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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.

Abstract
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)

Author Affiliations
From the Hepatitis Branch, Division of Viral and Rickettsial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Atlanta, Ga (Drs Alter, Hadler, Fields, Bradley, and Margolis and Mss Miller and Moyer); Denver (Colo) Department of Health and Hospitals (Dr Judson); Tacoma—Pierce County Department of Health, Tacoma, Wash (Ms Mares); Jefferson County Department of Health, Birmingham, Ala (Dr Alexander); and Pinellas County Department of Health, St Petersburg, Fla (Dr Hu). Dr Alexander is now with Glaxo, Inc, Research Triangle Park, NC.

Footnotes
Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the US Department of Health and Human Services.

Reprint requests to Hepatitis Branch, Bldg 6, Room 154 (A-33), Centers for Disease Control, Atlanta, GA 30333 (Dr Alter).

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