Hepatitis C 2018 - acute and chronic

Acute hepatitis C

In 2018, the Department of Infectious Disease Epidemiology and Prevention received eight notifications of cases of acute hepatitis C, whereof seven were men and one was a woman. The median age was 39.5 years (range 26-52 years). All were notified as having become infected in Denmark, five among men who have sex with men (MSM), two through IV drug use and one via heterosexual contact. Two of the cases were known HIV positives and two were receiving PrEP (Pre-Exposure Prophylaxis, HIV medication used preventively in HIV-negative risk groups).

Chronic hepatitis C

In 2018, a total of 179 cases of chronic hepatitis C were notified, including 132 (74%) men and 47 (26%) women. The median age was 47.5 years for men (range 0-73 years) and 49 years for women (range 24-71 years), Figure 1.

Table 1 presents the distribution by region and area and the notification incidence per 10⁵ citizens.

Transmission

A total of 146 (82%) had acquired the infection in Denmark, whereas 23 (13%) had become infected in 18 other countries, and the country of infection was not stated for 10 (6%) of the cases. Mode of transmission is presented in Table 2.

IV drug use was the most frequent mode of transmission with 125 (70%) notified persons. Of these, 122 (98%) had become infected in Denmark.

Nine persons (5%) were notified as nosocomially infected cases in 2018. Among these persons, two were born in Denmark one of whom had become infected in Denmark (pre-1991 blood transfusion) and the other in Spain. The remaining seven persons had all become infected abroad, prior to their arrival to Denmark. The majority via blood transfusions or surgery performed in Eastern Europe or the Middle East, but one patient had probably become infected occupationally due to non-sterile surgery devices while working in the US many years ago.

Six persons were notified as having become infected heterosexually, including four in Denmark and two in Greenland. None of the six persons were known HIV positives, and no information was provided about IV drug use.

One person was notified as having become infected as an MSM; he was not known to have HIV and it was stated that he had become infected in Denmark.

One child was notified as having become infected at birth in Denmark. The child was tested when the mother’s hepatitis C infection was detected by chance.

Tattooing was identified as the most probable route of infection in four cases. Two persons were notified as having become infected in Denmark (by unauthorised tattooists), and two had become infected in Syria and Slovakia, respectively. Two persons were notified as having become infected by sharps accidents, one in Denmark and one on Iceland. Both had presumably become infected at hospitals in the 1980s while working as healthcare assistants. One person was notified as having become infected through intramuscular injection of hormones used in connection with bodybuilding.

This report is described in EPI-NEWS 49/19.