Hepatitis C enhanced surveillance: results from a southeastern Sydney pilot program

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• Hepatitis C virus (HCV) infection can lead to severe liver disease, including cirrhosis and cancer.
• Early detection of new HCV infections is crucial for public health interventions.
• Routine laboratory surveillance is insufficient to distinguish between new and chronic HCV cases.

Purpose of the Study:

• To pilot an enhanced surveillance system to identify newly acquired HCV infections in southeastern Sydney.
• To determine the likely transmission routes for newly identified HCV cases.

Main Methods:

• A pilot program reviewed HCV notifications in southeastern Sydney residents between July and December 2012.
• Demographic data and previous laboratory results were collected from electronic medical records.
• Enhanced surveillance forms were sent to referring doctors to gather clinical and historical data.

Main Results:

• Six newly acquired HCV cases were identified (8%), a higher rate than routine surveillance (1-3%).
• Sexual transmission was the likely route for four cases; injecting drug use for two.
• The status of 64% of cases could not be determined, and 28% were not newly acquired.

Conclusions:

• Enhanced surveillance improved the identification of new HCV infections.
• The enhanced surveillance method was labor-intensive and had limitations in determining case status.
• Alternative strategies are needed to effectively identify new HCV infections for public health benefits.