Most U.S. adults with hepatitis C don’t know they have it, study finds

Although more patients have become aware of their hepatitis C virus (HCV) infection in recent years, more than 800,000 people are still unaware of this and the subsequent risk of liver disease, according to PLoS One.

The researchers explained that hepatitis C virus is one of the leading causes of liver-related mortality and morbidity. Therefore, the World Health Organization (WHO) announced in 2016 that they would attempt to eliminate HCV and hepatitis B virus as a public health threat by 2030; this would require diagnosing 90% of people with active HCV infection and 80% of Patients undergo treatment aimed at cure, and measures are taken to reduce HCV infection in high-risk groups.

Although current HCV therapies, direct-acting antiviral drugs (DAAs), have increased cure rates for HCV infection to over 90%, eradicating the HCV threat has proven difficult as almost 45% of infected people are unaware of HCV infection. their status. Therefore, researchers studied U.S. public awareness of HCV using National Health Nutrition and Examination Survey (NHANES) data from 2013 to 2020. Their survey goals included measuring patient awareness of HCV infection and identifying possible barriers to diagnosis.

Through analysis of NHANES data, researchers found that 206 adult participants were infected with HCV between January 2013 and March 2020. Overall, the weighted awareness rate of infection during the study period was 60.1%, which correlates with approximately 840,000 U.S. adults not knowing their infection status. Hepatitis C virus infection.

The results showed that awareness among Mexican Americans and Asians was much lower, at 39.8% and 13.4% respectively. The researchers added that compared with non-Hispanic white patients, Mexican-American patients had an odds ratio (OR) of 0.33 (95% CI, 0.15-0.72) for infection awareness; ) is 0.07 (95% CI, 0.0007-0.79). Asian patients. Additionally, disease awareness among non-U.S. citizens is quite low (ask < .001) and non-U.S.-born participants (OR, 0.19; 95% CI, 0.06-0.55).

Those who were unaware of their infection status had higher liver enzyme levels. Those who did not know they were infected had a mean (standard error (SE)) alanine aminotransferase level of 70.5 (7.2) U/L, compared with those who knew they were infected. The level is 53.9 (5.2) U/L (ask

=.041).

Although the researchers found that patient awareness of HCV infection increased during the study period, they noted that nearly 40% of Americans still don’t know. Despite increased awareness, the absolute number of people infected with HCV remains high as the number of people infected with HCV continues to increase over time. To truly minimize the impact of HCV, the number of diagnoses must first increase, the researchers explained.

“Because HCV is often asymptomatic, more aggressive measures in the form of public health messaging and outreach camps for screening, diagnosis, and referral are critical,” the authors wrote. “Early detection of these asymptomatic patients The diagnosis will aid in the treatment of patients in earlier stages of fibrosis. “This has been shown to have better sustained virological responses and outcomes. “

The researchers also acknowledge that their study has limitations, one of which is that they used NHANES to create the study population, which is only a sample of the U.S. population. Therefore, the results may not be generalizable globally. Furthermore, NHANES does not represent several high-risk groups for HCV, including institutionalized, homeless, and nursing home residents. Therefore, this may underestimate the burden of disease, the number of HCV infections, and the number of people who are undiagnosed and untreated.

“As treatments for hepatitis C advance, it is critical to diagnose these cases as early as possible to avoid liver damage and move toward the World Health Organization’s goal of eliminating the disease,” the authors concluded. “Future research and programs targeting poor and high-risk populations may help understand and remove barriers unique to these populations.”

refer to

Gnanapandithan K, Gali MP. Self-awareness of hepatitis C infection in the United States: A cross-sectional study based on the National Health Nutrition and Examination Survey. Public Library One. 2023;18(10):e0293315. Published October 24, 2023. doi:10.1371/journal.pone.0293315