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Risk Factors for Acute Non-A, Non-B Hepatitis in the United States and Association With Hepatitis C Virus Infection

Miriam J. Alter, PhD; Stephen C. Hadler, MD; Franklyn N. Judson, MD; Allene Mares, MPH; W. James Alexander, MD, MPH; Pin Ya Hu, MD; Joan K. Miller; Linda A. Moyer; Howard A. Fields, PhD; Daniel W. Bradley, PhD; Harold S. Margolis, MD
JAMA. 1990;264(17):2231-2235. doi:10.1001/jama.1990.03450170079026.
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The Centers for Disease Control conducted intensive surveillance for acute non-A, non-B hepatitis in four sentinel counties over a 7-year period. Testing for antibody to hepatitis C virus was performed with the newly developed enzyme immunoassay. The incidence of non-A, non-B hepatitis remained relatively stable (average, 7.1 cases per 100 000), but there were significant changes in disease transmission patterns. The proportion of patients with a history of blood transfusion declined from 17% to 6%, but the proportion with a history of parenteral drug use increased from 21% to 42%. The proportion of patients with histories of sexual exposure (6%), household exposure (3%), occupational exposure to blood (2%), or hemodialysis (0.6%) did not change over time. Antibody to hepatitis C virus was found in 45% of patients within 6 weeks of onset of illness and in 68% of patients followed up for at least 6 months. Patients with no history of transfusions were just as likely to be positive for antibody to hepatitis C virus as patients with transfusion-associated hepatitis, indicating that hepatitis C virus is the major causative agent of all non-A, non-B hepatitis in the United States.

(JAMA. 1990;264:2231-2235)


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