HCV Prevalence in the United States Stratified by Sex, Birth Cohort, and Race

Modeled estimates can help guide policy and programs for prevention and treatment of HCV infection.

Modeled estimates can help guide policy and programs for prevention and treatment of hepatitis C virus (HCV) infection by elucidating populations with the greatest need for intervention, according to a study published in Hepatology Communications.

More than 2 million adults in the United States are estimated to be infected with HCV. Reducing this burden requires an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. Researchers modeled state-level estimates of HCV prevalence among US adults by sex, birth cohort, and race during 2013-2016.

They found that nationally, the estimated prevalence of HCV was 1.3% among males and 0.6% among females. Among persons born between 1945 and 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969. Among those born from 1945-1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia.

However, among those born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Among non-Hispanic black persons, HCV prevalence was 1.8% and among persons of other races it was 0.8%, which varied across the jurisdictions.

Overall, 23% of HCV infections occurred among non-Hispanic black persons, whereas this racial group represented only 12% of the population.

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The authors concluded that, “In most jurisdictions, we estimated higher disease prevalence among males compared with females, persons born during 1945 to 1969 compared with older or younger persons, and non-Hispanic black persons compared with persons of other race/ethnicities.”

They added that, “Reducing the overall number of HCV infections with a focus on disparities requires an understanding of both hepatitis C prevalence and number of infections in high-risk populations.”


Bradley H, Hall EW, Rosenthal EM, Sullivan PS, Ryerson AB, Rosenberg ES. Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013-2016. Hepatol Commun. 2020;4(3):355-370.