Hepatitis C is more common than HIV
Each year, there are about 36,000 new cases of acute hepatitis C.1 It is estimated that about 4.1 million people in the United States are infected with hepatitis C, which is about 1.8% of the population.2 This makes hepatitis C much more common than HIV infection. About 75% to 85% have chronic hepatitis C infection, which means they could not get rid of the virus on their own.3
Hepatitis C prevalence is highest among those with large or repeated exposures to blood such as intravenous (IV) drug users, hemophiliacs treated with clotting factor concentrates produced prior to 1987; and recipients of transfusions or organs, or both, from HCV-positive donors. Most (65%) HCV infections are transmitted by intravenous drug use. Studies of prison inmates, military veterans and homeless men have confirmed injection drug use as the most common risk factor for HCV infection. 4,5
Hepatitis C and veterans
Several studies suggest veterans have a higher prevalence of hepatitis C virus infection than nonveterans, possibly because of military exposures. In a study with randomly selected veterans, significant predictors of HCV infection included demographic factors, period of military service (for example, Vietnam era), prior diagnoses, health care use, and lifestyle factors. The prevalence of hepatitis C among the veterans in this study exceeded the estimate from the general US population by more than twofold.6
If you are a veteran and think you might be at risk for hepatitis C, ask your doctor about Getting Tested for Hepatitis C. In some cases, the diagnosis can be related to military duty and treatment may be covered by VA benefits.
Hepatitis C and hemophiliacs
Hemophiliacs are at higher risk than the general population for all bloodborne infections because they regularly receive blood transfusions and blood products such as clotting factor. However, in 1987, a process to inactivate viruses such as HCV was introduced. In addition, screening for hepatitis C antibodies began in US blood banks in 1990, and continued to improve throughout the decade, with nucleic acid amplification (NAT) screening instituted in 1999. Altogether, these measures dramatically decreased the probability of blood or blood products as a potential source of HCV infection. However, hemophiliacs who received a transfusion or factor concentrate before 1987 may be at higher risk.7,8
Inmates are at risk for hepatitis C
The rate of hepatitis C infection is higher in the prison population than in the general population, with estimates ranging from 13% to 54%.9 This statistic is probably because injection drug use is very common among those who are in prison. And 70% to 80% of those currently in prison admit to having used illegal drugs.10
Homeless can be at risk for hepatitis C
Hepatitis C is also very common in the homeless population, again due to the prevalence injection drug use and high-risk sexual behavior.
Hepatitis C and HIV-positive people
About one quarter of people with HIV (the virus that causes AIDS) are also infected with the hepatitis C virus which is often contracted through injection drug use or blood transfusions.11 These people should be tested for HCV because hepatitis C infection can become serious very quickly in HIV-positive people.
1Afdhal, N.H. The Natural History of Hepatitis C. Seminars in Liver Disease. 2004. 24 (2): 3-8.
2Armstrong, G. L., Wasley, A., Simard, E.P., et al. The Prevalence of Hepatitis C Virus Infection in the United States, 1999 through 2002. Annals of Internal Medicine. 16 May, 2006. 144: 705-714. Available at: http://www.annals.org/cgi/content/full/144/10/705. Accessed January 14, 2009.
3Department of Health and Human Services, Centers for Disease Control and Prevention. Hepatitis C: FAQs for Health Professionals. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section1. Accessed January 8, 2009.
4Afdhal, N.H. The Natural History of Hepatitis C. Seminars in Liver Disease. 2004. 24 (2): 3-8.
5Stein, JA, Nyamathi, A. Correlates of Hepatitis C virus infection in homeless men: a latent variable approach. Drug and Alcohol Dependence. 15 July, 2004. 75 (1): 89-95.
6Dominitz JA, Boyko EJ, Koepsell TD et al. Elevated prevalence of hepatitis C infection in users of United States veterans medical centers. Hepatology. 2005 Jan; 41(1): 88-96.Available at: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=15619249&ordinalpos=20&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum. Accessed November 16, 2007.
7American Association of Blood Banks. Transfusion-Transmitted Diseases: Viruses. Available at: http://www.aabb.org/Content/About_Blood/Facts_About_Blood_and_Blood_Banking/fabloodtrans.htm. Accessed January 8, 2009.
8National Digestive Diseases Information Clearinghouse (NDDIC). Chronic Hepatitis C: Current Disease Management. Available at http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/. Accessed January 8, 2009.
9Cassidy W. Hepatitis C infections in prisons. HCV Advocate. 2003. Available at: http://www.hcvadvocate.org/hcsp/hcsp_pdf/cassidy-1.pdf. Accessed November 16, 2007.
10Hiller ML, Webster JM, Garrity TF. Prisoners with substance abuse and mental health problems: use of health and health services. American Journal of Drug and Alcohol Abuse. Feb, 2005. Available at: http://findarticles.com/p/articles/mi_m0978/is_1_31/ai_n13648103. Accessed November 16, 2007.
11Centers for Disease Control and Prevention. Frequently asked questions and answers about coinfection with hepatitis C virus. Available at: http://www.cdc.gov/hiv/resources/qa/HIV-HCV_Coinfection.htm. Accessed November 16, 2007.
