PERFORMANCE-CHARACTERISTICS AND RESULTS OF A LARGE-SCALE SCREENING-PROGRAM FOR VIRAL-HEPATITIS AND RISK-FACTORS ASSOCIATED WITH EXPOSURE TOVIRAL-HEPATITIS-B AND VIRAL-HEPATITIS-C - RESULTS OF THE NATIONAL HEPATITIS SCREENING SURVEY

Chronic viral hepatitis frequently goes undetected until cirrhosis dev elops, Although the effect of interferon on the natural history of hep atitis B virus (HBV) or hepatitis C virus (HCV) infection in asymptoma tic persons is unknown, treatment may modify the course of the infecti on, producing cures in some. In September 1992, screening for HBV and HCV was offered in 40 centers throughout the United States, Demographi c features, potential risk factors, and symptoms were studied, Blood s amples were obtained for the determination of serum alanine aminotrans ferase levels and for markers of HBV and HCV infection, Thirteen thous and nine hundred ninety seven subjects were screened, The prevalence o f infection with HBV or HCV was 24.8% (HBV 17.8%; HCV 7.0%; and both 2 .8%), Hepatitis B and C disease was present in 0.7% and 4.4% of the po pulation, respectively. Risk factors for HBV and HCV infection were si milar in: blood transfusions, hemodialysis, IV drug use, and sex with an IV drug user, For HBV infection, sex with multiple partners, increa sing age, and birth in South East Asia or Africa were additional risk factors, The cost to find a case of HCV infection is less than the cos ts for finding many other treatable diseases. Screening for HBV, thoug h more costly, is reasonably efficient, and simultaneous screening for HBV and HCV provides greater efficiency, It is practical to consider screening for HBV and HCV in the United States, particularly if any ri sk factor is present, Improved treatment strategies will make screenin g even more cost effective.