Hepatitis C Surveillance
Hepatitis C virus (HCV) infection is the most common chronic blood-borne infection in the United States. This virus usually is transmitted primarily through large or repeated percutaneous exposures to blood – for example, through sharing of equipment between injection drug users. Approximately 75% - 85% of persons with acute HCV infection will develop chronic HCV infection. An estimated 3.5 million persons in the U.S have chronic HCV infection. Most HCV-infected people are asymptomatic and may not be aware of their infection. They are a source of HCV to others and are at risk for chronic liver disease. Since the introduction of highly effective HCV protease inhibitor therapies in 2011, treatment options for hepatitis C have been rapidly progressing and new drugs continue to become available.
Current Surveillance Practices
On May 1, 2002, the Northern Nevada Public Health (NNPH) (WCHD) Communicable Disease (CD) Program began conducting surveillance for hepatitis C virus (HCV) in Washoe County.
The objectives of this surveillance are:
- Identify new cases
- Estimate disease burden
- Characterize risk factors of infected patients
- Identify infected person who can be counseled and referred for medical follow-up or immunization
- Provide healthcare providers and the public with local data to support hepatitis C testing, treatment, and prevention services
Currently WCHD actively investigates all reports of acute hepatitis C. Cases are interviewed by the a member of the Communicable Disease Program to learn their signs and symptoms, identify potential sources of exposure, identify contacts and refer them for testing, and provide recommendations for disease prevention and control. Due to resource constraints, cases of chronic hepatitis C are not routinely interviewed by public health. However, WCHD maintains laboratory-based surveillance for all reports of HCV, both acute and chronic. There data are made available each year in WCHD's Annual Communicable Disease Report.
Enhanced HCV Surveillance, 2002 - 2012
Northern Nevada Public Health (NNPH) (WCHD) conducted enhanced surveillance for hepatitis C virus (HCV) infections between May 2002 and December 2012. Data elements gathered during this enhanced surveillance period included demographics, reasons for testing, other hepatitis markers, genotypes, pregnancy status, cirrhosis, cancer, outcome, past and current risk factors, and insurance status. Enhanced surveillance for HCV was discontinued beginning in 2013 because the epidemiological profile from 2002 through 2012 had not demonstrated any significant changes and personnel resources were restricted. A summary of the results of this enhanced surveillance project are available at WCHD's Annual Communicable Disease Report.
Disease Reporting
Hepatitis C virus (HCV) has been a reportable condition in Nevada since 1992 per Nevada Administrative Code (NAC 441A). Nevada healthcare providers and laboratories are required to report all HCV infections (both acute and chronic) to their local health jurisdiction. Providers in Washoe County can report HCV infections to Northern Nevada Public Health (NNPH) (WCHD) using the Nevada Communicable Disease Report Form.
HCV Data and Reports
- Current HCV data for Washoe County
- WCHD's Annual Communicable Disease Report
- Northern Nevada Public Health (NNPH)’s Enhanced HCV Surveillance, 2002 – 2012
- Recent HCV Editions of Northern Nevada Public Health (NNPH)’s Epi News
- United States Viral Hepatitis Surveillance
Provider Guidance and Resources
- HCV Testing Guidance
- Testing for HCV infection: An update of guidance for clinicians and laboratorians (MMWR Report)
- Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infection (1 page)
- Interpretation of Results of Tests for Hepatitis C Virus (HCV) Infection and Further Actions (1 page)
- Persons for Whom HCV Testing Is Recommended
- Viral Hepatitis Serology Training (online training video by CDC)
- HCV Treatment Guidance
- HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C - Infectious Diseases Society of America (IDSA) and American Association for the Study of Liver Diseases (AASLD), in collaboration with the International Antiviral Society–USA (IAS–USA).
- Other Major Guidelines
- Testing for HCV infection: An update of guidance for clinicians and laboratorians (MMWR Report)
- Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965 (MMWR Report)
- Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease (MMWR Report)
Patient Education Materials
- Hepatitis C Questions and Answers for the Public
- Hepatitis C Questions and Answers for Health Professionals
- Patient Education Fact Sheets (in English and Spanish) including
- Hepatitis C - General Information
- Hepatitis C - What to Expect When Getting Tested
- Hepatitis C - Information on Testing & Diagnosis
- Hepatitis C - Why Baby Boomers Should Get Tested
- Viral Hepatitis – Information for Gay and Bisexual Men
- Hepatitis C and Incarceration
- Hepatitis C and Injection Drug Use