Bradley Heather, Hall Eric W, Rosenthal Elizabeth M, Sullivan Patrick S, Ryerson A Blythe, Rosenberg Eli S
Department of Population Health Sciences Georgia State University School of Public Health Atlanta GA.
Department of Epidemiology Emory University Rollins School of Public Health Atlanta GA.
Hepatol Commun. 2020 Jan 14;4(3):355-370. doi: 10.1002/hep4.1457. eCollection 2020 Mar.
Hepatitis C virus (HCV) infection is a leading cause of liver-related morbidity and mortality, and more than 2 million adults in the United States are estimated to be currently infected. Reducing HCV burden will require an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. We modeled state-level estimates of hepatitis C prevalence among U.S. adults by sex, birth cohort, and race during 2013-2016. National Health and Nutrition Examination Survey data were used in combination with state-level HCV-related and narcotic overdose-related mortality data from the National Vital Statistics System and estimates from external literature review on populations not sampled in the National Health and Nutrition Examination Survey. Nationally, estimated hepatitis C prevalence was 1.3% among males and 0.6% among females (prevalence ratio [PR] = 2.3). Among persons born during 1945 to 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969 (PR = 3.2). Among persons born during 1945 to 1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia. Among persons born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Hepatitis C prevalence was 1.8% among non-Hispanic black persons and 0.8% among persons of other races (PR = 2.2), and the magnitude of this disparity varied widely across jurisdictions (PR range: 1.3-7.8). Overall, 23% of prevalent HCV infections occurred among non-Hispanic black persons, whereas 12% of the population was represented by this racial group. These estimates provide information on prevalent HCV infections that jurisdictions can use for understanding and monitoring local disease patterns and racial disparities in burden of disease.
丙型肝炎病毒（HCV）感染是导致肝脏相关发病和死亡的主要原因，据估计，美国目前有超过200万成年人感染该病毒。减轻HCV负担需要了解人口统计学差异，并针对性地努力降低疾病发病率不成比例人群中的患病率。我们对2013 - 2016年期间美国成年人按性别、出生队列和种族划分的丙型肝炎患病率进行了州级估计建模。国家健康和营养检查调查数据与国家生命统计系统的州级HCV相关和麻醉品过量相关死亡率数据以及对国家健康和营养检查调查未抽样人群的外部文献综述估计数相结合使用。在全国范围内，男性丙型肝炎估计患病率为1.3%，女性为0.6%（患病率比[PR]=2.3）。在1945年至1969年出生的人群中，患病率为1.6%，而1969年以后出生的人群中患病率为0.5%（PR = 3.2）。在1945年至1969年出生的人群中，患病率从北达科他州的0.7%到俄克拉荷马州的3.6%以及哥伦比亚特区的6.8%不等。在1969年以后出生的人群中，肯塔基州、新墨西哥州、俄克拉荷马州和西弗吉尼亚州的患病率比全国平均水平高出两倍多。非西班牙裔黑人的丙型肝炎患病率为1.8%，其他种族人群为0.8%（PR = 2.2），这种差异的程度在不同司法管辖区差异很大（PR范围：1.3 - 7.8）。总体而言，23%的HCV现患感染发生在非西班牙裔黑人中，而该种族群体占总人口的12%。这些估计提供了有关HCV现患感染的信息，各司法管辖区可用于了解和监测当地疾病模式以及疾病负担方面的种族差异。
