Increasing prevalence of cirrhosis among U.S. adults aware or unaware of their chronic hepatitis C virus infection

Journal of Hepatology
Prowpanga UdompapW Ray Kim

Abstract

Cirrhosis from hepatitis C virus (HCV) infection is a major cause of end-stage liver disease and hepatocellular carcinoma worldwide. We determine the prevalence of cirrhosis among HCV-infected American adults including those unaware of their infection. Using the National Health and Nutrition Examination Survey (NHANES) data, we identified participants aged ⩾20 years with detectable serum HCV RNA. The prevalence of advanced fibrosis and cirrhosis was determined for eras 1 (1988-94), 2 (1999-2006) and 3 (2007-2012) by using FIB-4 >3.25 and APRI >2.0, respectively. Out of 52,644 NHANES examinees, 49,429 were tested for HCV, of whom 725 met the inclusion criteria (positive HCV RNA with available data for FIB-4 and APRI). Based on APRI, 6.6% (95% confidence interval [CI]: 2.2-11.0) of HCV-infected adults in era 1, 7.6% (95% CI: 3.4-11.8) in era 2 and 17.0% (95% CI: 8.0-26.0) in era 3 had cirrhosis. In the multivariable regression analysis, this era effect was attributable to increasing age (odds ratio [OR]:1.04, 95% CI: 1.02-1.07), diabetes (OR: 2.33, 95% CI: 1.01-5.40) and obesity (OR: 2.96, 95% CI: 1.15-7.57). Cirrhosis was as common among respondents who were unaware of their infection as those who were aware (both 11%). Results ...Continue Reading

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