Injection with nondisposable needles as an important route for transmission of acute community‐acquired hepatitis C virus infection in Taiwan

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Abstract
A prospective case‐controlled study was conducted in order to determine the transmission route of community‐acquired hepatitis C virus (HCV) infection in Taiwan. Thirty‐eight consecutive patients (25 men and 13 women) with acute community‐acquired HCV infection and 76 age (within 3 years)‐ and sex‐matched healthy control subjects without HCV infection were enrolled. Serum anti‐HCV was tested by second generation immunoassay. The sera of 26 family members from 12 families of index patients were also tested for anti‐HCV. A questionnaire covering the history of blood transfusion, surgery, intravenous drug abuse, prostitute contact, dental procedures, injection, acupuncture, tattooing, and ear‐piercing was conducted among patients and control subjects. Univariate analysis revealed injection with nondisposable needles was an independent risk factor (P = 0.02, odds ratio = 4.17, 95% confidence interval = 1.24‐14.47) associated with HCV infection. Other risk factors were not significant. Only 2 (7.7%) family members of index patients had an anti‐HCV. In conclusion, more vigorous effort to prohibit the use of nondisposable needles should be promoted to interrupt the spread of community‐acquired HCV infection in Taiwan. Of note, a significant number of patients (34.2%) contracted HCV infection without identifiable risk factors. Unidentified routes need to be investigated.