Estimating the prevalence of Hepatitis C cases in New York State

BACKGROUND: The prevalence of hepatitis C virus (HCV) in New York State (NYS) is currently unknown. With HCV-related morbidity, mortality, direct and indirect care costs expected to rise in the next two decades, an estimate of the prevalence of HCV antibody (anti-HCV) positivity and chronic HCV at the state-level can inform health policy and planning decisions regarding counseling, screening, medical management and resource allocation. METHODS: Anti-HCV prevalence by socio-demographic subgroups among respondents ages 20 and older from the National Health and Nutrition Examination Survey (NHANES) from 1999-2008, were extrapolated to the underlying socio-demographics within NYS regions. Socio-demographics chosen were based upon predictive modeling. Accounting for populations excluded in NHANES sampling (i.e. incarcerated and homeless), prevalence estimates from existing literature were extrapolated to the underlying size of such groups in NYS. The number of cases was summed providing a statewide anti-HCV estimate. The proportion of chronic cases from NHANES was applied to estimate the prevalence of chronic HCV. RESULTS: Socio-demographics predictive of anti-HCV positivity were: age-group, gender, race/ethnicity, and poverty. The expected anti-HCV prevalence in NYS, not accounting for populations excluded in NHANES was 1.64% (N=235,128). Accounting for excluded populations, there were an additional 51,134cases (anti-HCV prevalence: 1.95% (range: 0.96, 2.98%)). The chronic HCV prevalence estimate was 1.33% (range: 0.44, 2.31%) or 197,705 cases. CONCLUSION: This methodology suggests a high burden of HCV in NYS for those ages 20 and older. Results can be used to inform program planning, evaluate prevention measures and project future health needs of the population.