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This study estimated hepatitis C virus (HCV) prevalence across 48 US states and the District of Columbia from 2017-2020 using a Bayesian statistical model that integrated six different HCV-related data sources. The analysis found an average HCV prevalence of 1.32%, corresponding to approximately 3.33 million infected adults, with state-level estimates ranging from 0.74% in North Dakota to 2.22% in Oklahoma. Higher prevalence was concentrated in South Central states, Appalachia, and the West, while ten states accounted for 56% of all estimated infections.
Why it matters
These state-level estimates provide critical baseline data for allocating public health resources and measuring progress toward HCV elimination goals. The substantial geographic variation identified indicates that prevention and treatment strategies will need to be tailored to specific regional needs, particularly in high-burden areas.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background State-level estimates of hepatitis C virus (HCV) prevalence are needed to guide resource allocation and to provide a baseline against which to measure progress toward elimination goals. Population prevalence is not directly observable, requiring estimation from indirect data sources. Methods We adapted a Bayesian spatial integrated abundance model to estimate state-level HCV prevalence during 2017-2020 across 48 states and the District of Columbia. The model integrated six HCV-related outcomes: acute and chronic surveillance cases, HCV-related deaths, observations of HCV in [MarketScan] administrative claims data, diagnoses of HCV in Medicaid recipients, and treatment with direct-acting antivirals in Medicaid recipients. Estimates were anchored to a national prevalence estimate, and the model accounted for data source-specific selection, heterogeneity in HCV risk factors across states, and geospatial correlation. Results Estimated average prevalence was 1.32% (95% credible interval [CrI]: 0.94%-1.80%), corresponding to 3.33 million (95% CrI: 2.37-4.65 million) adults with HCV infection across 48 states and DC. State estimates ranged from 0.74% in North Dakota to 2.22% in Oklahoma (median state-specific prevalence, 1.27%), with higher prevalence concentrated in South Central states, Appalachia, and the West, and the lower prevalence in the upper Midwest, Southeast, and New England. Ten states accounted for 56% of estimated infections. Estimates were stable in sensitivity analyses (most differences <1 percentage point). Conclusions These estimates quantify state-level HCV burden prior to the 2021 federal expansion of HCV surveillance funding, providing a baseline for monitoring elimination progress. Geographic variation indicates that resource needs will differ by jurisdiction.
Source: Estimating Hepatitis C Virus Prevalence in US States and the District of Columbia, 2017-2020