The prevalence of hepatitis C virus infection in the United States, 1999 through 2002
The prevalence of hepatitis C virus infection in the United States, 1999 through 2002
复制标题
DOI：
10.7326/0003-4819-144-10-200605160-00004
复制
发表时间：
2006-05-16
影响因子：
39.2
通讯作者：
Alter, Miriam J.
中科院分区：
文献类型：
--
作者：
Armstrong, Gregory L.;Wasley, Annemarie;Alter, Miriam J.
背景资料：定义丙型肝炎病毒（HCV）感染者的主要特征使医生能够更容易地识别最有可能从该疾病检测中获益的人。目的：描述美国的HCV感染人群。设计：全国代表性家庭调查。设置：美国平民，非机构化人群。参与者：在1999年至2002年的全国健康和营养检查调查中，有15079名参与者。测量：所有参与者都提供了病史，20至59岁的参与者提供了吸毒和性行为史。参与者接受了HCV抗体检测结果：美国抗-HCV感染率为1.6%（12/10），HCV RNA阳性率为1.6%（12/10），血清丙氨酸氨基转移酶（ALT）阳性率为1.6%（12/10（95% CI，1.3%-1.9%），相当于全国估计有410万（C），340万-490万）抗-HCV阳性者; 1.3%或320万（CI，270万至390万）人患有慢性HCV感染。在40至49岁的人群中观察到抗-HCV的高峰患病率（4.3%）。在20 - 59岁的抗-HCV阳性人群中，共有48.4%的人报告有注射吸毒史，这是HCV感染的最大危险因素。在所有报告有注射毒品史的人中，83.3%在调查前至少1年没有使用过注射毒品。其他重要的危险因素包括20个或更多的终生性伴侣和1992年之前输血。HCVRNA阳性者血清ALT异常率为58.7%。三个特点（血清ALT水平异常，任何注射吸毒史，输血史，1992年之前）确定85.1%的HCV RNA阳性的参与者之间的20和59 years.Limitations：被监禁和无家可归的人不包括在surveillance.Conclusions：许多美国人感染HCV。大多数人出生于1945年至1964年之间，可以通过目前的筛查标准进行识别。注射吸毒史是感染的最大危险因素。
Background: Defining the primary characteristics of persons infected with hepatitis C virus (HCV) enables physicians to more easily identify persons who are most likely to benefit from testing for the disease.Objective: To describe the HCV-infected population in the United States.Design: Nationally representative household survey.Setting: U.S. civilian, noninstitutionalized population.Participants: 15 079 participants in the National Health and Nutrition Examination Survey between 1999 and 2002.Measurements: All participants provided medical histories, and those who were 20 to 59 years of age provided histories of drug use and sexual practices. Participants were tested for antibodies to HCV (anti-HCV) and HCV RNA, and their serum alanine aminotransferase (ALT) levels were measured.Results: The prevalence of anti-HCV in the United States was 1.6% (95% CI, 1.3% to 1.9%), equating to an estimated 4.1 million (C), 3.4 million to 4.9 million) anti-HCV-positive persons nationwide; 1.3% or 3.2 million (CI, 2.7 million to 3.9 million) persons had chronic HCV infection. Peak prevalence of anti-HCV (4.3%) was observed among persons 40 to 49 years of age. A total of 48.4% of anti-HCV-positive persons between 20 and 59 years of age reported a history of injection drug use, the strongest risk factor for HCV infection. Of all persons reporting such a history, 83.3% had not used injection drugs for at least 1 year before the survey. Other significant risk factors included 20 or more lifetime sex partners and blood transfusion before 1992. Abnormal serum ALT levels were found in 58.7% of HCV RNA-positive persons. Three characteristics (abnormal serum ALT level, any history of injection drug use, and history of blood transfusion before 1992) identified 85.1% of HCV RNA-positive participants between 20 and 59 years of age.Limitations: Incarcerated and homeless persons were not included in the survey.Conclusions: Many Americans are infected with HCV. Most were born between 1945 and 1964 and can be identified with current screening criteria. History of injection drug use is the strongest risk factor for infection.