Estimating hepatitis C prevalence in the United States, 2017–2020

Details

• Alternative Title:
  Hepatology
• Personal Author:
  Hall, Eric W. ; Bradley, Heather ; Barker, Laurie K. ; Lewis, Karon C. ; Shealey, Jalissa ; Valverde, Eduardo ; Sullivan, Patrick ; Gupta, Neil ; Hofmeister, Megan G.
• Description:
  Background and Aims:
  
  The National Health and Nutrition Examination Survey (NHANES) underestimates the true prevalence of HCV infection. By accounting for populations inadequately represented in NHANES, we created 2 models to estimate the national hepatitis C prevalence among US adults during 2017–2020.
  
  Approach and Results:
  
  The first approach (NHANES+) replicated previous methodology by supplementing hepatitis C prevalence estimates among the US noninstitutionalized civilian population with a literature review and meta-analysis of hepatitis C prevalence among populations not included in the NHANES sampling frame. In the second approach (persons who injected drugs [PWID] adjustment), we developed a model to account for the underrepresentation of PWID in NHANES by incorporating the estimated number of adult PWID in the United States and applying PWID-specific hepatitis C prevalence estimates. Using the NHANES+ model, we estimated HCV RNA prevalence of 1.0% (95% CI: 0.5%–1.4%) among US adults in 2017–2020, corresponding to 2,463,700 (95% CI: 1,321,700–3,629,400) current HCV infections. Using the PWID adjustment model, we estimated HCV RNA prevalence of 1.6% (95% CI: 0.9%–2.2%), corresponding to 4,043,200 (95% CI: 2,401,800–5,607,100) current HCV infections.
  
  Conclusions:
  
  Despite years of an effective cure, the estimated prevalence of hepatitis C in 2017–2020 remains unchanged from 2013 to 2016 when using a comparable methodology. When accounting for increased injection drug use, the estimated prevalence of hepatitis C is substantially higher than previously reported. National action is urgently needed to expand testing, increase access to treatment, and improve surveillance, especially among medically underserved populations, to support hepatitis C elimination goals.
  
  
• Subjects:
  Adolescent Adult Aged Female Hepatitis C Humans Male Middle Aged Nutrition Surveys Prevalence Substance Abuse, Intravenous United States Young Adult

  More +
• Source:
  Hepatology. 81(2):625-636
• Pubmed ID:
  38739849
• Pubmed Central ID:
  PMC11557732
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  81
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:228c88546fbd6797deabf8ca30826af1be10d7434f0ba1af399c4c8b1308d144bd814bc0a7c7e7c61d4ea5c5c42c98dd688d1a47b0efafd02ef0f6e17a7cac83
• Download URL:
  https://stacks.cdc.gov/view/cdc/169976/cdc_169976_DS1.pdf
• File Type:
  [PDF - 215.92 KB ]