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CDC: Acute HCV Quadruples, 63% Increase, Race & States Rates
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Acute hepatitis C infections reported to CDC quadrupled from 2009 to 2019, with injection drug use being the most reported risk factor for hepatitis C among cases reporting risk factors (67 percent in 2019). The rate of new hepatitis C infections has increased the most among younger adults, with injection drug use as the primary route of transmission.
• 20-29 yrs. acute hep C case rate: 0.7 (2009) 2.9 (2019)
• 30-39 yrs. acute hep C case rate 0.5 (2009) 3.2 (2019)
Since 2010, rates of reported acute hepatitis C increased among almost all age groups of ≥20 years. The rate of acute hepatitis C has remained the highest among persons aged 20-39 years, similar to age groups at highest risk for fatal overdose in the United States and age at initiation of injection drug use among certain US populations. Compared with 2018, the greatest increase in the rates of acute hepatitis C were observed among those aged 40-49 years (31% increase), followed by those aged 30-39 years (23% increase). For the first time in more than a decade, the rate of acute hepatitis C decreased slightly among those aged 20-29 years. Rates have consistently been lowest among those aged <20 years or ≥60 years; however, rates have been increasing among those aged ≥60 years since 2015.
During 2019, a total of 4,136 acute hepatitis C cases were reported to CDC, corresponding to 57,500 estimated infections (95% CI: 45,500-196,000) after adjusting for case underascertainment and underreporting (see Technical Notes) (9). The reported acute hepatitis C case count corresponds to a rate of 1.3 cases per 100,000 population, a 63% increase from the reported rate of 0.8 cases per 100,000 population during 2015. Approximately 63% of acute hepatitis C cases reported to CDC during 2019 were among persons aged 20-39 years. The rate of acute hepatitis C was highest among American Indian/Alaska Native persons (3.6 cases per 100,000 population), compared with other racial/ethnicity groups. Among the 1,952 (47%) reported acute cases that included risk information for injection drug use, 1,302 (67%) reported injection drug use. A total of 1,041 patients with acute hepatitis C were hospitalized (48% hospitalization rate among 2,156 cases with hospitalization information available).
A total of 123,312 new cases of chronic hepatitis C were reported to CDC during 2019, corresponding to a rate of 56.7 cases per 100,000 population. The rate of newly reported chronic hepatitis C was highest among persons aged 30-39 years (109.1 cases per 100,000 population), followed by persons aged 50-59 years (79.6 cases per 100,000 population), compared with other age categories. These rates are consistent with the previously reported bimodal distribution of newly reported chronic hepatitis C affecting multiple generations (11). The rate of newly reported chronic hepatitis C cases was highest among American Indian/Alaska Native persons (86.7 cases per 100,000 population), compared with other racial/ethnicity categories.
A total of 217 perinatal hepatitis C cases were reported to CDC during 2019, the second year that standardized surveillance for perinatal hepatitis C was conducted by states and case notifications submitted to CDC. Data from death certificates filed in the vital records offices of the 50 states and the District of Columbia indicated that the age-adjusted death rate for hepatitis C during 2019 was 3.33 deaths per 100,000 population, representing a 32% decrease from the mortality rate during 2015 (4.91 deaths per 100,000 population).
The capacity of each jurisdiction for notifying CDC of acute hepatitis C cases varies considerably on the basis of laws, resources, and infrastructure for conducting viral hepatitis surveillance. During 2019, a total of 7 jurisdictions did not submit acute hepatitis C case notifications to CDC. The national rate of acute hepatitis C was 1.3 reported cases per 100,000 population during 2019, a >60% increase from the rate reported during 2015. Indiana had the highest reported rate of acute hepatitis C (4.8 cases per 100,000 population), whereas Florida reported the largest number of cases (n = 616). Seven states with the highest number of reported acute cases (Florida, Indiana, New York, Ohio, Pennsylvania, Tennessee, and California) accounted for >50% of the national burden of acute hepatitis C during 2019.
https://www.cdc.gov/hepatitis/statistics/2019surveillance/Table3.1.htm
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