Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2012 Nov;102(11):e101-6.
doi: 10.2105/AJPH.2011.300488. Epub 2012 Jul 19.

Comparison of current US risk strategy to screen for hepatitis C virus with a hypothetical targeted birth cohort strategy

Kenneth J Tomaszewski  1 , Baris Deniz, Peter Tomanovich, Camilla S Graham
Affiliations
Comparative Study

Comparison of current US risk strategy to screen for hepatitis C virus with a hypothetical targeted birth cohort strategy

Kenneth J Tomaszewski et al. Am J Public Health. 2012 Nov.

Abstract

Objectives: We compared the theoretical performance of a 1-time, birth cohort strategy with the currently recommended risk strategy for screening for hepatitis C virus (HCV) infection, which is undetected in an estimated 75% of 4 million affected people in the United States.

Methods: We applied current American Association for the Study of Liver Disease risk screening guidelines and a targeted birth cohort strategy to National Health and Nutrition Examination Survey data from 2003 to 2006 to estimate their performance in identifying HCV cases.

Results: Risk guidelines would recommend testing 25% of the US population aged 20 years or older and, if fully implemented, identify 82% of the projected HCV-exposed population. A targeted birth cohort (1946-1964) strategy would test 45% of the same population and identify 76% of the projected HCV population.

Conclusions: In this ideal-world simulation, birth year and risk screening had similar theoretical performances for predicting HCV infection. However, actual implementation of risk screening has not achieved its theoretical performance, and birth cohort screening might increase HCV testing rates.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
Prevalence of HCV infection and percentage of HCV-infected persons in each birth cohort who would be screened under AASLD screening guidelines: National Health and Nutrition Examination Survey, United States, 2003–2006. Note. AASLD = American Association for the Study of Liver Disease; HCV = hepatitis C virus; NHANES = National Health and Nutrition Examination Survey. The risk-based screening guidelines were applied to the final analytic NHANES data set and grouped by birth cohort (x-axis). Stacked bars indicate the proportion of HCV-infected individuals in the overall US population who would (gray) or would not (black) be tested under current AASLD guidelines in ideal circumstances. Percentages of testing prevalence for each birth cohort are displayed within or above their corresponding bar.
See this image and copyright information in PMC

References

    1. Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144(10):705–714 - PubMed
    1. Davis GL, Alter MJ, El-Serag H, Poynard T, Jennings LW. Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterology. 2010;138(2):513–521 - PubMed
    1. Alter MJ, Kruszon-Moran D, Nainan OVet al.The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341(8):556–562 - PubMed
    1. Colvin HM, Mitchell AE. Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. Washington, DC: National Academies Press; 2010 - PubMed
    1. Pyenson BS, Fitch K, Iwasaki K. Consequences of Hepatitis C Virus (HCV): Costs of a Baby Boomer Epidemic of Liver Disease. New York, NY; 2009

Publication types

Substances