Advertisement

New Face of Hepatitis C

  • Tiffany Wu
  • Peter G. Konyn
  • Austin W. Cattaneo
  • Sammy SaabEmail author
Review

Abstract

Chronic hepatitis C viral (HCV) infection continues to carry a high burden of disease despite recent and emerging advancements in treatment. The persistently high prevalence of HCV is attributed to the rising opioid epidemic, with a history of injection drug use as the primary risk factor for infection. As a result, the epidemiology of HCV-infected individuals is changing. Previously a disease of “Baby Boomers,” males, and non-Hispanic blacks, the new generation of patients with HCV includes younger adults from 20 to 39 years of age, both men and women similarly represented, and non-Hispanic whites. Shifting trends in these demographics may be attributed to the use of injection drugs, which also has suggested impact on fibrosis progression in infected individuals. Awareness of the changing face of HCV is necessary to expand and revise recommendations regarding screening, outreach, and care engagement of infected individuals, in order to best identify patients at-risk for infection.

Keywords

Hepatitis C Epidemiology Diagnosis Risk factors 

Abbreviations

HCV

Hepatitis C virus

CDC

Center of Disease Control

PWID

People who inject drugs

NHANES

National Health and Nutrition Examination Survey

HCC

Hepatocellular carcinoma

Notes

Author’s contribution

TW and SS were involved in the study concept and design; TW and PGK acquired the data; TW, PGK, and SS analyzed and interpreted the data; TW, PGK, and SS drafted the manuscript; TW, PGK, AC, and SS were involved in the critical revision of the manuscript for important intellectual content; SS provided administrative, technical, or material support and was involved in the study supervision; statistical analysis (not applicable); obtained funding (not applicable).

Compliance with ethical standards

Conflict of Interest

The authors of this manuscript have no conflicts of interest to disclose.

References

  1. 1.
    Hofmeister MG, Rosenthal EM, Barker LK, et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013–2016. Hepatology 2018.  https://doi.org/10.1002/hep.30297. (Epub ahead of print).
  2. 2.
    Centers for Disease Control and Prevention (CDC). Viral hepatitis: statistics and surveillance. (2018, May 17). Retrieved from https://www.cdc.gov/hepatitis/hcv/index.htm.
  3. 3.
    Tempalski B, Pouget ER, Cleland CM, et al. Trends in the population prevalence of people who inject drugs in US metropolitan areas 1992–2007. PLoS ONE. 2013;8:e64789.CrossRefGoogle Scholar
  4. 4.
    Seth P, Scholl L, Rudd RA, Bacon S. Overdose deaths involving opioids, cocaine, and psychostimulants—United States, 2015–2016. MMWR Morb Mortal Wkly Rep. 2018;67:349–358.CrossRefGoogle Scholar
  5. 5.
    Zibbell JE, Iqbal K, Patel RC, et al. Increases in hepatitis C virus infection related to injection drug use among persons aged ≤ 30 years—Kentucky, Tennessee, Virginia, and West Virginia, 2006–2012. MMWR Morb Mortal Wkly Rep. 2015;64:453–458.Google Scholar
  6. 6.
    Martin NK, Vickerman P, Dore G, Hickman M. The HCV epidemics in key populations (including PWID, prisoners, and MSM): the use of DAAs as treatment for prevention. Curr Opin HIV AIDS. 2015;10:375–380.CrossRefGoogle Scholar
  7. 7.
    Denniston MM, Jiles RB, Drobeniuc J, et al. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. 2014;160:293–300.CrossRefGoogle Scholar
  8. 8.
    Tibbs CJ. Methods of transmission of hepatitis C. J Viral Hepat. 1995;2:113–119.CrossRefGoogle Scholar
  9. 9.
    Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR Recomm Rep. 2012;61:1–32.Google Scholar
  10. 10.
    Nili M, Luo L, Feng X, Chang J, Tan X. Disparities in hepatitis C virus infection screening among Baby Boomers in the United States. Am J Infect Control. 2018;46:1341–1347.CrossRefGoogle Scholar
  11. 11.
    Suryaprasad AG, White JZ, Xu F, et al. Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006–2012. Clin Infect Dis. 2014;59:1411–1419.CrossRefGoogle Scholar
  12. 12.
    Degenhardt L, Peacock A, Colledge S, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017;5:e1192–e1207.CrossRefGoogle Scholar
  13. 13.
    Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers and other drugs among women—United States, 1999–2010. MMWR Morb Mortal Wkly Rep. 2013;62:537–542.Google Scholar
  14. 14.
    Centers for Disease Control and Prevention (CDC). Emergency department visits involving nonmedical use of selected prescription drugs—United States, 2004–2008. MMWR Morb Mortal Wkly Rep. 2010;59:705–709.Google Scholar
  15. 15.
    Shiels MS, Freedman ND, Thomas D, Berrington de Gonzalez A. Trends in U.S. drug overdose deaths in non-hispanic black, hispanic, and non-hispanic white persons. Ann Intern Med. 2018;168:453–455.CrossRefGoogle Scholar
  16. 16.
    Zibbell JE, Asher AK, Patel RC, et al. Increases in acute hepatitis C virus infection related to a growing opioid epidemic and associated injection drug use, United States, 2004 to 2014. Am J Pub Health. 2018;108:175–181.CrossRefGoogle Scholar
  17. 17.
    Morse A, Barritt AS 4th, Jhaveri R. Individual state hepatitis C data supports expanding screening beyond baby boomers to all adults. Gastroenterology. 2018;154:1850–1851.CrossRefGoogle Scholar
  18. 18.
    Barritt AS 4th, Lee B, Runge T, Schmidt M, Jhaveri R. Increasing prevalence of hepatitis C among hospitalized children is associated with an increase in substance abuse. J Pediatr. 2018;192:159–164.CrossRefGoogle Scholar
  19. 19.
    Wang CC, Krantz E, Klarquist J, et al. Acute hepatitis C in a contemporary US cohort: modes of acquisition and factors influencing viral clearance. J Infect Dis. 2007;196:1474–1482.CrossRefGoogle Scholar
  20. 20.
    Grebely J, Page K, Sacks-Davis R, et al. The effects of female sex, viral genotype, and IL28B genotype on spontaneous clearance of acute hepatitis C virus infection. Hepatology. 2014;59:109–120.CrossRefGoogle Scholar
  21. 21.
    Villa E, Vukotic R, Cammà C, et al. Reproductive status is associated with the severity of fibrosis in women with hepatitis C. PLoS ONE. 2012;7:e44624.CrossRefGoogle Scholar
  22. 22.
    Hall EW, Rosenberg ES, Sullivan PS. Estimates of state-level chronic hepatitis C virus infection, stratified by race and sex, United States, 2010. BMC Infect Dis. 2018;18:224.CrossRefGoogle Scholar
  23. 23.
    Jhaveri R, Broder T, Bhattacharya D, Peters MG, Kim AY, Jonas MM. Universal screening of pregnant women for hepatitis C: the time is now. Clin Infect Dis. 2018;67:1493–1497.CrossRefGoogle Scholar
  24. 24.
    Ly KN, Jiles RB, Teshale EH, Foster MA, Pesano RL, Holmberg SD. Hepatitis C virus infection among reproductive-aged women and children in the United States, 2006 to 2014. Ann Intern Med. 2017;166:775–782.CrossRefGoogle Scholar
  25. 25.
    Patrick SW, Bauer AM, Warren MD, Jones TF, Wester C. Hepatitis C virus infection among women giving birth—Tennessee and United States, 2009–2014. MMWR Morb Mortal Wkly Rep. 2017;66:470–473.CrossRefGoogle Scholar
  26. 26.
    Haight SC, Ko JY, Tong VT, Bohm MK, Callaghan WM. Opioid use disorder documented at delivery hospitalization—United States, 1999–2014. MMWR Morb Mortal Wkly Rep. 2018;67:845–849.CrossRefGoogle Scholar
  27. 27.
    Benova L, Mohamoud YA, Calvert C, Abu-Raddad LJ. Vertical transmission of hepatitis C virus: systematic review and meta-analysis. Clin Infect Dis. 2014;59:765–773.CrossRefGoogle Scholar
  28. 28.
    Prasad MR, Hepatitis C. Virus screening in pregnancy: is it time to change our practice? Obstet Gynecol. 2016;128:229–230.CrossRefGoogle Scholar
  29. 29.
    Waruingi W, Mhanna MJ, Kumar D, Abughali N. Hepatitis C Virus universal screening versus risk based selective screening during pregnancy. J Neonat Perinat Med. 2015;8:371–378.CrossRefGoogle Scholar
  30. 30.
    Boaz K, Fiore AE, Schrag SJ, Gonik B, Schulkin J. Screening and counseling practices reported by obstetrician-gynecologists for patients with hepatitis C virus infection. Infect Dis Obstet Gynecol. 2003;11:39–44.CrossRefGoogle Scholar
  31. 31.
    Thomas DL, Astemborski J, Rai RM, et al. The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA. 2000;284:450–456.CrossRefGoogle Scholar
  32. 32.
    Mir HM, Stepanova M, Afendy M, Kugelmas M, Younossi ZM. African Americans are less likely to have clearance of hepatitis C virus infection: the findings from recent U.S. population data. J Clin Gastroenterol. 2012;46:e62–e65.CrossRefGoogle Scholar
  33. 33.
    Sterling R, Stravitz R, Luketic V, et al. A comparison of the spectrum of chronic hepatitis C virus between Caucasians and African Americans. Clin Gastroenterol Hepatol. 2004;2:469–473.CrossRefGoogle Scholar
  34. 34.
    Davila J, Morgan R, Shaib Y, McGlynn KA, El-Serag HB. Hepatitis C infection and the increasing incidence of hepatocellular carcinoma: a population-based study. Gastroenterology. 2004;127:1372–1380.CrossRefGoogle Scholar
  35. 35.
    Larney S, Zaller ND, Dumont DM, Willcock A, Degenhardt L. A systematic review and meta-analysis of racial and ethnic disparities in hepatitis C antibody prevalence in United States correctional populations. Ann Epidemiol. 2016;26:570-8.e2.CrossRefGoogle Scholar
  36. 36.
    Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–714.CrossRefGoogle Scholar
  37. 37.
    Saab S, Jackson C, Nieto J, Francois F. Hepatitis C in African Americans. Am J Gastroenterol. 2014;109:1576–1584.CrossRefGoogle Scholar
  38. 38.
    Gerbi GB, Xing J, Rupp LB et al. Hospitalization among persons with chronic hepatitis C virus infection in the United States: The Chronic Hepatitis Cohort Study (CHeCS), 2006–2010. IDSA, San Francisco, CA, 2–6 October 2013.Google Scholar
  39. 39.
    Surjadi M, Torruellas C, Ayala C, Yee HF Jr, Khalili M. Formal patient education improves patient knowledge of hepatitis C in vulnerable populations. Dig Dis Sci. 2011;56:213–219.  https://doi.org/10.1007/s10620-010-1455-3.CrossRefGoogle Scholar
  40. 40.
    Rempel JD, Uhanova J. Hepatitis C virus in American Indian/Alaskan native and aboriginal peoples of North America. Viruses. 2012;4:3912–3931.CrossRefGoogle Scholar
  41. 41.
    Sims OT, Guo Y, Shoreibah MG, et al. Short article: alcohol and substance use, race, and insurance status predict nontreatment for hepatitis C virus in the era of direct acting antivirals: a retrospective study in a large urban tertiary center. Eur J Gastroenterol Hepatol. 2017;29:1219–1222.CrossRefGoogle Scholar
  42. 42.
    Poynard T, Ratziu V, Charlotte F, Goodman Z, McHutchison J, Albrecht J. Rates and risk factors of liver fibrosis progression in patients with chronic hepatitis C. J Hepatol. 2001;34:730–739.CrossRefGoogle Scholar
  43. 43.
    Wright M, Goldin R, Fabre A, et al. Measurement and determinants of the natural history of liver fibrosis in hepatitis C virus infection: a cross sectional and longitudinal study. Gut. 2003;52:574–579.CrossRefGoogle Scholar
  44. 44.
    Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349:825–832.CrossRefGoogle Scholar
  45. 45.
    Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001;345:41–52.CrossRefGoogle Scholar
  46. 46.
    Wiley TE, Brown J, Chan J. Hepatitis C infection in African Americans: its natural history and histological progression. Am J Gastroenterol. 2002;97:700–706.CrossRefGoogle Scholar
  47. 47.
    Kallwitz ER, Layden-Almer J, Dhamija M, et al. Ethnicity and body mass index are associated with hepatitis C presentation and progression. Clin Gastroenterol Hepatol. 2010;8:72–78.CrossRefGoogle Scholar
  48. 48.
    Terrault NA, Im K, Boylan R, et al. Fibrosis progression in African Americans and Caucasian Americans with chronic hepatitis C. Clin Gastroenterol Hepatol. 2008;6:1403–1411.CrossRefGoogle Scholar
  49. 49.
    Tong MJ, el-Farra NS, Reikes AR, Co RL. Clinical outcomes after transfusion-associated hepatitis C. N Engl J Med. 1995;332:1463–1466.CrossRefGoogle Scholar
  50. 50.
    Wiese M, Grüngreiff K, Güthoff W, et al. Outcome in a hepatitis C (genotype 1b) single source outbreak in Germany—a 25-year multicenter study. J Hepatol. 2005;43:590–598.CrossRefGoogle Scholar
  51. 51.
    Wilson LE, Torbenson M, Astemborski J, et al. Progression of liver fibrosis among injection drug users with chronic hepatitis C. Hepatology. 2006;43:788–795.CrossRefGoogle Scholar
  52. 52.
    Chirikov VV, Marx SE, Mathena SR, Strezewski JP, Saab S. Development of a comprehensive dataset of hepatitis C patients and examination of disease epidemiology in the United States, 2013–2016. Adv Ther. 2018;35:1087–1102.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Tiffany Wu
    • 1
  • Peter G. Konyn
    • 2
  • Austin W. Cattaneo
    • 2
  • Sammy Saab
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Department of MedicineUniversity of California at Los AngelesLos AngelesUSA
  3. 3.Department of SurgeryUniversity of California at Los AngelesLos AngelesUSA
  4. 4.Pfleger Liver InstituteUCLA Medical CenterLos AngelesUSA

Personalised recommendations