The federal agency’s reports shows decreases in both hepatitis A and B, but hepatitis C saw a significant increase during 2021. However, the investigators note the pandemic may have impacted statistics and progress towards goals.
The CDC has published its Viral Hepatitis Surveillance Report – United States, 2021, which details the incidence rates during that time period. Although the rates of acute infections decreased for both hepatitis A and B, the report’s authors note the effects of the pandemic may have not been able to provide a true accounting of statistics due to various factors. In addition, hepatitis C rates did increase during this time.
In addition, the CDC published its 2023 National Viral Hepatitis Progress Report to offer some perspective on progress toward 2025 outcome goals for new viral hepatitis infections and viral hepatitis–related deaths, overall and for key populations.
Here are some key findings from the reports:
Hepatitis A
For the year observed, 2021, the authors explained that the reported rate of hepatitis A declined for a second year in a row. From 2020–2021, CDC said there was a 43% decrease in incidence. There were a total number of 5728 new cases corresponding to 11,500 estimated infections.
“By the end of 2021, 14 of 37 states had declared an end to widespread and prolonged hepatitis A outbreaks associated with person-to-person transmission, primarily occurring among persons who use drugs and those experiencing homelessness,” the authors wrote. “These outbreaks demonstrate the importance of surveillance to identify cases and vaccination to prevent and respond to hepatitis A.”
Hepatitis B
For hepatitis B, new virus infections declined in 2020 and 2021. According to the report, 47 states reported 2045 hepatitis B cases corresponding in an estimated 13,300 infections. The authors report that for years there were stable rates of hepatitis B infection, however, the rate of infections decreased significantly in 2020 and again the rate decreased by 14% in 2021.
The authors noted that although the 2 hepatitis B indicators for new infections met the annual target for 2021, they write, “it is difficult to determine to what degree the lower rates are attributable to true reductions in disease burden versus impact of the COVID-19 pandemic on access to healthcare, hepatitis testing, and health department capacity to perform viral hepatitis case investigations.”
For mortality, the indicators for hepatitis B-related deaths did not meet the annual targets in 2021; however, rates of hepatitis B-related deaths may have been impacted by the increase in overall deaths during the pandemic.
The authors said there is a strong public health need to continue the CDC’s expanded hepatitis B vaccination recommendations as well as improve testing and getting people into the continuum of care.
Hepatitis C
The figures on this form of the virus have continued a disturbing pattern. During 2020-2021, the infection rates increased 14%. This is after hepatitis C rates doubled during 2014-2020.
There were 5023 reported cases of hepatitis C (HCV), with 69,800 estimated infections and 43 states reporting 107,540 newly reported cases.
In addition, some other takeaways for people who contracted HCV, injection drug use was the most commonly reported risk factor at 57%.
“The death rates for hepatitis C among non-Hispanic American Indian (AI / Alaska Native (AN) persons and non-Hispanic Black persons were 3.4 times and 1.7 times, respectively, the death rate among non-Hispanic White persons.”This demonstrates the continued challenges amongst these groups.
The Pandemic Effect
The pandemic may have affected incidence numbers. “The findings in this report should be interpreted with caution,” the authors wrote. “The number of viral hepatitis cases reported to CDC in 2020 and 2021 may be lower than in years before the COVID-19 pandemic began. The decrease may be related to fewer people seeking healthcare and being tested for viral hepatitis during the COVID-19 pandemic.”
