Hepatitis C Virus Infection in WTC Responders

Details

• Personal Author:
  Boffetta P ; Factor SH
• Description:
  Chronic hepatitis C virus infection places infected persons at risk for liver cirrhosis, hepatocellular carcinoma, and non-Hodgkin lymphoma. According to CDC, persons born during 1945 through 1965 are at high risk for chronic hepatitis C virus infection and are likely to be unaware of their infection. There are identified risk factors for hepatitis C virus infection (including HIV infection, history of injection drug use, selected medical conditions (receipt of clotting factors concentrates produced before 1987, on chronic hemodialysis, and persistently abnormal alanine aminotransferase levels), recipients of transfusions or organ transplants (including persons who received blood from an HCV-infected donor, persons who received a transfusion of blood or blood components before July 1992, and persons who received an organ transplant before July 1992) and person with recognized exposures (including health care, emergency medical and public safety workers after needle sticks, sharps, or mucosal exposures to blood from hepatitis C virus-infected people, and children born to hepatitis C virus-infected women). However, many people with hepatitis C virus infection do not have any of these risk factors. Prior to 2011, treatments for hepatitis C virus infection were difficult to take (required injection) and had many side effects. Therefore, many people were not cured of their infection. In 2011, a new class of treatments became available that were easy to take (oral pills) and had few side effects. Therefore, many people are now likely to be cured of their infection. To cure people of hepatitis C virus infection, people need to be tested for hepatitis C virus infection and those with hepatitis C virus infection need to be linked to appropriate medical care. The World Trade Center General Responder Cohort followed at the Icahn School of Medicine at Mount Sinai consists of persons who worked or volunteered during the World Trade Center Rescue and Recovery between September 2001 and June 2002. The majority were born during 1945-1965, the birth years associated with a high prevalence of infection. In this study, we tested almost 4000 members of the World Trade Center General Responder Cohort for past and current hepatitis C virus infection. These were some of our main findings: 1) The proportion of persons who had ever had hepatitis C virus infection in this cohort is similar to the proportion of persons. who had ever had hepatitis C virus infection in general population of the United States, about 3% 2) Most persons who had ever had hepatitis C virus infection in this cohort (89%) did not have one of the identified hepatitis C virus infection risk factors. 3) People who were exposed to sewage during their work at the World Trade Center had a higher risk of hepatitis C virus infection than people who were not exposed to sewage during their work at the World Trade Center. 4) People who wore gloves when they were in contact with sewage during their work at the World Trade Center site had a lower risk of hepatitis C virus infection than people who did not wear gloves when they were in contact with sewage during their work at the World Trade Center site. 5) Most of the people who had ever had hepatitis C virus infection had either cleared their infection naturally or had been treated; we found 13 persons who had current hepatitis C virus infection. 6) After learning about their current hepatitis C virus infection from us, most of the persons who were found to have current hepatitis C virus infection were then seen by a liver disease specialist (11 out of 13, 85%). Of the 11 who were seen by an infectious disease specialist, most were treated and cured (9, 82%), 1 is currently on treatment (9%), and 1 was seen in a state outside of New York which does not provide treatment for hepatitis C virus infection in most cases. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Occupational Health Safety September 11 Terrorist Attacks Viral Diseases
• Keywords:
  Cohort Studies Disaster Clean-up Disaster Response Emergency Responders Hepatitis C Liver Disease Viral Infections World Trade Center WTC
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Final Cooperative Agreement Report
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-11
• NIOSHTIC Number:
  nn:20066218
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U01-OH-011307, 2020 Dec; :1-11
• Email:
  stephanie.factor@mssm.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20160901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d32f9da7284e38abd5284d162f49e6eba054a8dc33e9a1d25079c20fab143fcd502401346ac2dfdc83085304e1474ff8b8dde613d4954f683f5959eea9c323d0
• Download URL:
  https://stacks.cdc.gov/view/cdc/219148/cdc_219148_DS1.pdf
• File Type:
  [PDF - 144.03 KB ]