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THE PREVALENCE OF HEPATITIS C VIRUS INFECTION IN

THE UNITED STATES, 1988 THROUGH 1994


(INTERNASIONAL)

Disusun untuk melengkapi tugas Mata Kuliah Tekhnologi Informasi

Nama Kelompok :

1. Julan Ferdina Risca (201501001)

2. Fita Annisatur Rosyidah (201501022)

3. Dwi Rindayu Farista (201501036)

4. Adhe Sofiyanti (201501037)

5. Dwi Anggita Sari (201501045)

FAKULTAS S1 KEPERAWATAN

SEKOLAH TINGGI ILMU KESEHATAN BINA SEHAT PPNI

2017
ABSTRACT

Background Because many persons with chronic hepatitis C virus (HCV) infection are
asymptomatic, population-based serologic studies are needed to es-timate the prevalence of
the infection and to develop and evaluate prevention efforts.
Methods We performed tests for antibody to HCV (anti-HCV) on serum samples from
21,241 persons six years old or older who participated in the third Na-tional Health and
Nutrition Examination Survey, con-ducted during 1988 through 1994. We determined the
prevalence of HCV RNA by means of nucleic acid am-plification and the genotype by means
of sequencing. Results The overall prevalence of anti-HCV was 1.8 percent, corresponding to
an estimated 3.9 mil-lion persons nationwide (95 percent confidence in-terval, 3.1 million to
4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were
30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an
estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million
to 3.0 million) were chronically infected, of whom 73.7 percent were in-fected with genotype
1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among sub-jects 17 to
59 years of age, the strongest factors in-dependently associated with HCV infection were ille-
gal drug use and high-risk sexual behavior. Other factors independently associated with
infection in-cluded poverty, having had 12 or fewer years of ed-ucation, and having been
divorced or separated. Nei-ther sex nor racialethnic group was independently associated
with HCV infection.
Conclusions In the United States, about 2.7 mil-lion persons are chronically infected with
HCV. Peo-ple who use illegal drugs or engage in high-risk sex-ual behavior account for most
persons with HCV infection. (N Engl J Med 1999;341:556-62.)
1999, Massachusetts Medical Society.
HEPATITIS C virus (HCV) infection is a leading cause of chronic liver disease in the United
States. Before the character-ization of HCV,1,2 the magnitude of in-

fection could not be reliably determined because assessment of clinical disease (i.e., non-A,
non-B hep-atitis) underestimated the true extent of infection. After tests to detect antibody to
HCV (anti-HCV) became available, studies to determine the prevalence of HCV infection in
the general population were performed, mostly with volunteer blood donors as the subjects.3,4
However, the prevalence of HCV among blood donors does not reflect the prevalence in the
general population, since even first-time donors are a highly selected group that has been
screened for risk factors associated with various infectious dis-eases. To estimate the true
prevalence of HCV infec-tion in the United States, we tested serum samples from
participants in the third National Health and Nutrition Examination Survey (NHANES III)
for anti-HCV.
DAFTAR ISI
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Daftar Isi

Daftar Tabel

Daftar Gambar

BAB I

1.1 Latar Belakang Masalah

1.1.1 Contoh Permasalahan

BAB II

2.1 Hasil Penelitian Terdahulu

BAB III

3.1

Daftar Pustaka
DAFTAR TABEL

TABLE 1. PREVALENCE OF ANTIBODY TO HCV (ANTI-HCV) ACCORDING


TO DEMOGRAPHIC CHARACTERISTICS IN NHANES III.*
PREVALE
NCE OF ESTIMATED NO.
ANTI- INFECTED
NO. HCV NATIONWIDE
TEST
CHARACTERISTIC ED (95% CI) (95% CI)
% thousands
21,24 1.8 (1.5 387
All subjects 1 2.3) 5 (31024840)

Race or ethnic group


1. (1.1 235
Non-Hispanic white 7,965 5 2.0) 9 (17743137)
3. (2.6
Non-Hispanic black 6,119 2 4.0) 762 (609953)
2. (1.7
Mexican American 6,268 1 2.6) 261 (210323)
2. (1.4
Other 889 9 5.8) 493 (245993)
Sex
10,07 2. (2.0 258
Male 6 5 3.2) 6 (20123323)
11,16 1. (0.9 128
Female 5 2 1.6) 9 (9671717)
Marital status 5. (3.7
Divorced or separated 1,771 1 7.1) 921 (6681270)
Never married, married, or 14,80 1. (1.5 285
widowed 1 8 2.3) 5 (22833570)
Poverty index
3. (2.4
Below poverty level 5,345 2 4.3) 937 (7001254)
13,97 1. (1.2 262
At or above poverty level 4 6 2.0) 5 (20293396)
Education
11,97 2. (2.1 286
12 yr 1 8 3.6) 6 (22163706)
1. (0.8
>12 yr 4,528 3 2.0) 898 (5831384)
Area of residence
Metropolitan (population, 10,35 2. (1.6 218
1 million) 1 2 2.8) 8 (16732682)
Nonmetropolitan 10,89 1. (1.1 168
(population, <1 million) 0 6 2.2) 6 (12182334)
Region of residence
2. (1.4
Northeast 2,718 0 2.9) 847 (5941208)
2. (1.3 145
South 9,230 0 3.1) 5 (9572211)
1. (0.9
Midwest 4,101 3 1.8) 642 (443929)
2. (1.3
West 5,192 1 3.3) 931 (5911468)
Military-service status
1. (1.2
Ever in military 2,399 7 2.5) 469 (323680)
14,11 2. (1.8 329
Never in military 7 2 2.9) 0 (25844188)
Country of birth
17,28 1. (1.5 339
United States 8 9 2.3) 0 (27224222)
1. (0.9
Other 3,895 8 3.7) 480 (238966)

*NHANES III denotes the third National Health and Nutrition Examination Survey, and CI
con-fidence interval.

The totals vary according to the availability of data.

P<0.05 for the comparison with non-Hispanic whites.

P<0.05.

Only persons 17 years of age or older are included; values have not been adjusted for age.
TABLE 2. PREVALENCE OF ANTIBODY TO HCV (ANTI-HCV) ACCORDING TO
AGE AND RACE OR ETHNIC GROUP IN NHANES III.*
TOTAL NON- NON- MEXICAN
POPULATIO HISPANIC HISPANIC AMERICAN
AGE N WHITES BLACKS S
PREVALE PREVALE PREVALE PREVAL
NCE NCE NCE ENCE
OF ANTI- OF ANTI- NO OF ANTI- OF ANTI-
NO. HCV NO. HCV . HCV NO. HCV
TEST (95% TEST (95% TEST TEST
ED CI) ED CI) ED (95% CI) ED (95% CI)
% % % %
0. (0.04 0. (0.02 0.2 (0.1 (0.1
611 yr 2762 2 0.6) 732 2 1.2) 895 0.8) 1014 0.4 2.8)
1219 0. 0. (0.02 1.2 (0.4 (0.1
yr 2905 4 (0.20.9) 746 2 1.2) 1017 4.0) 995 0.4 1.2)
2029 1. 1. 1.8 (1.1 (1.4
yr 3275 6 (1.02.5) 849 6 (0.82.9) 1029 2.8) 1255 2.0 2.8)
3039 3. 3. 6.0 (4.6 (2.5
yr 3121 9 (2.85.5) 997 2 (2.15.0) 1041 7.8) 952 3.7 5.7)
4049 3. 2. 6.3 (4.2 (2.0
yr 2454 0 (2.14.4) 879 6 (1.64.4) 751 9.4) 718 3.0 4.8)
5059 1. 0. 3.6 (2.2 (3.4
yr 1762 4 (1.02.1) 865 4 (0.11.0) 447 6.1) 357 6.0 10.4)
6069 0. 0. 2.5 (1.8 (0.7
yr 2194 9 (0.51.7) 952 7 (0.31.9) 527 3.4) 638 1.5 3.4)
1. 0. 2.8 (1.4 (0.1
70 yr 2768 0 (0.71.4) 1945 9 (0.61.2) 412 5.4) 339 0.2 1.0)
*NHANES III denotes the third National Health and Nutrition Examination
Survey, and CI confidence interval. Totals include subjects whose race or ethnic
group was other.
TABLE 3. AGE-ADJUSTED PREVALENCE OF ANTIBODIES TO HCV (ANTI-
HCV) ACCORDING TO RACE OR ETHNIC GROUP AND POTENTIAL RISK
FACTORS FOR INFECTION IN NHANES III.*
TOTAL NON- NON- MEXICAN
POPULATIO HISPANIC HISPANIC AMERICAN
VARIABLE N WHITES BLACKS S
PREVALEN PREVALE PREVALEN PREVALE
CE NCE CE NCE
OF ANTI- OF ANTI- OF ANTI- OF ANTI-
NO. HCV NO. HCV NO. HCV NO. HCV
TEST (95% TEST TEST (95% TEST (95%
ED CI) ED (95% CI) ED CI) ED CI)
% % % %
Worked in
health-related

occupation
(2.1
Never 15,625 2.0 (1.62.5) 6405 1.6 (1.12.1) 4154 3.7 (3.04.6) 4419 2.7 3.4)
(1.2 (0.1
Ever 769 1.4 (0.73.1) 313 1.4 (0.53.5) 337 2.1 3.7) 106 0.6 3.2)
Lifetime cocaine
use
(1.4
Never 10,050 1.1 (0.81.4) 3374 0.8 (0.51.3) 3056 2.1 (1.62.8) 3178 2.1 3.2)
(5.3 12. (5.1 12. (6.9 12. (7.1
110 times 732 9.3 16.3) 260 3 29.9) 216 1 21.0) 235 4 21.7)
17. (12.3 11. (7.6 25. (18.5 26. (18.2
>10 times 519 8 25.8) 167 6 17.8) 219 3 34.7) 111 0 37.2)
Lifetime
marijuana use
(1.0
Never 6,997 0.8 (0.61.2) 2210 0.6 (0.31.1) 1949 1.9 (1.32.6) 2458 1.6 2.6)
(2.2
199 times 3,276 1.9 (1.42.7) 1184 1.3 (0.82.2) 1169 5.1 (3.47.6) 850 4.1 7.6)
(7.4 (4.6 15. (9.9 23. (17.0
100 times 1,025 9.5 12.2) 405 6.6 9.4) 373 3 23.6) 215 4 32.2)
Age at first
sexual
intercourse
(0.8
18 yr 4,126 0.7 (0.41.4) 1704 0.3 (0.10.8) 880 3.0 (1.46.4) 1332 1.5 2.6)
(2.4 (2.0 (3.4
<18 yr 6,337 3.2 4.1) 1897 2.8 4.0) 2285 4.4 (3.45.7) 1933 4.5 5.9)
No. of lifetime
sexual
partners
(0.5
01 2,808 0.6 (0.31.0) 1007 0.3 (0.11.2) 459 2.4 (1.63.8) 1171 0.9 1.5)
(2.2
29 5,545 1.6 (1.12.2) 1800 1.2 (0.72.0) 1895 3.0 (2.24.1) 1646 3.3 5.2)
(3.8
1049 2,299 3.3 (2.64.3) 824 2.9 (2.04.2) 839 4.7 (3.17.2) 544 6.0 9.5)
(5.6 11. (6.0 (5.6 (2.5
50 454 9.4 15.8) 140 8 23.0) 225 9.1 14.7) 74 6.1 15.1)
Herpes simplex
virus
type 2
infection
(1.3
No 8,107 1.3 (1.01.7) 3555 1.1 (0.81.6) 1719 2.1 (1.33.3) 2529 1.7 2.3)
(2.4 (1.6 (3.7 (2.2
Yes 3,453 3.4 4.9) 803 2.8 4.9) 1635 5.0 6.9) 899 3.6 5.9)
*NHANES III denotes the third National Health and Nutrition Examination Survey, and CI
confidence interval. Totals include subjects whose race or ethnic group was other.

Only persons 17 years of age or older are included. Totals vary according to the
availability of data.

P<0.05 for the comparison between the lowest and the highest categories (or between the
two categories) for the variable in question.

Only persons 17 to 59 years old are included. Totals vary according to the availability of
data.

TABLE 4. RELATIVE ODDS OF POSITIVITY FOR ANTIBODIES TO HCV


AMONG SUBJECTS 17 TO 59 YEARS OLD, ACCORDING TO SELECTED
VARIABLES IN NHANES III.*
ADJUSTED ODDS
RATIO
VARIABLE (95% CI)
Race or ethnic
group
Mexican
American 1.60 (0.922.79)
Non-Hispanic
black 1.44 (0.902.30)
Non-Hispanic
white 1.00
Sex
Male 1.22 (0.751.98)
Female 1.00
Marital status
Divorced or
separated 1.70 (1.082.66)
Never married,
married, 1.00
or widowed
Education
12 yr 1.92 (1.013.67)
>12 yr 1.00
Poverty index
Below poverty
level 2.37 (1.503.75)
At or above
poverty level 1.00
Marijuana use
100 times 2.99 (1.695.27)
199 times 1.15 (0.612.16)
Never 1.00
Cocaine use
Ever 4.70 (2.498.87)
Never 1.00
No. of sexual
partners
50 5.16 (1.8014.73)
249 2.54 (1.145.66)
01 1.00
Age at first sexual
intercourse
<18 yr 2.94 (1.505.78)
18 yr 1.00
*The values were derived from the logistic-regression model, with control for age.
NHANES III denotes the third National Health and Nutrition Examination Survey, and
CI confidence interval.

Subjects in this category served as the reference group.


BAB I
PENDAHULUAN

1.1 Latar Belakang Masalah