|
Hepatitis C virus (Hepatitis C Virus)
infection is the most common chronic bloodborne
infection in the United States. During the 1980s, an
average of 242,000 new infections occurred every year.
However, with the advent of new tests for Hepatitis C Virus, the
annual number of new infections has declined by
>80% to 36,000 by 1996. An estimated 3.9 million
(1.8%) Americans have been infected with Hepatitis C Virus.
75-85% of these persons are chronically infected and
may not be aware of their infection due to a lack of
clinical symptoms. However, infected persons can serve
as a source of transmission to others and are at risk
for chronic liver disease or other Hepatitis C Virus-related chronic
diseases during the first two or more decades
following initial infection.
Chronic liver disease is
the tenth leading cause of death among adults in the
United States, and accounts for approximately 25,000
deaths annually. It is estimated from population-based
studies that 40% of chronic liver disease is Hepatitis C Virus-related,
resulting in an estimated 8,00010,000 deaths each
year. Hepatitis C Virus- associated end-stage liver disease is the
most frequent indication for liver transplantation
among adults. Because most Hepatitis C Virus-infected persons are
aged 3049 years, the number of deaths attributable
to Hepatitis C Virus-related chronic liver disease could increase
substantially during the next 1020 years as this
group of infected persons reaches ages at which
complications from chronic liver disease typically
occur.
Hepatitis C Virus is transmitted
primarily through large or repeated direct
percutaneous exposures to blood. In the United States,
the relative importance of the two most common
exposures associated with transmission of Hepatitis C Virus, blood
transfusion and injecting-drug use, has changed over
time. Blood transfusion, which accounted for a
substantial proportion of Hepatitis C Virus infections acquired
>15 years ago, rarely accounts for recently
acquired infections although the risk is not zero. In
contrast, injecting-drug use consistently has
accounted for a substantial proportion of Hepatitis C Virus
infections and currently accounts for 60% of Hepatitis C Virus
transmission in the United States and a high
proportion of infections continue to be associated
with injecting-drug use.
Finally, in order to
reduce the burden of Hepatitis C Virus infection and Hepatitis C Virus-related
disease in the United States, primary prevention
activities to reduce the risk for contracting Hepatitis C Virus
infection and secondary prevention activities to
reduce the risk for liver and other chronic diseases
in Hepatitis C Virus-infected persons must be implemented. These
programs must be supported by the medical community
and the general population.
|
