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

Holly Hagan, Nadine Snyder, Eileen Hough, Tianji Yu, Shelly McKeirnan, Janice Boase, Jeffrey Duchin

Research output: Contribution to journalArticlepeer-review


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 hepatitis B and C reported to the health 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 had acute hepatitis B. The upper 95% confidence limit for case-reporting of hepatitis C in the cohort was 5.7%, and for hepatitis B, it was 7.5%. In this study, reporting of acute hepatitis in IDUs was extremely low, raising questions regarding the use of community surveillance data to estimate underlying incidence in that population group.

Original languageEnglish (US)
Pages (from-to)579-585
Number of pages7
JournalJournal of Urban Health
Issue number4
StatePublished - Dec 2002


  • Hepatitis B
  • Hepatitis C
  • Substance use
  • Surveillance

ASJC Scopus subject areas

  • Health(social science)
  • Urban Studies
  • Public Health, Environmental and Occupational Health


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