Abstract
HCV antibody (anti-HCV) test alone will not distinguish
current from resolved infection, whether spontaneously or by
treatment. Because new antiviral therapies are effective means to
reduce
HCV viremia, the proportion of persons with
current infection will decrease among those tested positive for
anti-HCV. The study aim was to describe the percentage of current
HCV infection,
defined by HCV RNA positivity, among
those tested positive for anti-HCV, in a nationally representative
sample of adults >40 years old in the United
States, focusing on racial/ethnic differences over
time.
Data were from National Health and Nutrition
Examination Surveys, collected from 2003-2010. Of 31,034
participants, we identified 304 positive for anti-HCV. Of these,
238 or 75.4% (95% CI 67.5-81.8) had current HCV infection. The
percentages of current HCV infection were highest among
non-Hispanic blacks (91.1%) and lowest among those with college or
more education (57.3%). This percentage was 92.7% among
non-Hispanic blacks and 61.9% among non-Hispanic whites in
2009-2010. Among persons with current HCV infection, most had
elevated ALT (56.5%) or AST (71.8%) levels, but 35.3% reported
having received a diagnosis of "liver condition". Excessive alcohol
drinking in the past year was reported by 27.3% of participants
with current infection. Conclusions: Among adults
>40 years who have ever been infected with HCV,
three quarters had current HCV infection. Non-Hispanic blacks were
more likely to have current infection compared to all other
racial/ethnic groups. Among those with current HCV infection, most
had abnormal liver function tests and many may benefit from
lifestyle modifications, but only a minority received appropriate
diagnoses.
Table of Contents
Chapter I. Background ................... 1
Chapter II. Manuscript ................... 5
Abstract ..................................... 5
Introduction ................................ 6
Methods ..................................... 7
Results .......................................11
Discussion ...................................14
References ..................................20
Tables ........................................33
Figure .........................................37
Chapter III. Summary .....................38
About this Master's Thesis
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