Although vastly under-reported, a large number of hepatitis C infections are identified through routine laboratory testing for other purposes. Positive hepatitis C laboratory results do not always result in appropriate clinical referral, however, and many local health departments do not routinely investigate laboratory-identified reports of hepatitis C infection without accompanying evidence of acute symptoms. This lack of follow-through from laboratory-confirmed hepatitis C infections likely contributes to the dearth of reported annual cases, and ultimately to the high morbidity and mortality associated with the disease.
METHODS: The Harris County Public Health and Environmental Services (HCPHES) Epidemiology Program identified a need to investigate and categorize hepatitis C laboratory reports. A system for processing electronic lab reports (ELRs) received by the Texas Department of State Health Services (DSHS) was designed. State-level hepatitis C data is retrieved weekly and processed through a series of queries that electronically assign case status based on specific criteria to identify chronic infections, resolved infections, and seroconversions. Criteria were patterned after the recommendations detailed in the 2015 CSTE position statement.
RESULTS: Results obtained by processing records through this system will be used to describe the burden of hepatitis C cases in Harris County, Texas. Geospatial analysis will also be conducted to identify clusters and non-random distributions.
CONCLUSIONS: The system implemented provides a dataset that has not been previously available in Harris County. By better understanding the prevalence and distribution of hepatitis C, we can evaluate for geospatial patterns, deliver notifications to the ordering physician regarding additional testing and treatment, and more accurately quantify and assess trends in the burden of acute and chronic hepatitis C in Harris County. These steps will help to close a critical gap in public health surveillance.