Journal of Urban Health

, Volume 79, Issue 4, pp 579–585 | Cite as

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

  • Holly Hagan
  • Nadine Snyder
  • Eillen Hough
  • Tianji Yu
  • Shelly McKeirnan
  • Janice Boase
  • Jeffrey Duchin
Various Topics


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 


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Copyright information

© The New York Academy of Medicine 2002

Authors and Affiliations

  • Holly Hagan
    • 3
    • 2
    • 1
  • Nadine Snyder
    • 2
  • Eillen Hough
    • 2
  • Tianji Yu
    • 2
  • Shelly McKeirnan
    • 2
  • Janice Boase
    • 2
  • Jeffrey Duchin
    • 2
    • 3
  1. 1.Center for Drug Use and HIV ResearchNational Development and Research InstitutesNew York
  2. 2.Public Health-Seattle and King CountySeattle
  3. 3.University of WashingtonSeattle

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