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Hepatology. 2015 Nov;62(5):1353-63. doi: 10.1002/hep.27978. Epub 2015 Aug 25.

Toward a more accurate estimate of the prevalence of hepatitis C in the United States.

Author information

1
Department of Medicine, Weill Cornell Medical College, New York, NY.
2
Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY.
3
Department of Psychiatry, Beth Israel Medical Center, New York, NY.
4
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA.
5
Treatment Action Group, New York, NY.

Abstract

Data from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) indicate that about 3.6 million people in the United States have antibodies to the hepatitis C virus, of whom 2.7 million are currently infected. NHANES, however, excludes several high-risk populations from its sampling frame, including people who are incarcerated, homeless, or hospitalized; nursing home residents; active-duty military personnel; and people living on Indian reservations. We undertook a systematic review of peer-reviewed literature and sought out unpublished presentations and data to estimate the prevalence of hepatitis C in these excluded populations and in turn improve the estimate of the number of people with hepatitis C in the United States. The available data do not support a precise result, but we estimated that 1.0 million (range 0.4 million-1.8 million) persons excluded from the NHANES sampling frame have hepatitis C virus antibody, including 500,000 incarcerated people, 220,000 homeless people, 120,000 people living on Indian reservations, and 75,000 people in hospitals. Most are men. An estimated 0.8 million (range 0.3 million-1.5 million) are currently infected. Several additional sources of underestimation, including nonresponse bias and the underrepresentation of other groups at increased risk of hepatitis C that are not excluded from the NHANES sampling frame, were not addressed in this study.

CONCLUSION:

The number of US residents who have been infected with hepatitis C is unknown but is probably at least 4.6 million (range 3.4 million-6.0 million), and of these, at least 3.5 million (range 2.5 million-4.7 million) are currently infected; additional sources of potential underestimation suggest that the true prevalence could well be higher.

PMID:
26171595
PMCID:
PMC4751870
DOI:
10.1002/hep.27978
[Indexed for MEDLINE]
Free PMC Article

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