Hepatitis C

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It is estimated that 3.9 million Americans have been infected with the hepatitis C virus, and 2.7 million of these individuals are chronically infected. Chronically infected persons are at increased risk for death from liver disease.

The Indiana Communicable Disease Reporting Rule for Physicians, Hospitals, and Laboratories requires physicians and hospitals to report acute cases of hepatitis C. Laboratories must report positive antibody to hepatitis C (anti-HCV) by Enzyme Immunoassay (EIA), Recombinant Immunoblot Assay (RIBA), and RNA tests. In 2001, there were 5,512 newly identified persons reported as testing positive for at least one of the reportable tests by laboratories. Of these, 2,735 (50%) reported positive results from the EIA test, but without a specific confirmatory test. Using only a RIBA test identified 85 (1.5%) reported individuals, and 873 (15%) persons were identified with only RNA testing. An EIA and RIBA confirmatory test was performed on 1,287 (23%) of the reported individuals, an EIA and RNA test was performed in 522 (9%) of persons reported, and a RIBA and PCR test was performed on 10 (<1%) of the reports received. The rates were highest for persons ages 40-49 (269/100,000 population), followed by those ages 30-39 (124/100,000 population). Because most reports of hepatitis C are originated by the laboratory and laboratories may not have access to all of the demographic information that physicians and hospitals report, some demographic information is unavailable.

• discrete onset of illness; and 
• jaundice or serum aminotransferase levels greater than 7 times the upper limit; and 
• serological tests negative for hepatitis A and hepatitis B; and 
• antibody to hepatitis C virus verified by an additional more specific assay [Recombinant Immunoblot Assay (RIBA) or RNA tests].

Estimated numbers of newly acquired hepatitis C infections in the U.S. for 2001 were 25,000, compared to 35,000 for 2000. There are no estimates of newly acquired infection specific to Indiana. Reporting of acute hepatitis C is unreliable for monitoring incidence of newly acquired infection, because no serologic marker is available to diagnose acute hepatitis C, and persons testing positive for hepatitis C antibody may be reported as acute hepatitis C when the case definition has not been met. In addition, approximately 80% of persons newly infected have no signs or symptoms of infection, are not seen by a physician, and do not have laboratory testing.

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