Adherence to Hepatitis C Treatment Interventions: A Comparative Effectiveness Review

Hepatitis C virus (HCV) infection is the most common chronic blood-borne infectious disease in the United States. The Centers for Disease Control and Prevention (CDC) estimates that 18,000 Americans were newly infected with the virus in 2008, and between 2.7 and 3.9 million people are living with chronic HCV infection. Chronic HCV infection is associated with increased rates of cirrhosis, liver failure, and liver cancer and with 12,000 deaths per year in the United States. It is estimated that the direct medical costs of HCV-related diseases will top $10 billion over the next 10 years.

The prevalence of HCV infection is highest in non-Hispanic blacks when compared to all other ethnic groups and is highest in the 40–49 age group. The prevalence also increases with lower family income and less education. The transmission of HCV is primarily through large and repeated percutaneous exposure to infected blood.⁴ The most common mode of HCV transmission in the United States is the use of injection drugs. HCV can also be transmitted through needle-stick injuries and via vertical transmission from an infected mother to infant. The less common modes of transmission include sexual activities with an HCV-infected person and receipt of donated blood, blood products, and organs that are infected.

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