title: Acute hepatitis C in Israel: a predominantly iatrogenic disease?
abstract: OBJECTIVE
  Acute hepatitis C virus infection in the era of universal screening of blood products has not disappeared, and is thought to be transmitted primarily via injecting drug use. A growing body of evidence supports iatrogenic transmission as an important mode of transmission. The aim of this study was to examine transmission routes and clinical characteristics in a group of patients with acute hepatitis C in Israel.
  
  
  METHODS
  A retrospective chart review was conducted in three different liver clinics in Israel, of all new hepatitis C patients. Patients identified as possible acute hepatitis C were re-interviewed and all other sources such as blood bank records and pre-employment check-ups reviewed in order to establish the diagnosis of acute hepatitis C infection and to identify the transmission route.
  
  
  RESULTS
  Twenty-nine patients were found to have acute hepatitis C, representing 0.75% of all new referrals for hepatitis C. The most frequent (65%) mode of transmission was iatrogenic involving several, often minimal, procedures and clinical settings. The group in which iatrogenic transmission was suspected was older and the patients more often in monogamous relationship compared with other transmission routes groups. Injecting drug use was the second most common route of infection. Spontaneous seroconversion has occurred in approximately one third of the patients.
  
  
  CONCLUSIONS
  Acute hepatitis C in the post universal blood products screening era was found to be predominantly an iatrogenic disease in the investigated localities. This finding should direct attention and resources towards the development and implementation of preventive measures.
authors.affiliation: Liver Disease Unit, Gastroenterology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. dr_lurie@tasmc.health.gov.il
authors.forename: Yoav
authors.initials: Y
authors.lastname: Lurie
authors.forename: Dan-Avi
authors.initials: DA
authors.lastname: Landau
authors.forename: Laurence
authors.initials: L
authors.lastname: Blendis
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Baruch
authors.forename: Ella
authors.initials: E
authors.lastname: Veitsman
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ackermann
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagie
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.forename: Ran
authors.initials: R
authors.lastname: Oren
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies