Hepatitis C Virus ¨C Reduce Deaths

Age-adjusted rate* of hepatitis C-related deaths^† and annual targets for the United States by year

Source: National Vital Statistics System (NVSS) data in this report are from the 2018–Present Provisional Multiple Cause of Death Data files in the CDC WONDER online database as of November 16, 2024.1
^*Rates are per 100,000 population and age-adjusted to the 2000 US Standard Population.
^†Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Diseases, 10^th Revision (ICD-10) codes B17.1 or B18.2.2

Summary of findings

Substantial progress has been made in reducing hepatitis C-related deaths. The age-adjusted hepatitis C-related death rate has steadily decreased since 2013, reaching 2.52 deaths per 100,000 population in 2023, below the annual target of 3.0. These declines coincide with the advent of highly effective, well-tolerated direct-acting antiviral (DAA) medications that cure most people and became available beginning in 2014. DAA medications not only substantially improved the percentage of people cured (compared with the treatments available prior to 2014) but because the medications are safer and better tolerated, many more people are eligible for treatment.

Further reduction can best be achieved by:

• Building and harnessing partnerships that amplify the use of effective prevention, testing, and treatment strategies in persons and settings with higher rates of hepatitis C virus (HCV) transmission.
• Developing trainings, technical assistance, and clinical decision support tools for primary care and other health care providers to support and increase implementation of hepatitis C screening, testing, and treatment.
• Developing public health campaigns that raise awareness about hepatitis C and encourage all persons to be screened.
• Increasing access to timely curative treatment by lowering costs, eliminating additional barriers (for example, prior authorization requirements), improving navigation to care, and integrating treatment into routine primary care.
• Promoting and implementing universal hepatitis C screening for all adults at least once in their lifetime and for every pregnant woman during each pregnancy.
• Promoting and implementing more frequent or periodic testing for persons with recognized exposures (such as use of injection drugs) as long as the risk persists and in settings where people receive care.
• Promoting and implementing testing of all infants and children perinatally exposed to hepatitis C.
• Supporting continuing medical education and developing partnerships with service providers to improve confidence and comfort when working with people with HCV infection.
• Using digital technology and telemedicine models to expand access to specialty health care providers.

Technical notes

Data sources: CDC, National Vital Statistics System (NVSS)

Numerator: Number of death records with a report of hepatitis C listed as the underlying or one of the multiple causes of death

Denominator: Total United States Census population

Indicator notes: Death certificates are completed for all deaths registered in the US.1 Information for death certificates is provided to funeral directors or cremation organizations by attending physicians, medical examiners, and coroners. Death certificates are filed in vital statistics offices within each state and the District of Columbia. Through the NVSS, information from death certificates is compiled by CDC to produce national Multiple Cause of Death data; causes of death are coded in accordance with the International Classification of Diseases, 10^th Revision (ICD-10).2 National Multiple Cause of Death data from NVSS were obtained and analyzed, and those death records with a report of hepatitis C (ICD-10: B17.1 or B18.2) listed as the underlying or one of the multiple (contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis C among US residents of the 50 states and the District of Columbia divided by the total US Census population using the postcensal estimates of the July 1 resident population. Rates were standardized to the age distribution of the 2000 US Standard Population.3

Goal setting: The 2025 goal of 3.00 hepatitis C-related deaths per 100,000 population is consistent with CDC’s Division of Viral Hepatitis 2025 Strategic Plan and the . Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).

Limitations: Death data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial and/or ethnic populations in US Census data, and underreporting of viral hepatitis as a cause of death on death certificates.4