title: Enhanced chronic hepatitis C surveillance in New York City, April 2009-January 2011.
abstract: OBJECTIVE
  We analyzed and evaluated enhanced chronic hepatitis C virus (HCV) surveillance in New York City (NYC), which involved detailed investigations on a sample of newly reported HCV patients.
  
  
  METHODS
  Beginning in July 2009, we generated a simple random sample bimonthly from all patients newly reported with a positive HCV test. We administered questionnaires to clinicians and patients to collect clinical and epidemiological information on patients diagnosed from April 2009 to January 2011 and evaluated the staff resources required to conduct enhanced surveillance.
  
  
  RESULTS
  Of 205 patients meeting inclusion criteria, 40 (19.5%) tested HCV ribonucleic acid (RNA) negative. For the remaining 165 patients, questionnaires were completed by 164 clinicians (99.4%) and 77 patients (46.7%). Many patients (54.0%) were born between 1945 and 1964, and most patients were Hispanic (32.7%) or non-Hispanic black (32.7%). Common risk factors were injection (43.0%) and intranasal (33.9%) drug use. One-third of patients were diagnosed in nontraditional medical settings including substance abuse/detoxification centers (25.0%), jail/prison (6.7%), and psychiatric facilities (1.8%). Of 98 patients with positive HCV RNA tests, 38.8% were immune to hepatitis A and 39.8% were immune to hepatitis B. Investigators required approximately 3.5 hours to complete each investigation and averaged 50 days from assignment to completion.
  
  
  CONCLUSIONS
  Although conducting enhanced HCV surveillance requires significant resources, investigating a representative sample provides detailed information about NYC's HCV population. Surveillance data have been used to plan educational initiatives for clinicians and patients, which may have led to increased awareness of HCV status, improved patient support, and better overall care.
authors.affiliation: New York City Department of Health and Mental Hygiene, Queens, NY ; Current affiliation: Philadelphia Department of Public Health, Philadelphia, PA.
authors.forename: Kate
authors.initials: K
authors.lastname: Drezner
authors.forename: Katherine
authors.initials: K
authors.lastname: Bornschlegel
authors.forename: Emily
authors.initials: E
authors.lastname: McGibbon
authors.forename: Sharon
authors.initials: S
authors.lastname: Balter
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D012494:Sampling Studies; D015819:Substance Abuse, Intravenous / Q000150:complications; D011795:Surveys and Questionnaires; D055815:Young Adult