Hepatitis C virus infection is the most common chronic bloodborne viral infection in the United States. First identified in 1988, HCV is the causative agent for what was formerly known as non-A non-B hepatitis, and is estimated to have infected as many as 242,000 Americans annually during the 1980's. Since 1989, the annual number of new infections has declined by more than 80 percent to approximately 41,000 by 1998. A national survey conducted between 1988-1994 [the third National Health and Nutrition Examination Survey; NHANES III] of the civilian, non-institutionalized U.S. population found that 1.8 percent of Americans (3.9 million) have been infected with HCV, of whom most (2.7 million) are chronically infected with HCV.
These estimates of prevalence are likely conservative, because the survey excluded incarcerated and homeless persons, groups that have high prevalence of HCV infection. Most infected persons were aged 30-49 years when the survey was done in the early 1990s. Many of these individuals are not aware of their infection and are not clinically ill. Infected persons serve as a source of transmission to others and are at risk for chronic liver disease during the first two or more decades following initial infection.
Hepatitis C is the major reason for liver transplants in the United States and accounts for the majority of the 4,900 people who undergo liver transplantation each year. In the U.S., the CDC estimates that hepatitis C is responsible for 8,000 to 10,000 deaths per year and could increase to 38,000 by the year 2010.
Hepatitis C infection occurs among persons of all ages, but the highest incidence of acute hepatitis C is found among persons aged 20-39 years, and males predominate slightly. African Americans and whites have similar incidence of acute disease; persons of Hispanic ethnicity have higher rates. In the general population, the highest prevalence rates of HCV infection are found among persons aged 30-49 years and among males. Unlike the racial/ethnic pattern of acute disease, African Americans have a substantially higher prevalence of HCV infection than do whites. It is estimated that one-quarter of those infected with HIV/AIDS are also infected with HCV.
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