NEW YORK (Reuters Health, 9/18/02) - The prevalence of hepatitis C virus (HCV) infection among military veterans in the New York City metropolitan area is 10.6%, much higher than the 1.8% rate reported in the general US population, according to a recent report.
 
Moreover, nearly one-quarter of HCV-infected veterans studied were also infected with HIV, study author Dr. Norbert Brau, from the Bronx VA Medical Center in New York, and colleagues note.
 
In the current study, the researchers assessed the prevalence of HCV infection among 1,098 New York City area veterans who underwent phlebotomy for any reason on one day in 1999. Of these patients, 1,016 completed a questionnaire regarding their demographic background and HCV risk factors.
 
All blood samples that tested positive for anti-HCV antibodies were confirmed by further RNA tests and also assayed for HCV viral load, HCV genotype, and anti-HIV antibodies.
 
The rates of HCV infection and viremia were 10.6% and 8.2%, respectively. Nearly 78% of HCV-infected patients had HCV viremia, the authors note. By far, the most common HCV genotype associated with viremia was type 1, identified in 87.5% of viremic patients.
 
The greatest risk factor for HCV infection was injection drug use. Injection drug users were 35.6 times more likely to be infected with HCV than nonusers. Other risk factors for infection included exposure to blood during combat, alcohol abuse, and service during the Vietnam War.
 
Nearly 25% of anti-HCV-positive patients were also infected with HIV, the authors note in the August issue of The American Journal of Gastroenterology. On multivariate analysis, the only risk factor independently associated with HIV coinfection was age less than 50 years.
 
The findings indicate that HCV infection is relatively common among New York City area veterans and that treatment will be challenging because most are infected with genotype 1, which is less responsive to therapy than other types, the authors write. Veterans with any of the risk factors identified should be offered HCV testing, the researchers emphasize.
 
Am J Gastroenterol 2002;97:2071-2078.