Maxine M. Denniston, MSPH; Ruth B. Jiles, PhD, MS, MPH; Jan Drobeniuc, MD, PhD; R. Monina Klevens, DDS, MPH; John W. Ward, MD; Geraldine M. McQuillan, PhD; Scott D. Holmberg, MD, MPH
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1133.
Reproducible Research Statement: Study protocol: Available at www.cdc.gov/nchs/nhanes/about_nhanes.htm. Statistical code: Available from Ms. Denniston (e-mail, firstname.lastname@example.org or email@example.com). Data set: Available at www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm.
Requests for Single Reprints: Scott D. Holmberg, MD, MPH, 1600 Clifton Road NE, Mail Stop G37, Atlanta, GA 30333; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Denniston and Drs. Jiles, Klevens, Ward, and Holmberg: 1600 Clifton Road NE, Mail Stop G37, Atlanta, GA 30333.
Dr. Drobeniuc: 1600 Clifton Road NE, Mail Stop A33, Atlanta, GA 30333.
Dr. McQuillan: 3311 Toledo Road, Room 4204, Hyattsville, MD 20782.
Maxine M. Denniston, MSPH; Ruth B. Jiles, PhD, MS, MPH; Jan Drobeniuc, MD, PhD; R. Monina Klevens, DDS, MPH; John W. Ward, MD; Geraldine M. McQuillan, PhD; and Scott D. Holmberg, MD, MPH
Author Contributions: Conception and design: M.M. Denniston, R.B. Jiles, J. Drobeniuc, M. Klevens, S.D. Holmberg.
Analysis and interpretation of the data: M.M. Denniston, R.B. Jiles, J. Drobeniuc, R.M. Klevens, G.M. McQuillan, S.D. Holmberg.
Drafting of the article: M.M. Denniston, J. Drobeniuc, S.D. Holmberg.
Critical revision of the article for important intellectual content: M.M. Denniston, R.B. Jiles, J. Drobeniuc, J.W. Ward, G.M. McQuillan, S.D. Holmberg.
Final approval of the article: M.M. Denniston, J. Drobeniuc, R.M. Klevens, J.W. Ward, G.M. McQuillan.
Provision of study materials or patients: G.M. McQuillan.
Statistical expertise: M.M. Denniston.
Obtaining of funding: J.W. Ward, S.D. Holmberg.
Administrative, technical, or logistic support: R.B. Jiles, J. Drobeniuc, R.M. Klevens, G.M. McQuillan, S.D. Holmberg.
Collection and assembly of data: J. Drobeniuc, G.M. McQuillan.
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.
Denniston MM, Jiles RB, Drobeniuc J, Klevens RM, Ward JW, McQuillan GM, et al. Chronic Hepatitis C Virus Infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. ;160:293–300. doi: 10.7326/M13-1133
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Published: Ann Intern Med. 2014;160(5):293-300.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease, Viral Hepatitis.
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