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      Epidemiology of Hepatitis C Virus (HCV) Infection

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          Abstract

          Hepatitis C virus remains a large health care burden to the world. Incidence rates across the world fluctuate and are difficult to calculate given the asymptomatic, often latent nature of the disease prior to clinical presentation. Prevalence rates across the world have changed as well with more countries aware of transfusion-related hepatitis C and more and more evidence supporting intravenous drug use as the leading risk factor of spread of the virus. This article reviews current hepatitis C virus prevalence and genotype data and examines the different risk factors associated with the virus.

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          Most cited references89

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          The prevalence of hepatitis C virus infection in the United States, 1988 through 1994.

          Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts. We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing. The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection. In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection.
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            Global surveillance and control of hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium.

            Hepatitis C is a global health problem caused by infection with the hepatitis C virus. Although representative prevalence data are not available from many countries, available data indicate that approximately 3% of the world's population is infected with HCV. It is estimated that as many as 170 million persons world-wide may be infected with HCV. In many countries, the exact magnitude of the problem and the relative contribution of the various routes of transmission have not been defined with population-based studies. Wherever possible such studies should be performed to enable countries to estimate the burden of hepatitis C disease, to prioritize their preventative measures and to make the most appropriate use of available resources. To assess hepatitis C on a global scale, the World Health Organization (WHO) organized a consultation of international experts, in order to review the public health aspects related to hepatitis C infection and to make recommendations for its prevention and control.
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              New hepatitis C virus (HCV) genotyping system that allows for identification of HCV genotypes 1a, 1b, 2a, 2b, 3a, 3b, 4, 5a, and 6a.

              Recent studies have focused on whether different hepatitis C virus (HCV) genotypes are associated with different profiles of pathogenicity, infectivity, and response to antiviral therapy. The establishment of a simple and precise genotyping system for HCV is essential to address these issues. A new genotyping system based on PCR of the core region with genotype-specific PCR primers for the determination of HCV genotypes 1a, 1b, 2a, 2b, 3a, 3b, 4, 5a, and 6a was developed. A total of 607 samples (379 from Japan, 63 from the United States, 53 from Korea, 35 from Taiwan, 32 from China, 20 from Hong Kong, 15 from Australia, 6 from Egypt, 3 from Bangladesh, and 1 from South Africa) were tested by both the assay of Okamoto et al. (H. Okamoto, Y. Sugiyama, S. Okada, K. Kurai, Y. Akahane, Y. Sugai, T. Tanaka, K. Sato, F. Tsuda, Y. Miyamura, and M. Mayumi, J. Gen. Virol. 73:673-679, 1992) and this new genotyping system. Comparison of the results showed concordant results for 539 samples (88.8%). Of the 68 samples with discordant results, the nucleotide sequences of the HCV isolates were determined in 23, and their genotypes were determined by molecular evolutionary analysis. In all 23 samples, the assignment of genotype by our new genotyping system was correct. This genotyping system may be useful for large-scale determination of HCV genotypes in clinical studies.
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                Author and article information

                Journal
                Int J Med Sci
                ijms
                International Journal of Medical Sciences
                Ivyspring International Publisher (Sydney )
                1449-1907
                2006
                1 April 2006
                : 3
                : 2
                : 41-46
                Affiliations
                Division of Gastroenterology, University of California, Irvine, CA 92868, USA
                Author notes
                Corresponding address: M. Mazen Jamal, University of California Irvine, 101 The City Drive, Orange, CA 92868, USA.

                Conflict of interest: The authors have declared that no conflict of interest exists.

                Article
                ijmsv03p0041
                10.7150/ijms.3.41
                1415844
                16614741
                2ed32683-559c-493a-bd55-24ecc3c7a3bc
                © Ivyspring International Publisher. This is an open access article. Reproduction is permitted for personal and noncommerical use, provided that the article is in whole, unmodified, and properly cited.
                History
                : 30 December 2005
                : 23 March 2006
                Categories
                Review

                Medicine
                blood transfusions,epidemiology,intravenous drug use,hepatitis c virus
                Medicine
                blood transfusions, epidemiology, intravenous drug use, hepatitis c virus

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