Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 15;77(12):1668-1675.
doi: 10.1093/cid/ciad425.

Temporal Trends in Hepatitis C-Related Hospitalizations, United States, 2000-2019

Megan G Hofmeister  1 , Yuna Zhong  1 , Anne C Moorman  1 , Christina R Samuel  1 , Eyasu H Teshale  1 , Philip R Spradling  1
Affiliations

Temporal Trends in Hepatitis C-Related Hospitalizations, United States, 2000-2019

Megan G Hofmeister et al. Clin Infect Dis. .

Abstract

Background: Hospitalization burden related to hepatitis C virus (HCV) infection is substantial. We sought to describe temporal trends in hospitalization rates before and after release of direct-acting antiviral (DAA) agents.

Methods: We analyzed 2000-2019 data from adults aged ≥18 years in the National Inpatient Sample. Hospitalizations were HCV-related if (1) hepatitis C was the primary diagnosis, or (2) hepatitis C was any secondary diagnosis with a liver-related primary diagnosis. We analyzed characteristics of HCV-related hospitalizations nationally and examined trends in age-adjusted hospitalization rates.

Results: During 2000-2019, there were an estimated 1 286 397 HCV-related hospitalizations in the United States. The annual age-adjusted hospitalization rate was lowest in 2019 (18.7/100 000 population) and highest in 2012 (29.6/100 000 population). Most hospitalizations occurred among persons aged 45-64 years (71.8%), males (67.1%), White non-Hispanic persons (60.5%), and Medicaid/Medicare recipients (64.0%). The national age-adjusted hospitalization rate increased during 2000-2003 (annual percentage change [APC], 9.4%; P < .001) and 2003-2013 (APC, 1.8%; P < .001) before decreasing during 2013-2019 (APC, -7.6%; P < .001). Comparing 2000 to 2019, the largest increases in hospitalization rates occurred among persons aged 55-64 years (132.9%), Medicaid recipients (41.6%), and Black non-Hispanic persons (22.3%).

Conclusions: Although multiple factors likely contributed, overall HCV-related hospitalization rates declined steadily after 2013, coinciding with the release of DAAs. However, the declines were not observed equally among age, race/ethnicity, or insurance categories. Expanded access to DAA treatment is needed, particularly among Medicaid and Medicare recipients, to reduce disparities and morbidity and eliminate hepatitis C as a public health threat.

Keywords: National Inpatient Sample; direct-acting antiviral; healthcare utilization; hepatitis C; hospitalization.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Figures

Figure 1.
Figure 1.
Estimated number and age-adjusted rate of hepatitis C–related hospitalizations, United States, 2000–2019.
Figure 2.
Figure 2.
Estimated age-adjusted rates of hepatitis C–related hospitalizations by age (A), payer (B), race/ethnicity (C), and sex (D), United States, 2000–2019.
Figure 3.
Figure 3.
Age-adjusted hepatitis C–related hospitalization rates per 100 000 population. United States, 2000–2019. *Indicates that the annual percentage change is significantly different from zero at the α = .05 level. Abbreviations: APC, annual percentage change; DAAs, second-generation direct-acting antiviral agents; PEG-IFN, pegylated interferon.
See this image and copyright information in PMC

References

    1. Hofmeister MG, Rosenthal EM, Barker LK, et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013–2016. Hepatology 2019; 69:1020–31. - PMC - PubMed
    1. Kim HS, Yang JD, El-Serag HB, Kanwal F. Awareness of chronic viral hepatitis in the United States: an update from the National Health and Nutrition Examination Survey. J Viral Hepat 2019; 26:596–602. - PubMed
    1. Ryerson AB, Schillie S, Barker LK, Kupronis BA, Wester C. Vital signs: newly reported acute and chronic hepatitis C cases—United States, 2009–2018. MMWR Morb Mortal Wkly Rep 2020; 69:399–404. - PMC - PubMed
    1. Centers for Disease Control and Prevention. Viral hepatitis surveillance—United States. 2021. Available at: https://www.cdc.gov/hepatitis/statistics/SurveillanceRpts.htm. Accessed 13 November 2022.
    1. Thomas DL, Seeff LB. Natural history of hepatitis C. Clin Liver Dis 2005; 9:383–98. - PubMed

Substances