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Updated: Sep 20, 2025
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Enhancing Surveillance Protocols for Acute Hepatitis C Virus Infection, Utah, 2014-2019
Nathaniel M Lewis1,2,3, Jeff Eason2, Bree Barbeau2
1Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Insights
Utah enhanced its hepatitis C virus (HCV) surveillance, leading to a 14-fold increase in detected acute cases. Electronic and manual reporting of negative test results significantly improved case identification.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Viral Hepatitis Surveillance
Background:
- Acute hepatitis C virus (HCV) infections pose a significant public health challenge.
- Effective surveillance is crucial for understanding and controlling HCV transmission.
- Previous surveillance methods in Utah may have underestimated the true incidence of acute HCV.
Purpose of the Study:
- To describe the enhancements made to the Utah Department of Health's (UDOH) acute HCV surveillance program between 2014 and 2019.
- To evaluate the impact of these enhancements on the detection of acute HCV infections.
- To identify challenges and practical considerations for improving HCV surveillance.
Main Methods:
- Mandatory electronic reporting of negative HCV and liver function test results.
- Engagement with blood/plasma donation centers and syringe exchange programs for manual reporting.
- Implementation of training for case investigations.
- Analysis of case detection data from 2012 to 2019.
Main Results:
- The number of detected acute HCV cases increased 14-fold, from 9 in 2012 to 127 in 2019.
- In 2019, 55% of cases were identified through electronically reported negative HCV tests (recent seroconversions).
- Manual reporting and positive test results with elevated liver function tests also contributed significantly to case detection.
Conclusions:
- Enhancements to HCV surveillance, particularly electronic reporting of negative tests, dramatically increased case detection.
- Collaboration with donation centers and syringe exchange programs is vital for comprehensive surveillance.
- Utah's experience offers valuable insights for improving acute HCV surveillance programs elsewhere.
Abstract:
During 2014-2019, the Utah Department of Health (UDOH) enhanced its surveillance program for acute hepatitis C virus (HCV) infections by mandating electronic reporting of negative HCV test results in 2015 and liver function test results in 2016. UDOH also engaged with blood and plasma donation centers beginning in 2014 and syringe exchange programs in 2018 to encourage manual reporting of negative HCV test results from facilities without electronic reporting capabilities. UDOH hepatitis surveillance staff also provided training for case investigations in 2017. The number of cases detected increased 14-fold, from 9 during 2012 to 127 during 2019. In 2019, of 127 cases, 55% (n = 70) were detected through negative HCV test results reported electronically before positive test results (ie, recent seroconversions), 25% (n = 32) through positive HCV test results and elevated liver function test results, 18% (n = 23) through manually reported negative HCV test results, and 2% (n = 2) through positive HCV test results and clinical evidence. Challenges to surveillance included accessing patients for investigations and engaging donation centers in reporting negative test results. Utah's experience demonstrates practical considerations for improving surveillance of acute HCV infections.
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