Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases - United States, 2009-2018
Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases - United States, 2009-2018
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DOI：
10.15585/mmwr.mm6914a2
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发表时间：
2020-04-10
影响因子：
33.9
通讯作者：
Wester, Carolyn
中科院分区：
文献类型：
--
作者：
Ryerson, A. Blythe;Schillie, Sarah;Wester, Carolyn
简介：丙型肝炎是美国肝病死亡的主要原因。急性丙型肝炎感染通常无症状，>50%的病例会进展为慢性感染，可能危及生命。丙型肝炎可以通过血液检查进行诊断，并且是可以治愈的，但这种可预防疾病的新发病例正在增加。方法：分析国家法定传染病监测系统数据，以确定2009-2018年按年龄组和年份向CDC报告的急性丙型肝炎病例的比率，以及2018年按性别和年龄新报告的慢性病例的数量和比率。根据2015-2018年全国健康和营养检查调查数据，估计了20岁以上丙型肝炎患者中报告曾被告知患有丙型肝炎的成年人的比例。在2018年期间，共报告了3，621例急性丙型肝炎病例，估计有50，300例（95%置信区间[CI] = 39，800 - 171，600）。每10万人口中报告的急性丙型肝炎病例的年发病率增加了三倍，从2009年的0.3增加到2018年的1.2，2018年20-29岁（3.1）和30-39岁（2.6）的人群最高。观察到2018年新报告的慢性丙型肝炎病例呈双峰分布，20-39岁和50-69岁的人群比例最高。只有60.6%（95%CI = 46.1%-73.9%）的成年丙型肝炎患者报告说，他们被告知，他们是infective.Conclusions和公共卫生实践的影响：急性丙型肝炎的年轻人，包括育龄期的人，增加了几代人的慢性丙型肝炎的风险。2018年，新报告的慢性感染人数在年轻人和老年人中大致相等。新的CDC丙型肝炎检测建议建议筛查所有成年人和孕妇，而不仅仅是1945-1965年出生的人，以及有风险因素的人。
Introduction: Hepatitis C is a leading cause of death from liver disease in the United States. Acute hepatitis C infection is often asymptomatic, and >50% of cases will progress to chronic infection, which can be life-threatening. Hepatitis C can be diagnosed with a blood test and is curable, yet new cases of this preventable disease are increasing.Methods: National Notifiable Diseases Surveillance System data were analyzed to determine the rate of acute hepatitis C cases reported to CDC by age group and year during 2009-2018 and the number and rate of newly reported chronic cases in 2018 by sex and age. The proportion of adults aged >= 20 years with hepatitis C who reported having ever been told that they had hepatitis C was estimated with 2015-2018 National Health and Nutrition Examination Survey data.Results: During 2018, a total of 3,621 cases of acute hepatitis C were reported, representing an estimated 50,300 cases (95% confidence interval [CI] = 39,800-171,600). The annual rate of reported acute hepatitis C cases per 100,000 population increased threefold, from 0.3 in 2009 to 1.2 in 2018, and was highest among persons aged 20-29 (3.1) and 30-39 years (2.6) in 2018. A bimodal distribution of newly reported chronic hepatitis C cases in 2018 was observed, with the highest proportions among persons aged 20-39 years and 50-69 years. Only 60.6% (95% CI = 46.1%-73.9%) of adults with hepatitis C reported having been told that they were infected.Conclusions and Implications for Public Health Practice: Increasing rates of acute hepatitis C among young adults, including reproductive-aged persons, have put multiple generations at risk for chronic hepatitis C. The number of newly reported chronic infections was approximately equal among younger and older adults in 2018. The new CDC hepatitis C testing recommendations advise screening all adults and pregnant women, not just persons born during 1945-1965, and those with risk factors.