A new study published in the Annals of Internal Medicine suggests massive amounts of underreporting may occur within the system set up by the Centers for Disease Control and Prevention to estimate the incidence of acute hepatitis C virus infection.
According to a team led by investigators from Massachusetts General Hospital in Boston and the Massachusetts Department of Public Health, less than 1 percent of a group of acute HCV patients participating in a long-term study of the disease had been reported to the CDC, largely because data that would have triggered reporting was either not available in a timely fashion or did not meet CDC definitions for acute HCV infection.
"The incidence of HCV can be likened to an 'iceberg,' in that only a fraction of cases — the proverbial 'tip' — is visible," said Arthur Kim, MD, of the MGH Division of Infectious Diseases and senior author of the study. "That is due to the minimal symptoms that usually accompany acute HCV and the fragmented care available to those at highest risk, such as those who inject drugs."
Dr. Kim also explained that many states have limited resources to track and identify HCV cases. "Since even Massachusetts, where we have reasonable resources for HCV surveillance, found it difficult to report acute cases during the period we studied, it's likely that national estimates have been based on inaccurate numbers," he said.
The authors noted the reported incidence of HCV infection in the U.S. has been decreasing since the 1990s, but the rate of decrease has leveled off in recent years and may now be increasing due to an expanding opioid epidemic.
To read more about the study, click here.
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