virol 35:22-27, 1991Google Scholar
  20. 20.
    Brettler DB, Mannucci PM, Gringeri A, Rasko JE, Forsberg AD, Rumi MG, Garsia RJ, Rickard KA, Colombo M: The low risk of hepatitis C virus transmission among sexual partners of hepatitis C-infected males: An international, multicenter study. Blood 80:540-543, 1992Google Scholar
  21. 21.
    Haley RW, Fischer RP: Commercial tattooing as a potentially important source of hepatitis C infection. Clinical epidemiology of 626 consecutive patients unaware of their hepatits C serologic status. Medicine (Baltimore) 80:134-151, 2001Google Scholar
  22. 22.
    Silverman AL, Sekhon JS, Saginaw SJ, Wiedbruk D, Balasubramaniam M, Gordon SC: Tattoo application is not associated with an increased risk for chronic viral hepatitis. Am J Gastroenterol 95:1312-1315, 2000Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Girish Mishra
    • 1
  • C. Sninsky
    • 1
  • Robert Roswell
    • 2
  • S. Fitzwilliam
    • 1
  • Kenneth C. Hyams
    • 3
  1. 1.University of Florida and Malcolm Randall VA Medical CenterFloridaUSA
  2. 2.Veterans Integrated Services Network 8FloridaUSA
  3. 3.VA Central OfficeWashington, DCUSA

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