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. 2024 Feb 12:333549231224199.
doi: 10.1177/00333549231224199. Online ahead of print.

Hepatitis C Virus Testing, Infection, and Cases Reported Through Public Health Surveillance During Expanded Screening Recommendations, United States, 2013-2021

Kathleen N Ly  1 , Justin K Niles  2 , Ruth B Jiles  1 , Harvey W Kaufman  2 , Mark K Weng  1 , Priti Patel  1 , William A Meyer 3rd  2 , William W Thompson  1 , Nicola D Thompson  1
Affiliations

Hepatitis C Virus Testing, Infection, and Cases Reported Through Public Health Surveillance During Expanded Screening Recommendations, United States, 2013-2021

Kathleen N Ly et al. Public Health Rep. .

Abstract

Objectives: Hepatitis C virus (HCV) infection is the most common bloodborne infection in the United States. We assessed trends in HCV testing, infection, and surveillance cases among US adults.

Methods: We used Quest Diagnostics data from 2013-2021 to assess trends in the numbers tested for HCV antibody and proportion of positivity for HCV antibody and HCV RNA. We also assessed National Notifiable Diseases Surveillance System 2013-2020 data for trends in the number and proportion of hepatitis C cases. We applied joinpoint regression for trends testing.

Results: Annual HCV antibody testing increased from 1.7 million to 4.8 million from 2013 to 2021, and the positivity proportion declined (average, 0.2% per year) from 5.5% to 3.7%. The greatest percentage-point increase in HCV antibody testing occurred in hospitals and substance use disorder treatment facilities and among addiction medicine providers. HCV RNA positivity was stable at about 60% in 2013-2015 and declined to 41.0% in 2021 (2015-2021 average, -3.2% per year). Age-specific HCV RNA positivity was highest among people aged 40-59 years during 2013-2015 and among people aged 18-39 years during 2016-2021. The number of reported hepatitis C cases (acute and chronic) declined from 179 341 in 2015 to 105 504 in 2020 (average decline, -13 177 per year). The proportion of hepatitis C cases among those aged 18-39 years increased by an average of 1.4% per year during 2013-2020; among individuals aged 40-59 years, it decreased by an average of 2.3% per year during 2013-2018.

Conclusions: HCV testing increased, suggesting improved universal screening. Various data sources are valuable for monitoring elimination progress.

Keywords: HCV; hepatitis C; laboratory; surveillance; testing; trends.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Harvey W. Kaufman and Justin K. Niles are employees of, and William A. Meyer III serves as a consultant to, Quest Diagnostics. Harvey W. Kaufman and William A. Meyer III own stock in Quest Diagnostics.

Figures

Figure.
Figure.
Simplified representation of the process from specimen collection to reporting to Quest Diagnostics Health Trends database and the Centers for Disease Control and Prevention’s (CDC’s) National Notifiable Diseases Surveillance System.
See this image and copyright information in PMC

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