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Estimated [UNDER-ESTIMATED] Prevalence and Awareness of
Hepatitis C Virus Infection Among US Adults: National Health
and Nutrition Examination Survey, January 2017-March 2020
- see full paper below
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Download the PDF here
Even though the NHANES design may yield conservative estimates, the number of persons estimated to have this curable infection is staggering.
The death rates were higher among non-Hispanic AI/AN and non-Hispanic Black persons (3.4 times and 1.7 times, respectively) than among non-Hispanic White persons. The number of reported cases of acute hepatitis C has doubled since 2014 (129% increase), and during 2021 increased 5% from 2020.,,,, highlighting the stark inequities associated with this disease.
Chronic Hepatitis C affects multiple generations with infections highest among two age groups: 20-39 and 55-70 years.
https://www.cdc.gov/hepatitis/statistics/2021surveillance/hepatitis-c.htm
The annual number of new hepatitis C virus (HCV) infections more than doubled during the last decade.
Approximately 68% of persons with current HCV infection were aware of their infection, an improvement from the estimated 56% during 2013-2016.
A recent study found that <35% of continuously insured persons with hepatitis C receive treatment within 1 year of diagnosis. Treatment was even lower among persons in state-administered Medicaid plans.
HCV infection prevalence among those in poverty more than 5 times the prevalence of those not experiencing poverty.
Another analysis estimated that only 1.2 million persons were treated for hepatitis C during 2014-2020, approximately 170 000 persons annually, far below the established hepatitis C elimination goal of treating 260 000 persons annually [10].
because certain groups known to have high hepatitis C prevalence, such as persons in correctional settings and persons experiencing unsheltered homelessness, are excluded from the NHANES sampling frame, this analysis likely underestimates the true prevalence of hepatitis C in the United States. A prior study estimated that an additional 250 000 persons during 2013-2016 unaccounted for by NHANES were also infected with HCV [2]. Second, selection bias may be possible if groups with higher prevalence, such as persons who inject drugs, are less likely to participate in NHANES.
RESULTS
During January 2017-March 2020, the estimated prevalence of current HCV infection (HCV RNA reactive) was 0.9% (95% CI, .5%-1.4%), or 2.2 million (95% CI, 1.3-3.6 million) persons aged ≥18 years (Table 1). Approximately 67.7% (95% CI, 50.2%-82.2%) were aware of their infection; however, based on published NCHS standards, this estimate was considered unreliable because the absolute CI width was greater than 30% [6].
Persons aged 55-64 years were 6.4 times as likely to have current HCV infection compared with persons aged 18-40 years (prevalence ratio [PR] = 6.4; 95% CI, 2.5-16.4). Males were 2.9 times as likely as females to have current HCV infection (PR = 2.9; 95% CI, 1.1-7.7). Compared with persons of other races and ethnicities, non-Hispanic White and non-Hispanic Black persons were 5 times (PR = 5.0, 95% CI, 1.6-15.7) and 4.9 times (PR = 4.8; 95% CI, 1.7-14.1) as likely, respectively, to have current HCV infection. Prevalence was 5.3 times as high among persons experiencing poverty compared with persons not experiencing poverty (PR = 5.3; 95% CI, 2.3-12.2). Compared with persons with private insurance, persons with public insurance and persons with no insurance were 4.7 times (PR = 4.7; 95% CI, 1.6-14.3) and 5.8 times (PR = 5.8; 95% CI, 1.7-19.8) as likely, respectively, to have current HCV infection (Table 1).
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