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NEWLY ACQUIRED HEPATITIS C VIRUS INFECTION IN BRITISH COLUMBIA, 1992-2005
ME Kuo1,2, P Janssen1, B Sobolev1, V Moravan3, J Buxton1,2, M Krajden2
1Department of Health Care and Epidemiology, Faculty of Medicine; University of British Columbia, 5804 Fairview Ave, Vancouver, Canada; 2British Columbia Centre for Disease Control, 655 12th Ave W., Vancouver, Canada; 3BC Cancer Agency, Statistician, 801 - 686 West Broadway, Vancouver, Canada
We estimated annual rates of newly acquired hepatitis C virus (HCV) infection in British Columbia (BC), Canada, using BC Centre for Disease Control (BCCDC) laboratory data from 1992-2005. BC’s centralized HCV laboratory testing and database enable identification of positive HCV cases among those with a prior negative test. Annual incidence estimates were constructed and Poisson regression was used to evaluate the effects of sex, age, year, and place of residence on disease incidence.
BC’s incident HCV cases per 100,000 persons have been declining since a peak in 2002 (8.1 in 2002 to 5.6 in 2005). Highest rates were consistently among 20-29 and 30-39 year-olds (13.6 and 11.3/100,000, respectively, in 2005). Male rates were higher than females’ across each year and age category, except 10-19 year-olds. Teen females had a 4-fold higher rate than teen males (5.0 vs. 1.3/100,000). Age and gender-based differences in both HCV risk behaviors and testing patterns may account for some of the variance.
A centralized laboratory database system provides an effective means of identifying newly acquired HCV cases and estimating disease incidence and trends for the province of BC. While males have long been known to have higher rates of IDU involvement and HCV acquisition as compared to females, this study highlights that recent incident HCV rates, among both males and females are significantly higher than previously published estimates. Rates among teens have been consistently low, from 4.4 to 1.3/100,000 in recent years, but incident cases among teens are mostly being found in females with important implications for the development of prevention strategies.
This retrospective characterization of incident HCV, combined with ongoing, timely surveillance and depiction of rate trends, can contribute to the development and evaluation of highly focused strategies for prevention of HCV transmission.