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
References
Jul 29, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Chun-Tao WaiAnna S-F Lok
Jan 13, 2006·The American Journal of Gastroenterology·George N IoannouSum P Lee
May 27, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Richard K SterlingUNKNOWN APRICOT Clinical Investigators
Jun 20, 2008·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Hla-Hla TheinMurray D Krahn
Oct 29, 2009·Gastroenterology·Gary L DavisLinda W Jennings
Aug 27, 2010·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·David B ReinSarah B Lesesne
Dec 28, 2010·Gastroenterology·Fasiha KanwalHashem B El-Serag
Jan 22, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Stella M MartínezXavier Forns
May 7, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Doris Nguyen, Jayant A Talwalkar
Jul 13, 2011·Liver International : Official Journal of the International Association for the Study of the Liver·Eric ChakSammy Saab
Dec 3, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Lisa J McGarryMilton C Weinstein
Jan 4, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Maxine M DennistonRuth B Jiles
Feb 22, 2012·Annals of Internal Medicine·Kathleen N LyScott D Holmberg
Nov 28, 2012·Annals of Internal Medicine·Roger ChouJeanne-Marie Guise
Dec 27, 2012·JAMA : the Journal of the American Medical Association·Adriaan J van der MeerHarry L A Janssen
Jan 3, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Homie RazaviRitesh Kumar
Apr 18, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Scott D HolmbergUNKNOWN Chronic Hepatitis Cohort Study (CHeCS) Investigators
Jun 26, 2013·Annals of Internal Medicine·Virginia A Moyer, UNKNOWN U.S. Preventive Services Task Force
Dec 3, 2013·Journal of Hepatology·Ivo DitahMichael Charlton
Jan 30, 2014·Journal of Viral Hepatitis·J LiUNKNOWN Chronic Hepatitis Cohort Study (CHeCS) Investigators
Mar 25, 2014·World Journal of Gastroenterology : WJG·Leonardo de Lucca SchiavonRoberto José de Carvalho-Filho
Apr 17, 2014·Annals of Internal Medicine·Maxine M DennistonScott D Holmberg
Aug 19, 2014·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Anne C MoormanUNKNOWN CHeCS Investigators
Aug 19, 2014·Journal of Viral Hepatitis·E TeshaleUNKNOWN CHeCS Investigators
Jan 15, 2015·BMJ : British Medical Journal·Ronald L KoretzJeanne Lenzer
Jan 24, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Glen Lutchman, W Ray Kim
Citations
May 1, 2016·Journal of Hepatology·Souvik SarkarJoseph K Lim
Aug 21, 2016·Clinics and Research in Hepatology and Gastroenterology·Karn WijarnpreechaWisit Cheungpasitporn
Aug 11, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R Monina KlevensScott Holmberg
Dec 13, 2016·International Journal of Molecular Sciences·Min DuPing Yao
Jan 17, 2017·Expert Opinion on Pharmacotherapy·Ilan S Weisberg, Ira M Jacobson
Jun 3, 2017·Nutrients·Ming-Ling ChangCheng-Tang Chiu
Feb 18, 2017·Scientific Reports·Ming-Ling ChangCheng-Tang Chiu
Jun 22, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Mei LuStuart C Gordon
Nov 11, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Allison KwongDonghee Kim
Dec 14, 2017·Histopathology·Juan PutraM Isabel Fiel
Dec 17, 2017·European Journal of Drug Metabolism and Pharmacokinetics·William L MarshallWendy W Yeh
Nov 30, 2016·World Journal of Gastrointestinal Pathophysiology·Karn WijarnpreechaWisit Cheungpasitporn
Sep 13, 2017·Health Promotion Practice·Bruce NitscheAndrew Muir
Nov 1, 2017·PloS One·Georg DultzTania M Welzel
Sep 21, 2017·PloS One·Magdalena RosińskaMałgorzata Stępień
Oct 12, 2018·Journal of Gastroenterology and Hepatology·Josephine CoolArun Jesudian
Nov 26, 2018·Liver International : Official Journal of the International Association for the Study of the Liver·Andrea LombardiUNKNOWN ESCMID Study Group for Viral Hepatitis (ESGVH)
Mar 14, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Sumant S AroraAshwani K Singal
Apr 27, 2019·International Journal of Circumpolar Health·Leisha D NolenMichael G Bruce
Nov 13, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Fahad AlqahtaniMohamad Alkhouli
Oct 15, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Giuseppe CullaroJennifer C Lai
Sep 7, 2019·European Journal of Gastroenterology & Hepatology·Dalia Morales-ArraezManuel Hernández-Guerra
Mar 29, 2019·Journal of Viral Hepatitis·Andrew de la TorreCherie Danko
Apr 7, 2020·Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates·Camila Guarnieri Ribeiro BuenoMaria Filomena Ceolim
Jul 11, 2019·PloS One·Simona CammarotaGiustino Parruti
Apr 17, 2019·Clinical Liver Disease·Amoah Yeboah-KorangClaus J Fimmel
May 12, 2019·Journal of Viral Hepatitis·Dalia Morales-ArraezManuel Hernández-Guerra
Apr 27, 2017·Journal of Clinical Gastroenterology·Ju Dong YangLewis R Roberts
Oct 2, 2020·Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates·Donald E Bailey, Donna M Zucker
Nov 22, 2019·World Journal of Hepatology·Nicholas LimAndrew Olson
Aug 8, 2021·Diagnostics·Imran ShahidSajida Hassan
Nov 20, 2021·Medicine·Nicolás MerchanteMiguel-Angel Simón