Hepatitis C Virus ¨C Reduce Infections

Estimated* new hepatitis C virus infections and annual targets for the United States by year

Source: CDC, National Notifiable Diseases Surveillance System.1
^*The number of estimated viral hepatitis infections was determined by multiplying the number of reported cases by a factor that adjusted for underascertainment and underreporting.12

Summary of findings

The number of new hepatitis C virus (HCV) infections steadily increased from 2013–2021 (29,700 to 69,800 estimated infections, respectively) and has remained relatively stable from 2021–2023. The number of estimated infections in 2023 was 69,000, well above the annual target of 35,000. The stable rate of new infections highlights the need for continued efforts to reduce new infections.

This 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 HCV transmission.
• Building capacity within jurisdictions to collect and analyze surveillance data to identify where HCV infection is occurring, understand transmission networks, and enhance what is learned from outbreak investigations.
• 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 Notifiable Diseases Surveillance System (NNDSS)

Numerator: Number of estimated new (acute) HCV infections

Denominator: Not applicable

Indicator notes: NNDSS is a nationwide collaboration that enables all levels of public health to share notifiable disease-related health information.1 Surveillance for viral hepatitis through NNDSS is based on case definitions developed and approved by the Council of State and Territorial Epidemiologists (CSTE) and CDC. . Estimated infections are based on laboratory-confirmed cases of acute viral hepatitis; these estimates are presented in the 2023 Annual Surveillance Report1 along with their 95% confidence intervals to show the range of estimated infections accounting for error. Acute hepatitis C is reportable in all jurisdictions except Alaska. Health care providers, hospitals, and/or laboratories report cases to the local or state health department, and states voluntarily submit reports or notify CDC of newly diagnosed cases of hepatitis C that meet the CSTE/CDC surveillance case definition. To account for underascertainment and underreporting, the number of reported cases is multiplied by 13.9 to estimate the number of new HCV infections for a given year. The methods for developing the multiplication factor have been previously described and used by CDC to estimate the number of annual infections.12

Goal setting: The 2025 goal of 35,000 estimated infections 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: The number of estimated infections is based on a simple, probabilistic model for estimating the proportion of patients who were symptomatic, received testing, and were reported to health officials in each year.1 This constant multiplier might not account for variations over time in underreporting and underascertainment due to changes in public and provider awareness, laboratory and diagnostic techniques, and the case definition for the condition.