Bureau of Infectious Disease and Laboratory Sciences Hepatitis C Virus Infection 2015 Surveillance Report

Transcription

1 Hepatitis C Virus Infection 2015 Surveillance Report Massachusetts State Public Health Laboratory 305 South Street Jamaica Plain, MA Tel: (617) Fax: (617) To speak to the on call epidemiologist Tel: (617) Requests for additional data surveillance data request.html Acknowledgments This report was prepared by the following MDPH staff: Anthony Osinski, MPH Shauna Onofrey, MPH Susan Soliva, MPH Daniel Church, MPH Suggested citation: Massachusetts Department of Public Health,. Hepatitis C Virus Infection 2015 Surveillance Report. Published March Accessed [date].

2 Massachusetts Department of Public Health Bureau of Infectious Disease Hepatitis C Virus (HCV) Infection Data Summary Table of Contents Number of HCV Cases by Year... 1 Number and Rate of HCV Cases by Year and Age Group.. 3 Number and Rate of Acute HCV Cases by Year.. 5 Number of HCV Cases by Race and Year. 7 Number of HCV Cases by Hispanic Ethnicity and Year... 9 Number of HCV Cases by Risk Factor and Year.. 11 Number of HCV Cases by Age and Gender.. 13 Number of HCV Cases Among Persons Aged by Year 14 Number of HCV Cases Among Persons Born Between Number and Rate of HCV Cases by Year and Age Group.. 16 Number of HCV Cases Aged by Gender and Year Number of HCV Cases by County and Year.. 19 Rate of HCV Cases by County and Year 20 Number of HCV Cases by County, Gender, and Year. 21 Number of HCV Cases Aged by County and Year 23 Rate of HCV Cases Aged by County and Year.. 24 Technical Notes.. 25

3 Massachusetts Department of Public Health 1 Number of Confirmed and Probable Past or Present and Acute HCV Cases Reported in MA by Year, CONFIRMED PROBABLE TOTAL CASES

4 2 Massachusetts Department of Public Health Number of Confirmed and Probable HCV Cases Reported in MA by Year, Number of cases Year Disease Status CONFIRMED PROBABLE N=67642

5 Massachusetts Department of Public Health 3 Number and Rate per 100,000 Population of Confirmed and Probable HCV Cases Reported in MA by Year and Age Group in Years, N Rate N Rate N Rate N Rate N Rate N Rate N Rate N Rate A) B) C) D) E) F) G) Missing values excluded. Rate denominators are based on 2010 Census data.

6 Massachusetts Department of Public Health 4 Percent of Confirmed and Probable HCV Cases Reported in MA by Age Group in Years, % Percent of Confirmed and Probable HCV Cases Reported in MA by Age Group in Years, % % % % % % % % % % % % % % % % % % Rate denominators are based on 2010 Census data. The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties. 24.1% % N= cases with missing age were excluded from analysis N= cases with missing age were excluded from analysis

7 Massachusetts Department of Public Health 5 Number and Rate per 100,000 Population of Confirmed Acute HCV Cases Reported in MA by Year, N Rate N Rate N Rate N Rate N Rate N Rate N Rate N Rate STATEWIDE TOTAL Rate denominators are based on 2010 Census data.

8 6 Massachusetts Department of Public Health Number of Confirmed Acute HCV Cases Reported in MA by Year, Number of cases Year N=1596

9 Massachusetts Department of Public Health 7 Number of Confirmed and Probable HCV Cases Reported in MA by Race and Year, N % N % N % N % N % N % N % N % A) American Indian/Alaskan Native B) Asian C) Black D) White E) Other F) Unknown

10 Massachusetts Department of Public Health 8 Percent of Confirmed and Probable HCV Cases Reported in MA by Race, 2007 Percent of Confirmed and Probable HCV Cases Reported White in MA by Race, % White 45.9% White 48.6% AIAN 0.3% Black 6.1% AIAN 0.3% Black 6.1% Asian 1.5% Asian 1.5% Other 6.8% AIAN 0.2% Black 5.4% Asian 1.8% Other 6.8% Other 5.4% Unknown 39.4% Unknown 39.4% N=7 Unknown 38.7% N=9141 N=8760

11 Massachusetts Department of Public Health 9 Number of Confirmed and Probable HCV Cases Reported in MA by Hispanic Ethnicity and Year, N % N % N % N % N % N % N % N % A) Hispanic B) Not Hispanic C) Unknown

12 10 Massachusetts Department of Public Health Percent of Confirmed and Probable HCV Cases Reported in MA by Hispanic Ethnicity, Not Hispanic 35.9% Hispanic 8.5% Unknown 55.6% N=67642

13 Massachusetts Department of Public Health 11 Number of Confirmed and Probable HCV Cases Reported in MA by Risk Factor and Year, N % N % N % N % N % N % N % N % A) Injected Drugs Ever B) Other risk history, excluding IDU C) No or unknown history reported D) No response Risks included in 'Other' category include: receiving blood products prior to June 1992, receiving an organ transplant prior to 1992, receiving clotting factor concentrates produced prior to 1987, ever being on long-term hemodialysis, ever being a sexual contact of a confirmed or suspected HCV case, ever being a household contact of a confirmed or suspected HCV case, and ever being employed in a medical or dental field involving direct contact with human blood. Note that 'C) No or unknown history reported' indicates that a case report form was received for the case, with 'No' or 'Unknown' marked for all relevant questions in the risk history. 'D) No response' indicates that no case report form was received for the case.

14 Massachusetts Department of Public Health 12 Percent of Confirmed and Probable HCV Cases Reported in MA by Risk Factor, Percent of Confirmed Acute HCV Cases Reported in MA by Risk Factor, Injected Drugs 28.2% No response 40.3% No response 40.3% Injected Drugs 28.2% Injected Drugs 60.4% Other risk history 3.0% Other risk history 3.0% No/unknown history 28.5% No response 2.8% No/unknown history 28.5% Other risk history 7.0% No/unknown history 29.8% N=6 N=67642 N=1596

15 Massachusetts Department of Public Health 13 Number of cases Number of Confirmed and Probable HCV Cases Reported in MA by Age and Gender GENDER Age (Years) FEMALE MALE N= cases with missing age and/or gender were excluded from analysis Number of Confirmed and Probable HCV Cases Reported in MA by Age and Gender Number of cases GENDER Age (Years) FEMALE MALE N= cases with missing age and/or gender were excluded from analysis

16 Massachusetts Department of Public Health Number of Confirmed and Probable HCV Cases Among Persons Aged Years Reported in MA by Year, Frequency Year Disease Status CONFIRMED PROBABLE N=16988

17 15 Massachusetts Department of Public Health Number of Confirmed and Probable HCV Cases Among Persons Born Between 1945 and 1965 Reported in MA by Year, Frequency Year Disease Status CONFIRMED PROBABLE N=28027

18 Massachusetts Department of Public Health 16 Number and Rate per 100,000 Population of Confirmed and Probable HCV Cases Reported in MA by Year and Age Group, N Rate N Rate N Rate N Rate N Rate N Rate N Rate N Rate A) Years B) All other age groups Missing values excluded. Rate denominators are based on 2010 Census data.

19 Massachusetts Department of Public Health 17 Number of Confirmed and Probable HCV Cases Aged Years Reported in MA by Gender and Year, FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE N % N % N % N % N % N % N % N % MA % % % % % % % % FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE N % N % N % N % N % N % N % N % MA % % % % % % % % Missing values excluded.

20 18 Massachusetts Department of Public Health Percent of Confirmed and Probable HCV Cases Aged Years Reported in MA by Gender and Year, Percent Female (%) Year N=15259

21 Massachusetts Department of Public Health 19 Number of Confirmed and Probable HCV Cases Reported in MA by County and Year, BERKSHIRE COUNTY BRISTOL COUNTY CAPE AND ISLANDS ESSEX COUNTY FRANKLIN COUNTY HAMPDEN COUNTY HAMPSHIRE COUNTY MIDDLESEX COUNTY NORFOLK COUNTY PLYMOUTH COUNTY SUFFOLK COUNTY WORCESTER COUNTY UNKNOWN COUNTY The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

22 Massachusetts Department of Public Health 20 Rate per 100,000 Population of Confirmed and Probable HCV Cases Reported in MA by County and Year, ALL MASSACHUSETTS BERKSHIRE COUNTY BRISTOL COUNTY CAPE AND ISLANDS ESSEX COUNTY FRANKLIN COUNTY HAMPDEN COUNTY HAMPSHIRE COUNTY MIDDLESEX COUNTY NORFOLK COUNTY PLYMOUTH COUNTY SUFFOLK COUNTY WORCESTER COUNTY Rate denominators are based on 2010 Census data. The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

23 Massachusetts Department of Public Health 21 Number of Confirmed and Probable HCV Cases Reported in MA by County, Gender, and Year, FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE N % N % N % N % N % N % N % N % ALL MASSACHUSETTS % % % % % % % % BERKSHIRE COUNTY 48 33% 97 67% 47 34% 90 66% 49 36% 89 64% 67 41% 96 59% BRISTOL COUNTY % % % % % % % % CAPE AND ISLANDS % % % % % % % % ESSEX COUNTY % % % % % % % % FRANKLIN COUNTY 28 35% 53 65% 21 28% 53 72% 24 39% 38 61% 25 41% 36 59% HAMPDEN COUNTY % % % % % % % % HAMPSHIRE COUNTY 44 40% 67 60% 25 29% 61 71% 36 40% 55 60% 40 42% 56 58% MIDDLESEX COUNTY % % % % % % % % NORFOLK COUNTY % % % % % % % % PLYMOUTH COUNTY % % % % % % % % SUFFOLK COUNTY % % % % % % % % WORCESTER COUNTY % % % % % % % % Missing values excluded. The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

24 Massachusetts Department of Public Health 22 Number of Confirmed and Probable HCV Cases Reported in MA by County, Gender, and Year, FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE N % N % N % N % N % N % N % N % ALL MASSACHUSETTS % % % % % % % % BERKSHIRE COUNTY 58 48% 63 52% 65 43% 85 57% 53 44% 68 56% 65 42% 89 58% BRISTOL COUNTY % % % % % % % % CAPE AND ISLANDS % % % % % % % % ESSEX COUNTY % % % % % % % % FRANKLIN COUNTY 20 34% 38 66% 32 46% 38 54% 34 37% 58 63% 42 45% 51 55% HAMPDEN COUNTY % % % % % % % % HAMPSHIRE COUNTY 32 33% 65 67% 37 34% 73 66% 46 40% 68 60% 43 37% 73 63% MIDDLESEX COUNTY % % % % % % % % NORFOLK COUNTY % % % % % % % % PLYMOUTH COUNTY % % % % % % % % SUFFOLK COUNTY % % % % % % % % WORCESTER COUNTY % % % % % % % % Missing values excluded. The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

25 Massachusetts Department of Public Health 23 Number of Confirmed and Probable HCV Cases Aged Years Reported in MA by County and Year, ALL MASSACHUSETTS BERKSHIRE COUNTY BRISTOL COUNTY CAPE AND ISLANDS ESSEX COUNTY FRANKLIN COUNTY HAMPDEN COUNTY HAMPSHIRE COUNTY MIDDLESEX COUNTY NORFOLK COUNTY PLYMOUTH COUNTY SUFFOLK COUNTY WORCESTER COUNTY The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

26 Massachusetts Department of Public Health 24 Rate per 100,000 Population of Confirmed and Probable HCV Cases Aged Years Reported in MA by County and Year, ALL MASSACHUSETTS BERKSHIRE COUNTY BRISTOL COUNTY CAPE AND ISLANDS ESSEX COUNTY FRANKLIN COUNTY HAMPDEN COUNTY HAMPSHIRE COUNTY MIDDLESEX COUNTY NORFOLK COUNTY PLYMOUTH COUNTY SUFFOLK COUNTY WORCESTER COUNTY Rate denominators are based on 2010 Census data. The Cape and Islands is comprised of Barnstable, Dukes, and Nantucket Counties.

27 25 Massachusetts Department of Public Health Bureau of Infectious Disease Hepatitis C Virus Infection Data Summary Case classification: Past or Present HCV Infection Newly Reported to MDPH Confirmed: One or more of the following criteria (except in persons less than 18 months of age, for whom only criteria 3 would meet the case classification criteria): 1. Antibodies to hepatitis C virus (anti-hcv) screening-testpositive with a signal to cut-off ratio predictive of a true positive as determined for the particular assay as defined by CDC, OR 2. Hepatitis C Virus Recombinant Immunoblot Assay (HCV RIBA) positive, OR 3. Nucleic Acid Test (NAT) for HCV RNA positive (including qualitative, quantitative, or genotype) Probable: 1. Rapid HCV antibody positive test, OR 2. Anti-HCV screening-test-positive that has not been verified by a more specific assay or has unknown signal to cut-off ratio (regardless of ALT results and acute hepatitis C status) AND, if done meets the following two criteria : 1. IgM anti-hav negative AND 2. IgM anti-hbv negative * - A documented negative HCV antibody laboratory result followed within 6 months by a positive test result (as described above) does NOT require an acute clinical presentation to meet the confirmed case definition - From , cases meeting the acute case definition but missing a negative HAV & HBV result were classified as Suspect. The case definition change in 2013 eliminated this requirement. Suspect: 1. A documented negative HCV antibody laboratory test result followed within 6-12 months by a positive test result (as described above) does NOT require an acute clinical presentation to meet the suspect case definition. 2. Low level viremia (<100,000 IU/mL) not known to have chronic HCV Case classification: Acute HCV Infection Confirmed: Clinically compatible presentation* not known to have chronic HCV with 1 or more of the following: a. Anti-HCV screening-test-positive with a signal to cut-off ratio predictive of a true positive as determined for the particular assay as defined by CDC, OR b. HCV RIBA positive, OR c. NAT for HCV RNA positive (including qualitative, quantitative, or genotype) Note that the year into which a case is categorized is based upon the case s Event Date, which can be calculated from the following case characteristics, in decreasing order of specificity, dependent on availability of information: symptom onset date, specimen collection date, diagnosis date, or case creation date.

28 26 Massachusetts Department of Public Health Bureau of Infectious Disease Hepatitis C Virus Infection Data Summary References: 1. "Hepatitis C, past or Present & Hepatitis C, acute Case Definitions." National Notifiable Diseases Surveillance System (NNDSS). Centers for Disease Control and Prevention, 6 May Massachusetts Virtual Epidemiologic Network (MAVEN), Bureau of Infectious Disease, Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130