New CDC Viral Hepatitis Reports on US Surveillance in 2021 and on Progress Toward Reaching National Elimination Goals

Cross-posted from CDC NCHHSTP Communication Center

Dear Colleague,

The Centers for Disease Control and Prevention (CDC) has published the Viral Hepatitis Surveillance Report— United States, 2021 and the 2023 Viral Hepatitis National Progress Report. These reports contain hepatitis A, hepatitis B, and hepatitis C surveillance and mortality data that inform the Nation’s viral hepatitis response and monitor progress towards achieving established national viral hepatitis elimination goals of reducing viral hepatitis infections and related mortality and disparities. To improve our nation’s data-driven response to viral hepatitis, these reports also highlight the improved viral hepatitis surveillance capacity that was achieved through new CDC funding, awarded in May 2021, to 59 US states, territories, and large cities in support of viral hepatitis surveillance and prevention activities.

During 2021, the incidence rate of hepatitis A decreased for the second year in a row, marking the resolution of the widespread and prolonged hepatitis A outbreaks that impacted 37 states and was associated with person-to-person transmission, primarily among people who use drugs and those experiencing homelessness. This decline is promising and highlights the need for continued and increased work to fully achieve our national target for even further reductions in new hepatitis A infections. A recent CDC analysis of hepatitis A epidemiology in the United States from 1976 to 2020Exit Disclaimer emphasizes the importance of vaccine coverage, particularly improved universal and catchup childhood vaccination and increased vaccination coverage among adult populations most affected by recent outbreaks. Vaccine coverage is an essential strategy to achieve our goal for hepatitis A.

The incidence rate of acute hepatitis B in 2021 decreased by 14% from 2020, following an abrupt decline from 2019 to 2020. While the reductions during 2020 and 2021 may be related to hepatitis B prevention activities, they may also be attributed to disruptions to healthcare access and public health surveillance activities due to the COVID-19 pandemic, impacting case detection and reporting. Despite the reductions in acute hepatitis B, the United States failed to reach the 2021 target for reducing overall hepatitis B-related deaths and hepatitis B-related deaths among Asian and Pacific Islander persons. Currently, only about half of people with hepatitis B in the U.S. are aware of their infection; full implementation of CDC’s universal hepatitis B screening and testing recommendations released in March 2023 will increase diagnosis among people with hepatitis B, while full implementation of CDC’s adult hepatitis B vaccination recommendations will save lives nationwide by connecting Americans to the most effective tool for preventing new hepatitis B infections.

Rates of acute hepatitis C have doubled from 2014 to 2021 and continue to climb, with an estimated 69,800 acute hepatitis C virus (HCV) infections in 2021; injection drug use was the most commonly reported risk factor. More than half of acute hepatitis C cases progress to chronic infection, and over 107,000 newly reported chronic cases were reported in 2021, with the highest rates among adults aged 30-59 years. Testing is the first step to linking people with hepatitis C to curative treatment, improving health and preventing transmission. In July 2023, CDC issued updated operational guidance for clinicians and laboratorians to ensure that the two-step HCV testing process is completed in a single patient encounter. Implementation of this guidance will increase the percentage of people with hepatitis C who are diagnosed, linked to care, and receive curative treatment.

The nation has tools to prevent and control viral hepatitis, and we have seen progress in reaching many of our national goals; however, we must continue to work to maximize implementation of these tools in support of reaching national viral hepatitis elimination goals. Thank you for your continued commitment to reaching our shared goals.

Sincerely,

/Carolyn Wester/
Carolyn Wester, MD
Director, Division of Viral Hepatitis
National Center for HIV, Viral Hepatitis, STD and TB Prevention
Centers for Disease Control and Prevention
https://www.cdc.gov/nchhstp/default.htm

/Jonathan Mermin/
Jonathan H. Mermin, MD, MPH
RADM and Assistant Surgeon General, USPHS
Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Stay connected: @DrMerminCDC & Connections