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Treatment for Hepatitis C Virus Infection in Adults: Comparative Effectiveness

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Background: Hepatitis C Virus Infection and Its Prevalence

Hepatitis C virus (HCV) is the most common chronic blood-borne pathogen in the United States. HCV is primarily acquired by repeated percutaneous exposures to blood, with injection drug use being the strongest risk factor. Approximately 1.6 percent of U.S. adults over 20 years of age have antibodies to HCV, indicating prior acute HCV infection. About 70 to 85 percent of patients with acute HCV infection develop chronic HCV infection, defined by the presence of persistent viremia.

In the United States, about 75 percent of patients with HCV infection are infected with genotype 1, 20 percent are infected with genotype 2 or 3, and the remainder are infected with genotypes 4, 5, or 6 of the virus.

Chronic HCV infection is associated with an estimated 15,000 deaths each year in the United States. It is the most common indication for liver transplantation among American adults, accounting for more than 30 percent of cases. The prevalence of chronic HCV infection is thought to have peaked in 2001 at 3.6 million people, and the yearly incidence has declined from more than 200,000 cases per year in the 1980s to around 16,000 cases in 2009.