The Natural History of Community-Acquired Hepatitis C in the United States
Open accessAbstract
BACKGROUND: Chronic liver disease develops in more than half of patients with post-transfusion hepatitis C, but little is known about the natural history of community-acquired hepatitis C. METHODS: In 1985 and 1986 we identified adults with acute non-A, non-B hepatitis in four counties in the United States and followed them prospectively. We used three markers to detect hepatitis C virus (HCV) infection in stored samples of serum: antibody to HCV (anti-HCV) detected by second-generation serologic assays; HCV RNA detected by polymerase-chain-reaction assay; and antibody to HCV antigen (anti-HCVAg) detected by fluorescent-antibody-blocking assay. RESULTS: Of 130 patients with non-A, non-B hepatitis, 106 (82 percent) had HCV infection, 93 were positive for anti-HCV, and 13 were positive only for HCV RNA or anti-HCVAg. Chronic hepatitis developed in 60 (62 percent) of 97 HCV-infected patients followed for 9 to 48 months, with no relation to the risk factors for infection. Ten of the 30 patients who had liver biopsies had chronic active hepatitis. In samples collected 42 to 48 months after the onset of hepatitis, HCV RNA was detected in 12 of 13 tested patients with chronic hepatitis and in all 15 tested patients with hepatitis that had resolved. Anti-HCV persisted in all but two of the initially positive patients, for a rate of antibody loss of 0.6 per 100 person-years. CONCLUSIONS: Patients with community-acquired hepatitis C have a high rate of chronic hepatitis. HCV may be a major cause of chronic liver disease in the United States, and in most patients HCV infection seems to persist for at least several years, even in the absence of active liver disease.
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HCV RNA can be detected in blood within 1-3 weeks after exposure.
“HCV RNA can be detected in blood within 1–3 weeks after exposure.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1363]
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- Authors
- Alter, M. J., Margolis, H. S., Krawczynski, K., Judson, F. N., Mares, A., Alexander, W. J., Hu, P. Y., Miller, J. K., Gerber, M. A., Sampliner, R. E., Meeks, E. L., & Beach, M. J.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Tulane University (US)
- ORCID
- Gerber, Michael A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1992-12-31
- Volume
- 327
- Issue
- 27
- Pages
- 1899-1905
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2328171401
- Cited by
- 1,592
- References
- 26
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 8 · 2021: 17 · 2020: 7 · 2019: 11 · 2018: 9 · 2017: 15 · 2016: 22 · 2015: 32 · 2014: 30 · 2013: 38 · 2012: 33
- FWCI
- 48.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (224-90-1002, 224-85-1001)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Keywords
- hepatitis C virus, chronic hepatitis, chronic liver disease, non-A non-B hepatitis, HCV RNA persistence, natural history of infection, chronic active hepatitis
- MeSH terms
- Adolescent, Adult, Antigens, Viral, Base Sequence, Chronic Disease, Female, Follow-Up Studies, Hepatitis Antibodies, Hepatitis, Chronic, Hepatitis C, Humans, Male, Molecular Sequence Data, Prospective Studies, RNA, Viral, Time Factors, United States, Hepacivirus, Hepatitis C Antigens, Hepatitis C Antibodies
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