MMWR Morb Mortal Wkly Rep. 2013 May 10;62(18):357-61.
Hepatitis C virus (HCV) infection is a serious public health problem. New infections continue to occur, and morbidity and mortality are increasing among an estimated 2.7-3.9 million persons in the United States living with HCV infection. Most persons are unaware of their infection status. Existing CDC guidelines for laboratory testing and reporting of antibody to HCV do not distinguish between past infection that has resolved and current infection that requires care and evaluation for treatment. To identify current infection, a test for HCV RNA is needed.
Surveillance data reported to CDC from eight U.S. sites during 2005-2011 were analyzed to determine the proportion of persons newly reported on the basis of a positive test result for HCV infection. Persons reported with a positive result from an HCV antibody test only were compared with persons reported with a positive result for HCV RNA and examined by birth cohort (1945-1965 compared with all other years), surveillance site, and number of reported deaths. Annual rates of persons newly reported with HCV infection in 2011 also were calculated for each site.
Of 217,755 persons newly reported, 107,209 (49.2%) were HCV antibody positive only, and 110,546 (50.8%) were reported with a positive HCV RNA result that confirmed current HCV infection. In both groups, persons were most likely to have been born during 1945-1965 (58.5% of those who were HCV antibody positive only; 67.2% of those who were HCV RNA positive). Among all persons newly reported for whom death data were available, 6,734 (3.4%) were known to have died; deaths were most likely among persons aged 50-59 years. In 2011, across all sites, the annual rate of persons newly reported with HCV infection (positive HCV antibody only and HCV RNA positive) was 84.7 per 100,000 population.
Hepatitis C is a commonly reported disease predominantly affecting persons born during 1945-1965, with deaths more frequent among persons of relatively young age. The lack of an HCV RNA test for approximately one half of persons newly reported suggests that testing and reporting must improve to detect all persons with current infection.
In an era of continued HCV transmission and expanding options for curative antiviral therapies, surveillance that identifies current HCV infection can help assess the need for services and link persons with infection to appropriate care and treatment.
丙型肝炎病毒（HCV）感染是一个严重的公共卫生问题。在美国，估计有 270 万至 390 万人感染了 HCV，新的感染病例仍在不断发生，发病率和死亡率呈上升趋势。大多数人不知道自己的感染状况。现有的美国疾病控制与预防中心（CDC）实验室检测和 HCV 抗体报告指南并没有区分已解决的既往感染和需要治疗的现患感染。要确定现患感染，需要进行 HCV RNA 检测。
对 2005 年至 2011 年期间美国八个地点向 CDC 报告的监测数据进行分析，以确定根据 HCV 感染阳性检测结果新报告的人数比例。将仅报告 HCV 抗体检测阳性的人与报告 HCV RNA 检测阳性的人进行比较，并按出生队列（1945-1965 年出生与所有其他年份出生）、监测地点和报告的死亡人数进行比较。还计算了 2011 年每个地点新报告 HCV 感染者的年度比例。
在新报告的 217755 人中，有 107209 人（49.2%）仅 HCV 抗体阳性，110546 人（50.8%）报告 HCV RNA 阳性结果，证实存在现患 HCV 感染。在这两个组中，大多数人最有可能在 1945-1965 年出生（仅 HCV 抗体阳性者中占 58.5%；HCV RNA 阳性者中占 67.2%）。在所有新报告的死亡数据可用的人中，有 6734 人（3.4%）已知死亡；50-59 岁人群的死亡风险最高。2011 年，在所有地点，新报告的 HCV 感染者（仅 HCV 抗体阳性和 HCV RNA 阳性）的年发病率为每 10 万人 84.7 例。
丙型肝炎是一种常见的报告疾病，主要影响 1945-1965 年出生的人群，相对年轻的人群中死亡人数更多。大约一半新报告的人没有进行 HCV RNA 检测，这表明必须改进检测和报告，以发现所有现患感染的人。
在 HCV 持续传播和治疗性抗病毒治疗选择不断扩大的时代，监测识别现患 HCV 感染有助于评估服务需求，并将感染者与适当的护理和治疗联系起来。
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