Ann Intern Med. 2014 Mar 4;160(5):293-300. doi: 10.7326/M13-1133.
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.
To estimate the prevalence of chronic HCV infection between 2003 and 2010 and to identify factors associated with this condition.
Nationally representative household survey.
U.S. noninstitutionalized civilian population.
30,074 NHANES (National Health and Nutrition Examination Survey) participants between 2003 and 2010.
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.
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.
Incarcerated and homeless persons were not surveyed.
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.
None.
了解美国慢性丙型肝炎病毒（HCV）感染者人数对于公共卫生和政策规划至关重要。
估计 2003 年至 2010 年期间慢性 HCV 感染的流行率，并确定与该疾病相关的因素。
全国代表性的家庭调查。
美国非住院的平民人口。
2003 年至 2010 年期间的 30074 名 NHANES（国家健康和营养检查调查）参与者。
访谈以确定 HCV 感染的人口统计学特征和可能的风险和暴露因素。对年龄在 6 岁或以上的参与者的血清样本进行抗 HCV 抗体检测；如果结果为阳性或不确定，则对样本进行 HCV RNA 检测，该检测可指示当前的慢性感染。
根据 273 名 HCV RNA 检测呈阳性的参与者，估计 HCV 感染的流行率为 1.0%（95%CI，0.8%至 1.2%），相当于美国非住院平民人口中 270 万慢性感染者（CI，220 万至 320 万人）。感染者更可能年龄在 40 至 59 岁，男性，非西班牙裔黑人和受教育程度较低，家庭收入较低。与慢性 HCV 感染显著相关的因素是非法药物使用（包括注射毒品）和 1992 年前接受过输血；49%的 HCV 感染者未报告任何危险因素。
未对被监禁者和无家可归者进行调查。
这项分析估计，NHANES 抽样人群中约有 270 万美国居民患有慢性 HCV 感染，比 1999 年至 2002 年期间类似分析估计的人数少约 50 万。这些数据强调了确定数百万仍受感染的人群并将其与适当的护理和治疗联系起来的紧迫性。
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