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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases - United States, 2009-2018
A Blythe Ryerson1, Sarah Schillie1, Laurie K Barker1
1Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
Insights
Hepatitis C cases are rising, especially among young adults. Increased testing and early diagnosis are crucial for preventing chronic infection and liver disease, as many infected individuals remain unaware of their condition.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Hepatitis C is a significant cause of liver disease mortality in the U.S.
- Acute hepatitis C often presents asymptomatically, leading to over 50% progression to chronic, potentially fatal infections.
- Despite being diagnosable and curable, new hepatitis C cases are on the rise.
Purpose of the Study:
- To analyze trends in acute and chronic hepatitis C cases reported to the CDC from 2009-2018.
- To identify demographic groups most affected by acute and newly reported chronic hepatitis C infections.
- To assess awareness of hepatitis C infection among affected adults.
Main Methods:
- Analysis of National Notifiable Diseases Surveillance System data (2009-2018) for acute and chronic hepatitis C case rates by age and sex.
- Utilized National Health and Nutrition Examination Survey data (2015-2018) to estimate the proportion of adults aware of their hepatitis C status.
Main Results:
- Reported acute hepatitis C cases increased threefold from 2009 to 2018, with the highest rates in young adults (20-39 years).
- In 2018, an estimated 50,300 acute hepatitis C cases occurred, with a threefold increase in annual reported cases.
- Newly reported chronic hepatitis C cases in 2018 showed a bimodal distribution among younger (20-39) and older (50-69) adults. Only 60.6% of infected adults were aware of their diagnosis.
Conclusions:
- Rising acute hepatitis C rates in young, reproductive-aged adults pose a risk to multiple generations.
- New CDC recommendations emphasize universal screening for all adults and pregnant women, moving beyond historical birth year cohorts.
- Early detection and treatment are vital to curb the increasing incidence of hepatitis C and its severe liver-related outcomes.
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.
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