Communicable diseases; Community/public health; Diagnostic services; Hepatitis C; Indians of North America; Infectious Disease; Liver – Diseases; Primary Care Issues; Special population: Native American/First Nations


Community-Based Research | Demography, Population, and Ecology | Inequality and Stratification | Medicine and Health | Public Health | Race and Ethnicity


BACKGROUND: Despite large disparities in the burden of chronic liver disease, data on hepatitis C virus (HCV) infection among American Indians (AIs) are lacking. We reviewed hepatitis C diagnoses in 35,712 AI/AN primary care patients.

MAIN FINDINGS: At least one HCV-associated ICD-9 code was recorded in 251 (1%) patients between October 1, 2001 and September 30, 2003. An HCV enzyme-linked immunoassay (HCVEIA) was sent in 209 (83.0%); 206/209 (99%) were positive. Confirmatory testing was performed in 144/206 (70%) HCV-EIA positive patients; HCV infection was confirmed in 144 (100%). In the 90/144 (63%) charts with risk factor documentation, injection drug use was the most common risk factor (61/90, 68%). Deficiencies were present in hepatitis B and HIV testing, and hepatitis A and B vaccination.

PRINCIPAL CONCLUSIONS: Improvements in laboratory workup of HCV and co-infections, risk factor ascertainment and documentation, and adult vaccination are needed to address HCV effectively in this population.