Community acquired viral hepatitis B and C in the United States

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis B virus (HBV) infections primarily affect adults in the US, but children are also infected.
• While childhood HBV infections are rare, they contribute significantly to chronic cases, prompting vaccine integration into childhood schedules.
• Previous vaccination strategies targeting high-risk groups for HBV have proven ineffective.

Purpose of the Study:

• To assess the prevalence and severity of community-acquired chronic hepatitis C (HCV) in the United States.
• To identify risk factors associated with HCV infection.
• To determine the long-term viral persistence and disease progression in HCV-infected patients.

Main Methods:

• Prospective follow-up of patients diagnosed with acute non-A, non-B hepatitis in four sentinel US counties.
• Hepatitis C virus (HCV) RNA testing to confirm infection.
• Assessment of risk factors, including parenteral, sexual, household, and socioeconomic status.
• Monitoring for the development of chronic hepatitis and viral persistence.

Main Results:

• HCV infection was confirmed in 82% (106/130) of patients with acute non-A, non-B hepatitis.
• Ninety-three percent of HCV-positive patients reported a risk factor: 59% parenteral, 6% sexual/household, and 28% low socioeconomic status.
• Chronic hepatitis developed in 62% of patients, irrespective of the identified risk factor.
• HCV-RNA persisted in the majority of patients, even those showing biochemical resolution of hepatitis.

Conclusions:

• Hepatitis C virus (HCV) is a significant cause of community-acquired liver disease in the United States.
• Parenteral exposure is the most common risk factor identified for HCV infection.
• HCV infection frequently leads to persistent viraemia and chronic liver disease, highlighting the need for effective prevention and management strategies.