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
. 2014 Mar 4;160(5):293-300.
doi: 10.7326/M13-1133.

Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010

Maxine M Denniston, Ruth B Jiles, Jan Drobeniuc, R Monina Klevens, John W Ward, Geraldine M McQuillan, Scott D Holmberg

Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010

Maxine M Denniston et al. Ann Intern Med. .

Abstract

Background: Knowledge of the number of persons with chronic hepatitis C virus (HCV) infection in the United States is critical for public health and policy planning.

Objective: To estimate the prevalence of chronic HCV infection between 2003 and 2010 and to identify factors associated with this condition.

Design: Nationally representative household survey.

Setting: U.S. noninstitutionalized civilian population.

Participants: 30,074 NHANES (National Health and Nutrition Examination Survey) participants between 2003 and 2010.

Measurements: Interviews to ascertain demographic characteristics and possible risks and exposures for HCV infection. Serum samples from participants aged 6 years or older were tested for antibody to HCV; if results were positive or indeterminate, the samples were tested for HCV RNA, which indicates current chronic infection.

Results: Based on 273 participants who tested positive for HCV RNA, the estimated prevalence of HCV infection was 1.0% (95% CI, 0.8% to 1.2%), corresponding to 2.7 million chronically infected persons (CI, 2.2 to 3.2 million persons) in the U.S. noninstitutionalized civilian population. Infected persons were more likely to be aged 40 to 59 years, male, and non-Hispanic black and to have less education and lower family income. Factors significantly associated with chronic HCV infection were illicit drug use (including injection drugs) and receipt of a blood transfusion before 1992; 49% of persons with HCV infection did not report either risk factor.

Limitation: Incarcerated and homeless persons were not surveyed.

Conclusion: This analysis estimated that approximately 2.7 million U.S. residents in the population sampled by NHANES have chronic HCV infection, about 500,000 fewer than estimated in a similar analysis between 1999 and 2002. These data underscore the urgency of identifying the millions of persons who remain infected and linking them to appropriate care and treatment.

Primary funding source: None.

PubMed Disclaimer

Figures

Figure
Figure. Estimated prevalence of anti-HCV and HCV RNA in persons aged ≥6 y, according to NHANES III (1988–1994), NHANES 1999–2002, and NHANES 2003–2010
Estimated persons infected are reported in millions. Anti-HCV = antibody to HCV; HCV = hepatitis C virus; NHANES = National Health and Nutrition Examination Survey.
See this image and copyright information in PMC

References

    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128. [PMID: 23245604] - PMC - PubMed
    1. Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao F, Moyer LA, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341:556–62. [PMID: 10451460] - PubMed
    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;144:705–14. [PMID: 16702586] - PubMed
    1. Pyenson B, Fitch K, Iwasaki K. Consequences of Hepatitis C Virus (HCV): Costs of a Baby Boomer Epidemic of Liver Disease. Milliman; New York: 2009.
    1. Institute of Medicine . A National Strategy for Prevention and Control of Hepatitis B and C. National Academies Pr; Washington, DC: 2010. Hepatitis and Liver Cancer. - PubMed