Four Million People in US Infected With Hepatitis C Virus

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NEW YORK (Reuters Health) May 15 - Findings from a nationwide study suggest
that 4.1 million people in the US have been infected with hepatitis C virus
(HCV), most of these individuals have chronic infection. However, the current
prevalence of infection, 1.6%, is actually slightly lower than a decade ago when
the rate was 1.8%.
The findings are based on analysis of data for 15,079 participants in the
National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002. In
addition to answering detailed questions about their health and lifestyles, the
subjects submitted blood samples for HCV testing and liver panel analysis.
The new findings build on those from the previous NHANES, conducted between
1988 and 1994, according to the report in the Annals of Internal Medicine for
May 16.
As noted, the prevalence of anti-HCV antibodies was 1.6%, and 1.3% of all
subjects had chronic HCV infection, lead author Dr. Gregory L. Armstrong, from
the Centers for Disease Control and Prevention in Atlanta, and colleagues note.
Subjects in their 40s had the highest prevalence of anti-HCV antibodies --
4.3%, the researchers point out.
The biggest risk factor for HCV infection was injection drug use: nearly half
of anti-HCV-positive subjects between 20 and 59 years of age reported injecting
drugs. The majority of anti-HCV-positive injection drug users said they had not
used drugs for at least 1 year prior to being surveyed.
Blood transfusion before 1992 and 20 or more lifetime sexual partners were
also significant risk factors for HCV infection, the report indicates.
Nearly 59% of HCV RNA-positive subjects had abnormal serum ALT levels. When
combined with any history of injection drug use and blood transfusion before
1992, this parameter identified 85.1% of HCV RNA-positive subjects between 20
and 59 years of age.
In a related commentary, Dr. Jules L. Dienstag, from Harvard Medical School in
Boston, comments that "the new data build on those reported previously to paint
a vivid portrait of hepatitis C in the US. A self-limited epidemic of injection
drug use over several decades amplified the transmission of HCV, and we are now
seeing the delayed, bitter harvest of chronic liver disease."
Ann Intern Med 2006;144:705-714,770-771.


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