Prevalence of hepatitis C virus seropositivity among hospitalized US veterans

Background: Hepatitis C virus (HCV) is a major cause of acute and chronic h epatitis in the United States and abroad. HCV antibody prevalences ranging from 10 to 90% have been reported in intravenous drug abusers, hemodialysis patients, and persons suffering from other liver diseases, whereas HCV ser opositivity rates for volunteer blood donor populations are generally under 1%. However no information has been available concerning the prevalence of HCV in general hospital populations in the United States. Methods: We exam ined the rate of HCV seropositivity in 530 patients admitted to the Atlanta VA Medical Center between November 1993 and November 1994. The test popula tion consisted of 400 random hospital admissions, 100 successive admissions to the surgical service, and 30 random admissions to the gastrointestinal service. Serum samples were assayed for HCV antibodies by a second generati on EIA, and all repeat reactives were re-examined using a supplemental rese arch assay to confirm the presence of HCV antibodies. Complete chart review s were carried out on all HCV seropositive patients and on 100 HCV seronega tive patients. Results: Sixty-two of the 530 patients tested (11.7%) were r epeatedly positive for HCV antibodies. Of these 62 repeat reactives, 56 (90 .3%) were positive and 3 others (4.8%) indeterminate by the supplemental as say. The HCV seropositivity rate after supplemental testing was 11.8% for r andom admissions, 5.0% for surgical admissions, and 13.3% for patients admi tted to the gastroenterology service. HCV-associated risk factors in HCV se ropositive patients included a history of intravenous drug abuse, current o r previous alcohol abuse, previous or concurrent liver disease, previous bl ood transfusions, hemodialysis, and multiple sex partners or unsafe sex. Co nclusions: HCV infection may be more prevalent among hospitalized VA patien ts (and among other US hospital populations) than previously expected.