Chronic Hepatitis C Virus Infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010

Abstract

Background Knowledge of the number of persons with chronic hepatitis C virus (HCV) infection in the United States is critical for public health and policy planning. Objective To estimate the prevalence of chronic HCV infection between 2003 and 2010 and to identify factors associated with this condition. Design Nationally representative household survey. Setting U.S. noninstitutionalized civilian population. Participants 30 074 NHANES (National Health and Nutrition Examination Survey) participants between 2003 and 2010. Measurements Interviews to ascertain demographic characteristics and possible risks and exposures for HCV infection. Serum samples from participants aged 6 years or older were tested for antibody to HCV; if results were positive or indeterminate, the samples were tested for HCV RNA, which indicates current chronic infection. Results Based on 273 participants who tested positive for HCV RNA, the estimated prevalence of HCV infection was 1.0% (95% CI, 0.8% to 1.2%), corresponding to 2.7 million chronically infected persons (CI, 2.2 to 3.2 million persons) in the U.S. noninstitutionalized civilian population. Infected persons were more likely to be aged 40 to 59 years, male, and non-Hispanic black and to have less education and lower family income. Factors significantly associated with chronic HCV infection were illicit drug use (including injection drugs) and receipt of a blood transfusion before 1992; 49% of persons with HCV infection did not report either risk factor. Limitation Incarcerated and homeless persons were not surveyed. Conclusion This analysis estimated that approximately 2.7 million U.S. residents in the population sampled by NHANES have chronic HCV infection, about 500 000 fewer than estimated in a similar analysis between 1999 and 2002. These data underscore the urgency of identifying the millions of persons who remain infected and linking them to appropriate care and treatment. Primary Funding Source None.

Historical trends and projected hospital admissions for chronic hepatitis C infection in Canada: a birth cohort analysis

“…[11][12][13] A small portion of people, estimated at 15% by the American National Health and Nutrition Examination Survey, 14 clear their infection. For others, symptoms of chronic infection often emerge 20 years or more after the initial infection.…”

Historical Trends in the Hepatitis C Virus Epidemics in North America and Australia

“…The model was simulated using a Monte-Carlo approach to determine the 95% uncertainty interval for prevalence [20,21]. The epidemiological estimates of HCV infection prevalence by age and sex [22][23][24] for the United States were extracted from the National Health and Nutrition Examination Survey, the US Centers for Disease Control and Prevention surveillance data between 1997 and 2007, and the number of patients with HCV infection cured antiviral therapy reported by publications between 1997 and 2007 [20]. The model was also calibrated to account for US populations not captured by the National Health and Nutrition Examination Survey, such as incarcerated and homeless persons.…”

Safety and efficacy of ledipasvir/sofosbuvir for the treatment of genotype 1 hepatitis C in subjects aged 65 years or older

“…(3) Although the rate of HCV is decreasing overall due to attrition from mortality, (4,5) the rate of HCV-related cirrhosis is anticipated to increase by Abbreviations: AE, adverse event; CI, confidence interval; eGFR, estimated glomerular filtration rate; HCV, hepatitis C virus; LDV/SOF, ledipasvir/sofosbuvir; RAV, resistance-associated variant; RBV, ribavirin; SVR12, sustained virological response at 12 weeks…”

“…Addition of RBV did not increase sustained virological response at 12 weeks rates but led to higher rates of AEs, especially in elderly subjects. (HEPATOLOGY 2016;63:1112-1119 C hronic hepatitis C viral (HCV) infection is an important cause of morbidity and mortality in infected individuals worldwide.(1) The World Health Organization estimates that the worldwide prevalence of HCV infection is 2.2%, representing 123 million people.(2) Globally, HCV accounts for 27% of liver cirrhosis and 25% of hepatocellular carcinoma cases.(3) Although the rate of HCV is decreasing overall due to attrition from mortality, (4,5) the rate of HCV-related cirrhosis is anticipated to increase by Abbreviations: AE, adverse event; CI, confidence interval; eGFR, estimated glomerular filtration rate; HCV, hepatitis C virus; LDV/SOF, ledipasvir/sofosbuvir; RAV, resistance-associated variant; RBV, ribavirin; SVR12, sustained virological response at 12 weeks …”