Hepatitis C is of the three most common strains of viral hepatitis that most frequently infect the human body — hepatitis A, hepatitis B and hepatitis C. All three strains of the virus, though unrelated, can create an acute illness that includes nausea, abdominal pain and jaundice, though in many patients, the body shows no obvious signs of infection.

Hep C spreads easily among injection drug users, though the disease also can be spread sexually from an infected person to a non-infected person. Untreated hep C can cause permanent damage, even inducing liver cancer.

Who is most at risk of hep C, what does it do to the body, and how common is the virus in the United States and around the world?

What Is Hep C?

Hep C is a viral infection that sometimes results in a short-term illness but that causes a chronic, long-term health issue for as many as 85% of people who contract the hepatitis C virus (HCV). No vaccine exists for hep C, but in people who develop a chronic HCV infection, treatments are available that can remove the virus entirely from the body.

As many as 25% of people who contract hep C never develop symptoms and their bodies are able to clear up the infection on their own. Scientists don’t yet understand why some bodies are able to do this while others aren’t, but being young and female is correlated with spontaneous clearance of HCV.

Who Is Most Likely to Get Hep C?

Men are more likely than women to be infected with hep C, and about 2.4 million Americans are living with HCV. In addition to injection drug users’ elevated risk of contracting hep C, baby boomers, or those born between 1945 and 1965 are at a higher risk of the virus, possibly owing to poor medical hygiene practices that were in place at that time.

Studies suggest that as many as 53% of injection drug users in the U.S. are infected with hep C, and the rate of HCV-related death is about 60% higher than the rate for women, though hep C death rates are on the decline overall.

Hepatitis C death rates by sex and year (cases per 100,000 people)

Year Males Females
2012 7.3 2.8
2013 7.4 2.9
2014 7.4 2.8
2015 7.3 2.7
2016 6.5 2.5

Hepatitis C death rates by age group (cases per 100,000 people)

0–34 0.11
35–44 1.32
45–54 7.1
55–64 21.78
65–74 14.27
75+ 6.27

Among racial and ethnic groups, Native Americans and Alaska Natives are most likely to die from hep C.

Hepatitis C death rates by race, age 15+ (cases per 100,000 people)

Native American/Alaska Native 10.75
African-American 7.42
Hispanic 5.69
White 3.97
Asian/Pacific Islander 2.14

Hep C Across the U.S.

In the most recent reporting year, several states and the District of Columbia did not report statistics on cases of acute hep C, but among the states that did report, the rate of acute hep C has risen by about 60% since 2012.

Acute hepatitis C infection rate by state (cases per 100,000 people)

Alaska N/A
Arizona N/A
District of Columbia N/A
Hawaii N/A
Iowa N/A
Mississippi N/A
New Hampshire N/A
Rhode Island N/A
Wyoming N/A
Massachusetts 6.2
West Virginia 5.1
Delaware 2.6
Utah 2.5
Kentucky 2.3
South Dakota 2.3
Tennessee 2.3
Indiana 2.2
Maine 1.9
Montana 1.9
Pennsylvania 1.8
Wisconsin 1.8
Ohio 1.6
New Jersey 1.4
Florida 1.1
Michigan 1.1
Georgia 0.9
Minnesota 0.9
New Mexico 0.9
New York 0.9
Washington 0.9
North Carolina 0.8
Oklahoma 0.8
Vermont 0.8
Alabama 0.7
Colorado 0.6
Maryland 0.6
Connecticut 0.5
Kansas 0.5
Nevada 0.5
Oregon 0.5
Virginia 0.5
Idaho 0.4
Missouri 0.4
California 0.2
Illinois 0.2
South Carolina 0.2
Louisiana 0.1
Nebraska 0.1
North Dakota 0.1
Texas 0.1
Arkansas 0
Total 1.0

Among states that reported data for both 2012 and 2016, more than half have seen rates of acute hep C infections rise, though many states have seen huge declines.

Percentage change in acute hepatitis C infection rates (cases per 100,000 people), 2012-2016

Arkansas -100%
Oklahoma -62%
Louisiana -50%
Nebraska -50%
Texas -50%
Connecticut -44%
Oregon -44%
Virginia -44%
Kentucky -44%
Idaho -43%
Colorado -25%
Vermont -20%
Kansas -17%
Maryland -14%
New Mexico -10%
California 0%
Illinois 0%
Georgia 13%
Washington 13%
Tennessee 15%
Nevada 25%
Indiana 29%
North Carolina 33%
Michigan 38%
Alabama 40%
Minnesota 50%
West Virginia 70%
New Jersey 75%
New York 80%
Florida 83%
Montana 111%
Maine 217%
Pennsylvania 260%
Wisconsin 260%
Missouri 300%
Utah 317%
Massachusetts 933%
Ohio 1,500%
Alaska N/A
Arizona N/A
District of Columbia N/A
Hawaii N/A
Iowa N/A
Mississippi N/A
New Hampshire N/A
Rhode Island N/A
Wyoming N/A
Delaware N/A
South Dakota N/A
South Carolina N/A

Globally, about 71 million people have chronic HCV, and nearly 400,000 die from it each year. Infection rates are highest in Europe and the Eastern Mediterranean regions.

Hepatitis C virus prevalence by World Health Organization region (% of population infected)

Eastern Mediterranean 3.00%
Europe 2.30%
Africa 1.50%
Western Pacific 1.20%
Americas 0.90%
Southeast Asia 0.70%

The number of acute hep C cases in the U.S. has risen steadily in recent years to the highest levels in this century.

Acute hepatitis C cases by year

2001 1,640
2002 1,223
2003 891
2004 758
2005 694
2006 802
2007 849
2008 877
2009 781
2010 850
2011 1,232
2012 1,778
2013 2,138
2014 2,194
2015 2,436
2016 2,967

Conclusion

Untreated hep C can be very dangerous, even deadly. The number of acute cases in the U.S. has risen by 80% since the start of this century, jumping by nearly 22% in just one year.

Despite the risks of hep C, about half of those who have it are unaware they are infected with the virus, which puts them at risk of permanent damage as well as passing the disease along to others, including, possibly, their sexual partners.

But hep C can be cured for many patients, so the fear that comes with realizing you have an incurable condition should be no barrier to getting tested and finding out your status.

Additional References

Centers for Disease Control and Prevention, Surveillance for Viral Hepatitis – United States, 2016. (2018). Retrieved from https://www.cdc.gov/hepatitis/statistics/2016surveillance/index.htm#tabs-3-5

Centers for Disease Control and Prevention, New Hepatitis C Infections Nearly Tripled over Five Years. (2017). Retrieved from https://www.cdc.gov/nchhstp/newsroom/2017/Hepatitis-Surveillance-Press-Release.html

Centers for Disease Control and Prevention, Surveillance for Viral Hepatitis – United States, 2015. (2017). Retrieved from https://www.cdc.gov/hepatitis/statistics/2015surveillance/commentary.htm

Centers for Disease Control and Prevention, Hepatitis C Prevalence Estimates 2013-2016. (2018). Retrieved from https://www.cdc.gov/nchhstp/newsroom/2018/hepatitis-c-prevalence-estimates.html

World Health Organization, Hepatitis C. (2018). Retrieved from https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

World Health Organization, Global hepatitis report, 2017. (2017). Retrieved from https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/