Details:

Alternative Title:
Am J Prev Med
Personal Author:
Smith, Bryce D. ; Yartel, Anthony K.
Smith, Bryce D. ; Yartel, Anthony K. Less -
Description:
Background

Hepatitis C virus (HCV) infection is unidentified in an estimated 40%–85% of infected adults. Surveillance and modeling data have found significant increases in HCV-associated morbidity and mortality.

Purpose

To compare two HCV antibody (anti-HCV) testing strategies based on (1) elevated alanine aminotransferase levels (ALT) and (2) a birth cohort approach for people born during 1945–1965.

Methods

Data from 19,055 adults aged 20–70 years who completed the National Health and Nutrition Examination Survey in 1999–2008 were analyzed in 2013. Two independent models were evaluated, based on membership in the 1945–1965 birth cohort or elevated ALT, to compare the number of identified anti-HCV-positive (anti-HCV+) individuals; proportion of total identified cases; and the number of people that would be tested using either strategy.

Results

The prevalence of anti-HCV among adults aged 20–70 years was estimated at 2.0% (95% CI=1.8%, 2.3%), representing about 3.6 million people. The birth cohort strategy would result in testing about 85.4 million people and identifying nearly 2.8 million anti-HCV+ people with a sensitivity of 76.6%. The ALT strategy would test about 21.5 million adults and identify approximately 1.8 million anti-HCV+ people with a sensitivity of 50.0%. Implementing both strategies concurrently would identify 87.3% of anti-HCV+ adults.

Conclusions

The birth cohort strategy, which is recommended by both the CDC and the U.S. Preventive Services Task Force, would identify 1 million more anti-HCV+ people than the elevated ALT approach. Concurrent implementation would identify an even larger number of individuals ever infected.


Subjects:
[+]
Adult Aged Alanine Transaminase Cross-Sectional Studies Female Hepatitis C Hepatitis C Antibodies Humans Male Middle Aged Nutrition Surveys Prevalence Sensitivity And Specificity United States Young Adult
Source:
Am J Prev Med. 47(3):233-241
Pubmed ID:
25145616
Pubmed Central ID:
PMC5759754
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:82742d8615cab0be8309dcaab03add4e4f5a39adc469a727241463bef9b401d6
Download URL:
https://stacks.cdc.gov/view/cdc/50776/cdc_50776_DS1.pdf
File Type:

Supporting Files

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