The prevalence of hepatitis C virus infection in the United States, 1988 through 1994
The prevalence of hepatitis C virus infection in the United States, 1988 through 1994
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DOI：
10.1056/nejm199908193410802
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发表时间：
1999-08-19
影响因子：
158.5
通讯作者：
Margolis, HS
中科院分区：
文献类型：
--
作者：
Alter, MJ;Kruszon-Moran, D;Margolis, HS
由于许多慢性丙型肝炎病毒（HCV）感染者无症状，因此需要进行基于人群的血清学研究，以估计感染的患病率，并制定和评估预防措施。（抗-HCV）的血清样本来自21，241名6岁或以上的人，他们参加了第三次全国健康和营养检查调查，在1988年至1994年期间进行。我们确定的HCV RNA的流行情况，通过核酸扩增和基因型通过sequencing.Results抗-HCV的总患病率为1.8%，相当于估计全国390万人（95%的置信区间，310万至480万）与HCV感染。65%的HCV感染者年龄在30 - 49岁之间。74%的人HCV RNA阳性，表明美国估计有270万人（95%置信区间，240万至300万）慢性感染，其中73.7%感染基因型1（56.7%为基因型la，17.0%为基因型Ib）。在17至59岁的受试者中，与HCV感染独立相关的最强因素是非法药物使用和高危性行为。与感染相关的其他独立因素包括贫穷、受教育年限不超过12年、离婚或分居。无论是性别还是种族，民族群体是独立与HCV infection.Conclusions在美国，约270万人慢性感染HCV。使用非法药物或从事高风险性行为的人占HCV感染者的大多数。（N Engl J Med 1999;341：556-62.）（C）1999年，马萨诸塞州医学会。
Background Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts.Methods We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing.Results The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype la, and 17.0 percent with genotype Ib). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection.Conclusions In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection. (N Engl J Med 1999;341:556-62.) (C)1999, Massachusetts Medical Society.