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Estimating hepatitis C prevalence in the United States, 2017–2020
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2 01 2025
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Source: Hepatology. 81(2):625-636
[PDF-215.92 KB]
Details:
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Alternative Title:Hepatology
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Personal Author:
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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.
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Source:
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Pubmed ID:38739849
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Pubmed Central ID:PMC11557732
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Document Type:
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Funding:
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Volume:81
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Issue:2
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