Hepatitis C

Study Suggests Rates of Hep C Infection Are Underestimated

Rates of hepatitis C virus (HCV) infection in the United States have been “grossly underascertained” by surveillance conducted by the CDC, according to a new report, with factors like incomplete clinician reporting, limitations of diagnostic testing, and imperfect data capture to blame.

In order to validate estimates of the incidence of HCV infection, researchers conducted a review of medical records from 2 hospitals and a state correctional healthcare system in Massachusetts.
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Overall, researchers identified 183 patients who had been diagnosed with acute HCV infection between 2001 and 2011. Of these, 81.4% were reported to the Massachusetts Department of Public Health (MDPH), but less than 1% were reported to the CDC, and most did not match national case definitions for acute infection.

The authors noted, however, that because of differences in resources and surveillance, these findings may not reflect the current state of other clinical settings.

“Discordance in clinical and surveillance classification was often related to missing clinical or laboratory data at the MDPH as well as restrictive definitions, including requirements for negative hepatitis A and B laboratory results,” they concluded.

“These findings may have implications for national estimates of the incidence of HCV infection.”

—Michael Potts

Reference:

1. Onofrey S, Aneja J, Haney GA, et al. Underascertainment of acute hepatitis c virus infections in the u.s. surveillance system: a case series and chart review. Ann Intern Med. June 2015 [epub ahead of print]. doi:10.7326/M14-2939.