Viral Hepatitis

Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA.
NCHS data brief 03/2010; 27(27):1-8.
Source: PubMed


KEY FINDINGS: The prevalence of hepatitis A antibody, which is indicative of immunity to hepatitis A virus, increased among U.S. born persons aged 6-19, but decreased among persons aged 40 years and over. Hepatitis B virus (HBV) infection among persons aged 6-19 has decreased in recent years. By 2003-2006, over 90% of children had received at least one dose of the recommended three-dose series of hepatitis B vaccine. Prevalence of infection with hepatitis C virus (HCV) decreased among those at highest risk of infection including males and Mexican- American and non-Hispanic black populations. Despite this decrease, the prevalence of infection remains higher in the non-Hispanic black population. The peak prevalence of HCV infection has shifted over time from persons aged 30-39 years (3.9%) to those aged 40-49 years (4.3%).

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    ABSTRACT: In the United States, about 70% of 2.9-3.7 million people with hepatitis C (HCV) are unaware of their infection. Although universal screening might be a cost-effective way to identify infections, prevent morbidity, and reduce transmission, few efforts have been made to determine patient opinions about new approaches to screening. We surveyed 200 patients in August 2010 at five outpatient clinics of a major public urban medical center in Seattle, WA, with an 85.8% response rate. The sample was 55.3% women, median 47 years of age, and 56.3% white and 32.7% African or African-American; 9.5% and 2.5% reported testing positive for HCV and HIV, respectively. The vast majority of patients supported universal screening for HCV. When presented with three options for screening, 48% preferred universal testing without being informed that they were being tested or provided with negative results, 37% preferred testing with the chance to "opt-out" of being tested and without being provided with negative results, and 15% preferred testing based on clinician judgment. Results were similar for HIV screening. Patients support universal screening for HCV, even if that screening involves testing without prior consent or the routine provision of negative test results. Current screening guidelines and procedures should be reconsidered in light of patient priorities.
    BMC Infectious Diseases 06/2011; 11(1):160. DOI:10.1186/1471-2334-11-160 · 2.61 Impact Factor
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    ABSTRACT: Watch an interview with Dr. Schwarz Watch the video presentation of this article Answer questions and earn CME
    Clinical Liver Disease 07/2012; 1(3). DOI:10.1002/cld.64
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    ABSTRACT: Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.
    BMC Infectious Diseases 02/2013; 13(1):60. DOI:10.1186/1471-2334-13-60 · 2.61 Impact Factor

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