1039. Improving Estimation of the Prevalence of Hepatitis C in the United States
Session: Poster Abstract Session: Hepatitis Viruses
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDSA poster.pdf (931.8 kB)
  • Background: Data from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) indicate that about 3.6 million non-institutionalized, housed, civilians in the United States are HCV antibody positive, and 2.7 million are currently infected. NHANES excludes several high-risk populations from its sampling frame, including incarcerated, homeless, and hospitalized persons; nursing home residents, active-duty military personnel, and persons living on Indian reservations. The purpose of this study is to provide a more accurate estimate of the size of the U.S. hepatitis C epidemic by including estimates from these groups.

    Methods: We performed a systematic review of literature by searching MEDLINE, Embase, conference proceedings, and related article listings through October 2014 and contacted experts for unpublished data on HCV seroprevalence in six key populations excluded from NHANES.  Using the HCV seroprevalence in each population we estimated the total number of people with hepatitis C excluded from the NHANES sampling frame.

    Results: An estimated 1.0 million (range, 0.4 to 1.8 million) persons excluded from the NHANES sampling frame are HCV antibody positive, of whom an estimated 0.8 million (range, 0.3 to 1.5 million) are currently infected (see Table).

    __________

    Table. Estimated Numbers of HCV Infections in Groups Excluded from NHANES

    Population

    Estimated Size

    HCV Antibody Prevalence

    Estimate of Persons with Current HCV Infection

    Estimate

     (Range)

    Estimate

     (Range)

    Incarcerated

    2,186,230

    23.1%

    7.5% - 44.0%

    505,350

    163,967 – 961,941

    Homeless

    691,899

    32.1%

    7.5% - 52.5%

    222,100

    51,892 – 363,246

    Hospitalized

    478,054

    15.6%

    4.0% - 38.0%

    74,576

    19,122 – 181,660

    Nursing Homes

    1,446,959

    4.5%

    2.1% - 8.4%

    65,113

    30,386 – 121,545

    Military

    1,404,060

    0.5%

    0.48% - 0.84%

    7,020

    6,739 – 11,794

    Indian reservations

    1,069,411

    11.5%

    7.8% - 16.2%

    123,224

    83,358 – 173,474

    Total:

    997,384

    355,466 – 1,813,661

    __________

    Conclusion: The number of U.S. residents with chronic HCV infection is unknown; but at least 4.6 million (range, 3.4 to 6.0 million) are HCV antibody positive and at least 3.5 million (range, 2.5 to 4.7 million) are currently infected.  More data would better inform the response to the HCV epidemic and help allocate sufficient resources to it.

    Benjamin Eckhardt, MD, Weill Cornell Medical College, New York, NY, Marla Shu, MD, Department of Psychiatry, Beth Israel Medical Center, New York, NY, Scott D. Holmberg, MD, MPH, FIDSA, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, Tracy Swan, Treatment Action Group, New York, NY and Brian R. Edlin, MD, Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY

    Disclosures:

    B. Eckhardt, None

    M. Shu, None

    S. D. Holmberg, None

    T. Swan, None

    B. R. Edlin, None

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