title: Epidemiology and risk factors for hepatitis C in Alaska Natives.
abstract: Large cohorts of persons infected with hepatitis C virus (HCV) that include patients with multiple risk exposures and behaviors have been rarely reported. We herein describe a population-based cohort of 759 Alaska Natives (AN) with HCV who were recruited into a long-term follow-up study. History of injection drug use (IDU) was reported by 60.1% and blood transfusion by 14.0%. The most common genotype was 1a (42.0%), followed by 1b (20.3%), 2b (14.7%), 3a (14.3%), and 2a (7.8%). By multivariable analysis, risk exposures (blood transfusion vs. other; P < 0.01; odds ratio [OR], 2.87; 95% confidence interval [CI], 1.51-5.45) and year of infection (P < 0.01; OR, 3.47; 95% CI, 1.34-8.96) were significantly associated with HCV RNA-positivity. Having an RNA concentration >/=2 million copies/mL was associated with male gender (OR, 1.94) and genotype (P < 0.01 overall; 1a vs. 3a: OR, 1.92; 2b vs. 3a: OR, 3.17) by multivariable analysis. In conclusion, the two principal risk exposures for AN infected with HCV (IDU and blood transfusion) are the same as the overall U.S. population. Persons with a history of blood transfusion were more likely to be HCV RNA positive than those without such history. Higher RNA levels found in males may explain the more severe disease previously reported in this group.
authors.affiliation: Viral Hepatitis Program, Alaska Native Medical Center, Anchorage, AK, USA. bdm9@cddc.gov
authors.forename: Brian J
authors.initials: BJ
authors.lastname: McMahon
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
authors.forename: Carol
authors.initials: C
authors.lastname: Christensen
authors.forename: Dana
authors.initials: D
authors.lastname: Bruden
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Sullivan
authors.forename: Chriss
authors.initials: C
authors.lastname: Homan
authors.forename: Heike
authors.initials: H
authors.lastname: Deubner
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bruce
authors.forename: Stephen
authors.initials: S
authors.lastname: Livingston
authors.forename: James
authors.initials: J
authors.lastname: Williams
authors.forename: David R
authors.initials: DR
authors.lastname: Gretch
mesh_terms: D000328:Adult; D000413:Alaska / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D012367:RNA, Viral