Surveillance of known hepatitis C antibody positive cases in Scotland: Results to 31 December 2013

Transcription

1 In Scotland Surveillance Report Surveillance of known hepatitis C antibody positive cases in Scotland: Results to 31 December 2013 Prepared by: Allan McLeod, Sharon Hutchinson and David Goldberg During January to December 2013, 1903 new cases of hepatitis C antibody-positivity were diagnosed. 1 See Table 1-6 and Figure 1 for more details on the cases of antibody-positivity to 31 December This figure compares with 2327 and 2009 for 2011 and 2012, respectively, and an average of 1716 in the years FIGURE 1: Persons in Scotland reported to be hepatitis C antibody positive by year and quarter of earliest positive specimen; to 31 December Annual No. of diagnoses Year of earliest positive specimen Quarter 1 Quarter 2 Quarter 3 Quarter 4 33% (623) resided in the Greater Glasgow and Clyde NHS board area, 12% (235) in Lothian, 11% (218) in Tayside, 10% (193) in Grampian, and 10% each in the other NHS board areas. 65% (1229) were male and 35% (662) female. Gender was not reported in fewer than 1% (12) of cases. 23% (432) are known to have injected drugs, representing 97% of those with a known risk factor. At the time of diagnosis, 19% (356) were aged years, 39% (749) were aged years, 24% (464) were aged years, 11% (213) were aged years and 4% (82) were aged over 60 years. Source of referral was known in 81% (1600) of cases. 33% (533) were diagnosed in the hospital setting (including infectious disease and gastroenterology units) and 30% (473) were diagnosed by general practitioners. 1. Data for 2013 are provisional and may be subject to change HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

2 19% (300) were known to have been diagnosed in specialist drug services, where dry blood spot testing for hepatitis C was introduced in A total of cases of hepatitis C antibody-positivity had been diagnosed as at 31 December % (23675) are male and 32% (11452) female; gender was not known in 1% (347) of cases. 55% (19644) are known to have injected drugs, representing 90% of those with a known risk factor, while 1% (362) of all cases were associated with the receipt of blood factor. 3 For the 5% (1711) who were placed in the Other category, risk information such as blood transfusion, sexual intercourse and tattoo were indicated. At the time of diagnosis, 33% (11533) were aged years, 36% (12765) were aged years, 18% (6298) were aged years, 6% (2191) were aged years and 3% (1222) were aged over 60 years. Age was not known in 1% (406) of cases. 40% (14076) of cases resided in the Greater Glasgow and Clyde NHS board area, 14% (4876) in Lothian, 11% (3816) in Grampian, 8% (2898) in Tayside, 7% (2486) in Lanarkshire, 7% (2305) in Ayrshire & Arran and 5% (1712) in Forth Valley. Source of referral was known in 80% (28351) of cases. Of these, 35% (9836) were diagnosed in the hospital setting (including infectious disease and gastroenterology units), 29% (8234) by general practitioners, 7% (2116) in genito-urinary medicine clinics, 7% (2064) in prisons, and 6% (1837) in specialist drug services. 39% (13828) were known to have had a genotype test for hepatitis C. Of these, 48% (6606) were genotype 1, 5% (697) were genotype 2, 46% (6413) were genotype 3, and fewer than 1% were genotype 4 (102) and genotype 5 or 6 (10). 16% (5522) of cases were known to have died, as at 31 December Of the cases not known to have died, 6% (1893) were aged years, 32% (9707) were aged years, 37% (10958) were aged years, 17% (4945) were aged years and 6% (1919) were aged over 60 years as at 31 December Age was not known in 1% (400) of cases. As at 31 December 2013, approximately 0.9% (27543/ ) of Scotland s population aged years had been diagnosed hepatitis C antibody-positive. Methods For details of methods see SCIEH Weekly Report vol.33 no.99/29 (at ewr/redirect.aspx?id=14870). In collaboration with the Scottish National Blood Transfusion Service (SNBTS), records of hepatitis C antibody positive cases diagnosed through their screening programme have been added to the national surveillance database. 2. Diagnoses made on dry blood spot samples were confirmed at NHS testing laboratories 3. Persons who acquired their hepatitis C infection In Scotland through blood factor will have become infected prior to the time, in the mid 1980 s, when heat treatment was introduced to prevent blood borne infection. (See Tables 2 and 3) HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

3 Principal Investigators The following are the principal investigators: Dr Celia Aitken 2 ; Mr Glenn Codere 3 ; Prof David Goldberg 3 ; Dr Rory Gunson 2 ; Dr Sharon Hutchinson 3 ; Dr Lisa Jarvis 8 ; Dr Paul McIntyre 7 ; Mr Allan McLeod 3 ; Dr Pamela Molyneaux 4 ; Dr Kirsty Roy 3 ; Dr Christian Schnier 3, Ms Louise Shaw 3 and Dr Kate Templeton 1. Co-workers We are very grateful to the following staff who have put an enormous amount of effort into collecting and collating the data: Mr Keith Appleyard 7 ; Ms Lesley Cairns 3, Mr Ian Collacot 4 ; Ms Joan Findlay 4 ; Ms Liz McCann 5 ; Ms Hazel Paterson 2 ; Ms Hannah Robertson 6 ; Ms Dorothy Ross 7 ; Ms Morag Taylor 7 ; Ms Carol Thompson 1 ; Dr Andrew Todd 5 and Mr John Wallace 7. Support The work is supported by the Scottish Government Health and Wellbeing Directorate. Locations 1. East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh 2. West of Scotland Specialist Virology Centre, Gartnavel General Hospital, Glasgow 3. Health Protection Scotland, Meridian Court, Glasgow 4. Dept of Medical Microbiology, University Medical School, Foresterhill, Aberdeen 5. Lanarkshire HIV/AIDS and Hepatitis Centre, Monklands Hospital, NHS Lanarkshire 6. Microbiology Department, Monklands District General Hospital, NHS Lanarkshire 7. Department of Medical Microbiology, Ninewells Hospital & Medical School, Dundee 8. SNBTS, National Microbial Reference Unit, Ellen s Glens Road, Edinburgh HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

4 TABLE 1: Persons in Scotland reported to be hepatitis C antibody positive; Number and rate/ population 1 by NHS board and year of earliest positive specimen to 31 December NHS Board Total 2 AA Number Rate/ BR Number Rate/ DG Number Rate/ Fife Number Rate/ FV Number Rate/ GR Number Rate/ GG&C Number Rate/ HG Number Rate/ LN Number Rate/ LO Number Rate/ TY Number Rate/ Number Scotland Rate/ Based on population at 30 June of indicated year 2. Includes persons diagnosed prior to Includes persons diagnosed in Island Boards (NHS Orkney, NHS Shetland and NHS Western Isles) NHS board refers to the persons NHS board of residence, or where this is not known, the NHS board of source of referral HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

5 TABLE 2: Persons in Scotland reported to be hepatitis C antibody positive by NHS board and risk group; to 31 December 2013 NHS Board IDU Blood Factor Other Not Known Total AA BR D&G Fife FV GR GG&C HG LN LO TY All Islands Scotland Notes: Other includes sexual contact, tattoo/body piercing, needlestick, bite, blood spillage, blood transfusion, or perinatal risk NHS board refers to the persons NHS board of residence, or where this is not known, the NHS board of source of referral All Islands refers to NHS Orkney, NHS Shetland and NHS Western Isles TABLE 3: Persons in Scotland reported to be hepatitis C antibody positive by gender, risk group and earliest positive specimen; to 31 December 2013 Total Gender Risk Prior Group to 2003 IDU Other Female Not known Total IDU Other Male Not known Total IDU Other All Not known Total All includes those for whom gender is not known Other includes sexual contact, tattoo/body piercing, needlestick, bite, blood spillage, blood products, blood transfusion, or perinatal risk Persons who acquired their hepatitis C infection In Scotland through blood factor will have become infected prior to the time, in the mid 1980 s, when heat treatment was introduced to prevent blood borne infection HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

6 TABLE 4: Persons in Scotland reported to be hepatitis C antibody positive, by age group at time of earliest positive specimen and year of earliest positive specimen; to 31 December 2013 Age Group at diagnosis Prior to Total Under Total Includes those for whom age at diagnosis is not known Earliest positive specimens with specimen dates prior to 1991 were identified through retrospective testing of stored sera Children aged under 2 years at the time of diagnosis were included if they had two consecutive PCR positive tests TABLE 5: Persons in Scotland reported to be hepatitis C antibody positive by source of referral and year of earliest positive specimen; to 31 December 2013 Source of Referral Prior to Total GP Hospital Patients GUM Clinic Prison Drug Service Other Not Known Total Earliest positive specimens with specimen dates prior to 1991 were identified through retrospective testing of stored sera Other includes those diagnosed in Specialist Drug Services, Counselling Clinics, Renal Units, Haemophilia Clinics, Occupational Health and Scottish National Blood Transfusion Service donor screening. HPS WEEKLY REPORT Volume 48 No.2014/18 8 May

7 TABLE 6: Persons in Scotland reported to be hepatitis C antibody positive and not known to be dead by NHS board and current age group; to 31 December 2013 NHS Board Total 1 AA Number % 7.4% 40.4% 32.7% 13.5% 4.1% BR Number % 8.4% 30.0% 30.4% 16.1% 11.7% D&G Number % 10.4% 43.2% 24.4% 10.4% 7.9% FF Number % 8.6% 41.7% 27.3% 16.2% 5.7% FV Number % 10.8% 36.8% 30.5% 14.0% 6.3% GR Number % 7.1% 43.2% 30.3% 12.7% 5.7% GG&C Number % 3.2% 29.6% 44.3% 16.1% 4.8% HG Number % 6.7% 27.9% 29.9% 23.5% 10.7% LN Number % 5.6% 35.2% 36.4% 14.9% 6.4% LO Number % 6.5% 24.1% 33.7% 23.2% 11.4% TY Number % 14.1% 28.4% 31.4% 17.2% 6.1% All Islands Number % 50.0% 16.3% 23.9% 31.5% 17.4% Scotland Number % 6.3% 32.4% 36.6% 16.5% 6.4% 1. Includes those under the age of 20 and those for whom age was not known NHS board refers to the persons NHS board of residence, or where this is not known, the NHS board of source of referral All Islands refers to NHS Orkney, NHS Shetland and NHS Western Isles The last hepatitis c Surveillance Report was in Issue 13/43 The next hepatitis c Surveillance Report will be in Issue 14/42 HPS WEEKLY REPORT Volume 48 No.2014/18 8 May