title: Racial disparities in the proportion of current, unresolved hepatitis C virus infections in the United States, 2003-2010.
abstract: BACKGROUND
  The hepatitis C virus (HCV) antibody test alone does not distinguish current from resolved infections.
  
  
  OBJECTIVE
  The study aimed to describe the percentage of current HCV infection, defined by HCV RNA positivity, among those tested positive for anti-HCV, and to examine characteristics of those with current infection.
  
  
  METHODS
  Using nationally representative data from the 2003 to 2010 National Health and Nutrition Examination Surveys, descriptive analyses and regressions were performed on data from anti-HCV-positive adults aged ≥ 40 years.
  
  
  RESULTS
  Of 13,909 participants examined, 304 were anti-HCV-positive. Of these, 238 or 75.3% [95% confidence interval (CI) 67.5-81.8%] had detectable viral RNA. The percentage of current, unresolved HCV infection was highest among non-Hispanic Blacks (91.1%) and lowest among those with a college education (57.3%). In multivariate analyses, non-Hispanic Blacks were more likely to have current HCV infection compared to non-Hispanic Whites (adjusted odds ratio 3.9, 95% CI 1.6-9.2). Among persons with current HCV infection, most had elevated alanine aminotransferase (56.5%) or aspartate aminotransferase (71.8%) levels, but only 35.3% reported having been diagnosed with any abnormal liver conditions. Excessive alcohol drinking was reported by 27.3% of participants with current HCV infection.
  
  
  CONCLUSIONS
  Among adults aged ≥ 40 years who had ever been infected with HCV, approximately three-quarters had current, unresolved HCV infection. Non-Hispanic Blacks were more likely to have current infection than non-Hispanic Whites. The majority of those with current infection had abnormal liver function tests but had not received appropriate diagnoses. Many currently infected persons would benefit from lifestyle modifications to avoid the multiplicative effect of alcohol on HCV infection.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Mailstop G-37, 1600 Clifton Road, Atlanta, GA, 30333, USA.
authors.forename: Gui
authors.initials: G
authors.lastname: Liu
authors.forename: Scott D
authors.initials: SD
authors.lastname: Holmberg
authors.forename: Saleem
authors.initials: S
authors.lastname: Kamili
authors.forename: Fujie
authors.initials: F
authors.lastname: Xu
mesh_terms: D000328:Adult; D005260:Female; D054625:Healthcare Disparities; D019698:Hepatitis C, Chronic / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology