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From Discovery to Cure-Where Are We Now? Mortality Trends in Chronic Hepatitis C: An Analysis of CDC WONDER Database

Ashraf Ullah1, Hina Wazir2, Abdullah Sultany1

  • 1Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA 18840, USA.

Viruses
|May 27, 2026
PubMed

Insights

Hepatitis C virus (HCV) mortality has declined nationally since 2014 due to direct-acting antivirals (DAAs), but significant disparities persist among racial/ethnic minorities and in rural areas, necessitating equitable treatment access.

Area of Science:

  • Public Health
  • Epidemiology
  • Hepatology

Background:

  • Hepatitis C virus (HCV) is a significant cause of liver-related mortality in the US.
  • Direct-acting antivirals (DAAs) offer highly effective treatment, yet mortality disparities persist.
  • Assessing current mortality trends is crucial for HCV elimination strategies.

Purpose of the Study:

  • To analyze national trends and disparities in Hepatitis C virus (HCV)-related mortality from 1999 to 2023.
  • To identify specific populations and regions experiencing disproportionate HCV mortality.
  • To evaluate the impact of direct-acting antivirals (DAAs) on HCV mortality trends.

Main Methods:

  • Utilized CDC WONDER data (1999-2023) for HCV-related deaths (ICD-10 codes B17.1, B18.2).
  • Calculated age-adjusted mortality rates (AAMRs) and stratified by demographics and geography.
  • Employed joinpoint regression to analyze temporal trends and annual percent changes (APCs).

Main Results:

  • Overall HCV AAMR peaked in 2014 and declined by 2023 (APC -8.2%), but remained higher in males.
  • American Indian/Alaska Native and non-Hispanic Black individuals showed the highest mortality rates in 2023.
  • Non-metropolitan areas exhibited higher mortality and a slower decline post-2014 compared to metropolitan counties.

Conclusions:

  • DAA era has reduced national HCV mortality, but progress is uneven across populations.
  • Persistent disparities among Native American and Black populations suggest inequities in the HCV care cascade.
  • Policy and public health strategies are needed to ensure equitable and affordable access to curative HCV treatment.
Abstract

Keywords:
CDC WONDERdirect-acting antiviralshealth disparitieshepatitis Cmortality

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