The prevalence of hepatitis C virus infection in the United States, 1988 through 1994

Most past studies on the prevalence of hepatitis C virus (HCV) infection in the general population have been performed using samples from blood donors, a selected group that is screened for risk factors associated with infectious diseases. This study assessed the prevalence of HCV infection in the United States using serum samples from participants in the third National Health and Nutrition Examination Study (NHANES III) which was conducted from 1988 through 1994. NHANES III was conducted by the United States Centers for Disease Control and Prevention to obtain national statistics on the health and nutritional status of the population.

Participants were from 89 randomly selected locations in the United States. Tests for antibodies against HCV were performed on 21,241 serum samples from persons six years old or older who participated in this study. The overall prevalence of anti-HCV antibodies was 1.8%, which would correspond to an estimated 3.9 million persons nationwide. Sixty-five percent of these were between the ages of 30 and 49 years old. Of those with anti-HCV antibodies, 74% had detectable viral RNA (73.7% were genotype 1) in their serum, corresponding to 2.7 million persons in the United States with active HCV infection.

Among subjects 17 to 59 years old, illegal drug use and high risk sexual behavior were the factors most strongly associated with HCV infection. These results show that approximately 2.7 million American are chronically infected with HCV. They also suggest that the burden on the health care system caused by HCV may be increase as most infected individual are in their middle ages and may develop worsening liver damage over time.

By Howard J. Worman, M. D.

Alter, M. J., Kruszon-Moran, D., Nainan, O. V., McQuillan, G. M., Gao, F., Moyer, L. A., Kaslow, R. A., and Margolis, H. S. 1999.

New England Journal of Medicine. 341:556-562.

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