Risk of Chronic Hepatitis C in a Metropolitan Indianapolis Region of Indiana

Introduction: Chronic hepatitis C infection (HCV) is increasing among Boone county residents and particularly among people who inject drugs and people with a history of incarceration. The individual risk of gender and age, the association of injection drug use (IDU) and incarceration on chronic HCV in the county were analyzed and recommendations for post diagnostic care were provided.

Materials and Methods: Hepatitis C data on confirmed cases was retrieved from the case investigations in Indiana National Electronic Disease Surveillance System (I-NEDSS) over a 5 years period –January 2009 through October 2014- among Boone county residents. Data on age, gender, history of IDU and incarceration were collected. SAS statistical software was used to analyze cases with complete information.

Results: Ninety-three out of 223 HCV cases had complete information entered into I-NEDSS. Two third of the cases were males (65.59%) and females (34.41%). Eighty-four of the cases were chronic HCV while 9 were acute. Eighty-five percent of the cases were either current or former IDU with heroin (52%) the most common drug used while 15% had never injected drugs. About 67% had spent over 24 hours in either jail or prison while 33% had never been incarcerated. There was a statistically significant relationship between chronic HCV and IDU (p = 0.02) and incarceration (p = 0.05). There was no statistically significant relationship between chronic HCV and age (p =0.35) and gender (p = 0.49).

Conclusions:  The rate of HCV infection in Boone County is increasing and IDU and incarceration were major risk factors associated with the disease. Age and gender were not were not identified as risk for developing HCV. A collaborative effort of the local public health department, law enforcement, and healthcare providers would be needed to address the growing problem of HCV. Increased awareness, education, and resources are important tools for prevention.