Hepatitis C Statistics in US 2026 | Key Facts

Hepatitis C in the US 2026

Hepatitis C remains one of the most significant bloodborne infections affecting millions of Americans today. The disease, caused by the Hepatitis C virus (HCV), continues to pose substantial public health challenges despite the availability of highly effective treatments since 2013. Understanding the current landscape of Hepatitis C in 2026 requires examining the latest surveillance data, mortality trends, demographic patterns, and the ongoing impact of injection drug use on transmission rates across the United States.

The most recent data from the Centers for Disease Control and Prevention (CDC) reveals that while progress has been made in certain areas, Hepatitis C infection rates have stabilized after years of increases linked to the opioid epidemic. Current estimates indicate approximately 2.2 million adults were living with active HCV infection during the 2017-2020 period, though newer research suggests this number could be substantially higher when accounting for underrepresented populations. The burden of Hepatitis C-related deaths has been declining since 2014, thanks to the introduction of direct-acting antiviral (DAA) treatments that can cure more than 95% of infected individuals. However, significant disparities persist across racial, ethnic, and age groups, requiring targeted interventions to achieve the nation’s elimination goals by 2030.

Latest Hepatitis C Facts and Statistics in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, Published April 2025; CDC National Vital Statistics System 2023

The data presented reflects the most comprehensive understanding of the Hepatitis C epidemic as it stands entering 2026. The gap between reported acute cases (4,966) and estimated actual infections (69,000) highlights a critical challenge in surveillance. This approximately 14-fold underascertainment occurs because most individuals with acute HCV infection experience no symptoms and never seek medical care, while many diagnosed cases go unreported by healthcare providers. The CDC uses a multiplication factor of 13.9 to account for this underreporting when estimating true infection numbers.

Examining the chronic infection prevalence, estimates range from 1.7 million to 2.2 million adults currently living with HCV, with a more recent commercial laboratory study from November 2023 through September 2024 suggesting approximately 1.7 million adults aged 18-75 years have active infection. The 101,525 newly reported chronic cases in 2023 represents a 36.2 per 100,000 population rate, indicating ongoing identification of previously undiagnosed infections. Meanwhile, the declining death rate from 2.9 per 100,000 in 2022 to 2.5 per 100,000 in 2023 demonstrates the life-saving impact of expanded access to curative treatments. Despite these advances, awareness remains suboptimal, with only 60-68% of infected individuals knowing their status, creating barriers to treatment uptake and continued transmission risks.

Acute Hepatitis C Infections in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, Published April 2025

Acute Hepatitis C infections in the United States have shown concerning patterns over the past decade, with steady increases from 2010 through 2021 before stabilizing in recent years. The 69,000 estimated acute infections in 2023 represents a persistent burden that remains well above the national elimination target of 35,000 set for 2025. This means a 49% reduction would have been needed to meet the goal, highlighting the ongoing challenges in prevention efforts. The stabilization after years of increases offers some hope, but the current infection rate of 1.5 per 100,000 population still reflects the lasting impact of the opioid epidemic and associated injection drug use practices.

The demographic breakdown reveals that males account for approximately 67% of acute cases, with 3,321 cases compared to 1,645 among females in 2023. The highest rates occur among individuals aged 30-39 years, a pattern that has persisted throughout the surveillance period. This age distribution reflects the peak years for injection drug use behaviors that drive most new HCV transmissions. Among cases where risk factor information was available, injection drug use was identified as the primary transmission route, though comprehensive risk factor data is often lacking due to incomplete case investigations. The 2020 case definition changes improved sensitivity for detecting acute cases, allowing for laboratory-confirmed cases without requiring clinical symptoms, which has helped capture more infections that would have previously gone unrecognized.

Chronic Hepatitis C Burden in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, Published April 2025; CDC National Health and Nutrition Examination Survey 2017-2020

The chronic Hepatitis C burden in the United States reflects the cumulative impact of decades of transmission, with multiple generations affected by the disease. The 101,525 newly reported chronic cases in 2023 from 45 states and the District of Columbia demonstrates ongoing case identification through expanded screening efforts following the CDC’s 2020 universal adult screening recommendations. These newly reported cases represent individuals who likely acquired their infections years or even decades ago but are only now being diagnosed as healthcare systems implement routine HCV testing for all adults at least once in their lifetime.

The bimodal age distribution seen in chronic cases tells the story of two distinct epidemic waves. The first peak among 30-39 year-olds and 40-49 year-olds represents individuals who acquired infection more recently, often through injection drug use during the opioid epidemic. These two age groups combined account for 48% of all newly reported chronic cases. The secondary peak around 65 years reflects the aging cohort born between 1945-1965, who have the highest HCV prevalence at approximately 3%. This group likely acquired infection through blood transfusions before screening began in 1992, through injection drug use, or other healthcare-related exposures. The 65% male predominance among chronic cases mirrors the gender disparity seen in acute infections and likely reflects higher historical rates of injection drug use and other risk behaviors among men.

Hepatitis C Demographics and Disparities in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, Published April 2025

Racial and ethnic disparities in Hepatitis C infection rates represent one of the most pressing equity challenges in viral hepatitis elimination efforts. The data reveals stark differences, with non-Hispanic American Indian and Alaska Native persons experiencing a chronic HCV case rate of 99.4 per 100,000 population—3.3 times higher than the rate among non-Hispanic White persons at 30.1 per 100,000. For acute infections, AI/AN persons face rates 2.3 times higher than their White counterparts. These disparities reflect complex factors including higher rates of substance use disorders, limited access to healthcare services, historical trauma, and systemic barriers to treatment in tribal and rural communities.

Non-Hispanic Black persons also experience disproportionate burden with a chronic case rate of 51.2 per 100,000, approximately 1.7 times the rate among non-Hispanic White persons. The male predominance across all racial and ethnic groups is consistent, with men accounting for roughly 65-67% of cases. Geographic patterns show concentration in the Eastern and Southeastern United States, particularly in areas affected by the opioid epidemic and with higher rates of injection drug use. States in the Appalachian region have been especially impacted. These demographic patterns underscore the urgent need for targeted interventions, including culturally appropriate prevention programs, expanded access to harm reduction services like syringe service programs, elimination of treatment restrictions based on substance use or liver disease stage, and integration of HCV testing and treatment into primary care and community health settings serving high-burden populations.

Hepatitis C Mortality Trends in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, CDC National Vital Statistics System 2023, Published April 2025

Hepatitis C mortality in the United States has shown encouraging downward trends since peaking in 2014-2015, when annual deaths exceeded 19,600. The 11,194 deaths recorded in 2023 represents a substantial decline and continues the pattern of year-over-year improvements. The age-adjusted death rate of 2.5 per 100,000 population in 2023 marks a 13% decrease from the 2022 rate of 2.9 per 100,000 and represents a 4% improvement below the 2025 elimination goal of 3.0 per 100,000. This progress is largely attributable to the widespread availability and uptake of direct-acting antiviral (DAA) treatments since 2014, which cure 95% or more of treated individuals.

However, significant disparities persist in mortality rates across demographic groups. Males continue to account for 71% of all HCV-related deaths, reflecting their higher infection rates and potentially lower rates of treatment uptake. Non-Hispanic American Indian and Alaska Native persons experience death rates 3.2 times higher than non-Hispanic White persons, while non-Hispanic Black persons have rates 1.7 times higher. These disparities indicate that while overall mortality is declining, the benefits of treatment are not being equitably distributed across all populations. Death rates are highest among persons aged 55 years and older, representing the aging cohort that acquired infection decades ago. The continued mortality despite curative treatment availability highlights ongoing barriers including late diagnosis, lack of awareness, treatment access limitations due to cost or insurance restrictions, and inability to engage in care among people with substance use disorders or unstable housing.

Hepatitis C Prevalence Estimates in the US 2026

Data source: CDC NHANES 2017-2020, Hall et al. Hepatology 2025, Hofmeister et al. Clinical Infectious Diseases 2026

Hepatitis C prevalence estimation has become increasingly sophisticated, revealing that the true burden may be substantially higher than previously recognized. The traditional NHANES+ model, which adjusts for populations not sampled in the National Health and Nutrition Examination Survey (incarcerated persons, those experiencing homelessness, nursing home residents), estimates 2.2 million adults had active HCV RNA-positive infection during 2017-2020, corresponding to a 0.9-1.0% prevalence among the adult population. However, a newer PWID-adjusted model that better accounts for the underrepresentation of people who inject drugs in NHANES suggests the actual number could be as high as 4.0 million adults with a 1.6% prevalence rate.

The most recent prevalence data comes from a novel study using residual sera from a large commercial laboratory conducted between November 2023 and September 2024, which estimated approximately 1.7 million adults aged 18-75 years currently have HCV infection. This study found that 2.9% of adults (6.9 million people) have ever been infected with Hepatitis C based on antibody testing. The difference between antibody prevalence and RNA prevalence reflects viral clearance through either spontaneous resolution or successful treatment. Younger adults (18-49 years) showed lower clearance rates of 63.8% compared to 81.1% among older adults (50-75 years), likely because younger adults with recent infections have had less time to access treatment or experience spontaneous clearance. The prevalence among certain high-risk populations is substantially higher, with estimates ranging from 2.3% to 35.3% among people who use non-injection drugs and even higher rates among active people who inject drugs.

Risk Factors for Hepatitis C Transmission in the US 2026

Data source: CDC Hepatitis C Surveillance 2023, Handanagic et al. MMWR 2021

Injection drug use remains the overwhelmingly dominant risk factor for Hepatitis C transmission in the United States today, accounting for approximately 43% of cases where risk information is available. The opioid epidemic that intensified during 2010-2020 drove significant increases in HCV incidence, particularly among younger adults in rural and suburban areas who began injecting prescription opioids. Studies of people who inject drugs show that 38-42% report receptive syringe sharing (using needles after someone else), creating efficient transmission networks. The risk of acquiring HCV is extraordinarily high among people who inject drugs, with some cohorts showing infection rates exceeding 50% within the first few years of injection initiation.

Historical transmission routes have largely been eliminated through public health interventions. Blood transfusions, which were the primary transmission route before universal donor screening began in July 1992, now represent minimal risk. Healthcare-associated transmission occurs rarely through needle stick injuries among healthcare workers or inadequate infection control practices during medical procedures, hemodialysis, or in outbreak settings. Sexual transmission accounts for a relatively small proportion of cases (<15%), though risk is higher among men who have sex with men, particularly those with HIV co-infection. Perinatal transmission from infected mothers to infants occurs in approximately 5-6% of pregnancies when the mother has detectable HCV RNA. Other exposures like tattooing, body piercing, or intranasal drug use (sharing contaminated straws or pipes) contribute to transmission when proper sterilization procedures are not followed, though quantifying their exact contribution remains challenging.

Geographic Distribution of Hepatitis C in the US 2026

Data source: CDC Hepatitis C Surveillance Report 2023, CDC National Vital Statistics System 2023, Published April 2025

The geographic distribution of Hepatitis C in the United States shows clear regional patterns that reflect the intersection of the opioid epidemic, socioeconomic factors, and healthcare access disparities. The Eastern and Southeastern states consistently report the highest rates of both acute and chronic HCV infections, with particular concentration in the Appalachian region spanning states including Kentucky, West Virginia, Tennessee, and Ohio. This region has been devastated by opioid use disorder and injection drug use, driving sustained high rates of Hepatitis C transmission. County-level analyses reveal clustering of infections in areas with documented opioid overdose mortality, prescription opioid dispensing rates, and limited access to harm reduction services.

HHS Region 10, comprising Alaska, Idaho, Oregon, and Washington, reports the highest age-adjusted death rates from Hepatitis C, reflecting both high infection prevalence and potentially barriers to treatment access in remote or rural areas. The geographic patterns have evolved over time, with historically high rates in urban centers now joined by significant rural and suburban burden. This shift reflects the changing epidemiology driven by prescription opioid misuse and transition to injection drug use in non-urban settings. Forty-five states and the District of Columbia reported chronic Hepatitis C cases in 2023, though reporting completeness varies. Some states have more robust surveillance systems and linkage to care programs, while others face resource constraints. Understanding these geographic patterns is crucial for targeting prevention resources, expanding access to syringe service programs, and ensuring treatment availability in the highest-burden communities.

Hepatitis C Testing and Screening Recommendations in the US 2026

Data source: CDC Hepatitis C Testing Recommendations 2020 and 2023

The CDC’s universal screening recommendations represent a paradigm shift in Hepatitis C case-finding strategy, moving from risk-based testing to a one-time test for all adults. Issued in 2020, these guidelines recommend that all adults aged 18 years and older receive at least one HCV screening test during their lifetime, regardless of identified risk factors. This approach acknowledges that many people with Hepatitis C do not disclose or even recognize their risk factors, and that risk-based screening was missing a substantial proportion of infected individuals. Additionally, all pregnant women should be tested during each pregnancy to identify infections and prevent perinatal transmission.

Beyond universal screening, individuals with ongoing risk factors require more frequent testing. People who inject drugs should receive periodic HCV testing as long as their injection use continues, as they remain at high risk for new infections even after successful treatment. The standard testing sequence begins with an HCV antibody test, which if reactive, should be followed by a confirmatory HCV RNA test to determine if the person has current infection versus past cleared infection. The 2023 updated recommendations emphasized the importance of complete and accurate testing sequences and strengthened perinatal testing protocols. Despite these comprehensive recommendations, awareness remains suboptimal with only 60-68% of infected individuals knowing their status. Barriers to testing include lack of provider awareness, patient reluctance to disclose risk behaviors, limited access in underserved communities, and competing healthcare priorities. Achieving elimination goals requires dramatically expanding testing implementation across all healthcare settings, integrating testing into routine primary care, emergency departments, substance use treatment programs, correctional facilities, and community-based organizations serving at-risk populations.

Hepatitis C Treatment Advances and Outcomes in the US 2026

Data source: CDC Viral Hepatitis National Strategic Plan 2021-2025, Clinical Treatment Guidelines

The development of direct-acting antiviral (DAA) treatments represents one of the most transformative advances in modern medicine, converting Hepatitis C from a chronic, progressive disease to a curable infection. Since 2013, and particularly since 2014 when multiple pan-genotypic DAAs became available, treatment regimens require only 8-12 weeks of once-daily oral pills with minimal side effects and achieve sustained virologic response (cure) in 95% or more of patients. These medications work against all seven major HCV genotypes, eliminate the need for interferon injections, and are effective regardless of prior treatment history, HIV co-infection status, or presence of cirrhosis.

Despite these remarkable advances, substantial gaps remain between the number of people living with Hepatitis C and those accessing cure. The Viral Hepatitis National Strategic Plan calls for 80% of persons with HCV infection to achieve viral clearance by 2030, but current data suggests only 63.8% of younger adults and 81.1% of older adults have cleared the virus through either treatment or spontaneous resolution. Barriers to treatment include cost, although prices have declined substantially since initial market introduction, many state Medicaid programs historically imposed restrictions requiring advanced liver disease or sobriety before approving treatment, creating inequitable access. While these restrictions have been reduced in many states, disparities persist. Additional barriers include lack of provider comfort prescribing DAAs outside specialty care, competing priorities for people with substance use disorders or unstable housing, stigma, and system-level failures to link diagnosed individuals to treatment. Achieving elimination requires not only universal screening but also universal access to treatment, integration of HCV care into primary care and community settings, elimination of all sobriety and fibrosis stage restrictions, and patient navigation programs to support treatment completion.

Hepatitis C Prevention Strategies in the US 2026

Data source: CDC Viral Hepatitis National Strategic Plan 2021-2025, CDC Division of Viral Hepatitis 2025 Strategic Plan

Prevention of Hepatitis C transmission requires comprehensive strategies addressing the primary risk factor of injection drug use while also ensuring safety across all potential exposure routes. Syringe service programs (SSPs), which provide sterile injection equipment and safely dispose of used syringes, are among the most effective evidence-based interventions for reducing HCV transmission among people who inject drugs. Studies consistently demonstrate that communities with accessible SSPs experience lower rates of new infections compared to areas without these services. However, SSP availability remains inadequate across much of the country, particularly in rural areas most affected by the opioid epidemic, often due to political opposition, lack of funding, or legal barriers.

Substance use disorder treatment, including medications for opioid use disorder like methadone and buprenorphine, reduces injection behavior and consequently HCV transmission risk. Comprehensive harm reduction services should include not only sterile syringes but also other safe consumption supplies, naloxone for overdose prevention, linkage to medical and social services, and non-judgmental support. Treatment as prevention is an increasingly recognized strategy, as curing people with Hepatitis C eliminates their ability to transmit the virus to others. Mathematical models suggest that treating sufficient numbers of people who inject drugs could significantly reduce community-level HCV prevalence. Maintaining safe blood supply through universal donor screening since 1992 has virtually eliminated transfusion-associated transmission. Healthcare settings must maintain rigorous infection control practices and ensure proper sterilization of medical equipment. The 2020 pregnancy screening recommendations aim to identify infected mothers and eventually test exposed infants. Community education efforts work to reduce stigma, increase awareness of testing recommendations, and normalize discussion of substance use and HCV testing. Achieving the 2030 elimination target of 80% viral clearance requires coordinated implementation of all these prevention strategies, addressing both primary prevention of new infections and secondary prevention through early detection and treatment of existing infections.

Hepatitis C in Special Populations in the US 2026

Data source: CDC Hepatitis C Surveillance 2023, Various epidemiologic studies

Special populations disproportionately affected by Hepatitis C require tailored prevention, testing, and treatment strategies. People who inject drugs (PWID) face the highest infection risk, with studies showing 38-42% report sharing syringes and rapidly acquiring HCV infection after initiating injection use. This population requires harm reduction services, regular testing, immediate linkage to treatment without requiring abstinence, and patient navigation support. HIV-HCV co-infection occurs in approximately 25% of people living with HIV in the United States, with even higher rates among men who have sex with men with HIV. Co-infected individuals experience faster liver disease progression and require coordinated management of both infections.

Incarcerated populations have HCV prevalence rates of 10-30%, substantially higher than the general population, reflecting higher rates of injection drug use and other risk factors before incarceration. Correctional facilities represent important opportunities for testing and treatment, though many facilities lack adequate resources. Veterans have higher Hepatitis C prevalence than the general population and the Veterans Health Administration has implemented successful screening and treatment programs. Persons experiencing homelessness face multiple barriers including competing survival priorities, lack of access to care, substance use disorders, and difficulty maintaining treatment adherence. Pregnant women should receive universal screening to identify infections and enable infant testing, though perinatal transmission at 5-6% is relatively low. Healthcare workers face occupational exposure risk through needle sticks, requiring post-exposure testing protocols. Immigrants from countries with high HCV prevalence may have acquired infection through healthcare procedures, blood products, or other exposures in their countries of origin and benefit from targeted screening and linkage to treatment within refugee and immigrant health programs.

Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.

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