Viral Hepatitis Surveillance Report 2018 — Hepatitis C

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ACUTE HEPATITIS C, 2018. 3,621 New cases reported. 1.2 Reported cases per 100,000 population. 50,300 Acute infections estimated
* 95% Bootstrap Confidence Interval: (39,800–171,600)
† Indicates groups above the national average in 2018

AT A GLANCE: Acute Hepatitis C in 2018

Rates of acute hepatitis C increased in 2018, particularly among those aged 20-39 years, consistent with age groups most impacted by the nation’s opioid crisis.

Groups Most Affected by Acute Hepatitis C in 2018

By Age†
20-29 years: 3.1 cases per 100,000 people
30-39 years: 2.6 cases per 100,000 people
40-49 years: 1.3 cases per 100,000 people

By Sex†
Males: 1.3 cases per 100,000 people

By Race/ Ethnicity†
American Indian/Alaska Native: 3.6 cases per 100,000 people

By Risk
Injection Drug Use (IDU): Among the 1,535 reported cases with IDU information available, 1,102 (72%) report IDU

† Indicates groups above the national average in 2018
On This Page

Figure 3.1. Number of reported acute hepatitis C cases and estimated infections* — United States, 2011–2018

Figure 3.1 This figure shows the number of reported cases of acute hepatitis C and estimated acute hepatitis C infections for 2011 through 2018. The number of reported acute hepatitis C cases and estimated acute hepatitis C infection generally increased each year during the time period. In 2018 there were 3,621 reported cases of acute hepatitis C and 50,300 estimated acute hepatitis C infections.

Hepatitis C 2011 2012 2013 2014 2015 2016 2017 2018
Data points for figure 3.1
Reported cases 1,232 1,778 2,138 2,194 2,436 2,967 3,216 3,621
Estimated cases 17,100 24,700 29,700 30,500 33,900 41,200 44,700 50,300
Source: CDC, National Notifiable Diseases Surveillance System.
* The number of estimated viral hepatitis infections was determined by multiplying the number of reported cases by a factor that adjusted for under-ascertainment and
under-reporting(7). The 95% bootstrap confidence intervals for the estimated number of infections are shown in the Appendix.

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Table 3.1. Number and rate* of reported cases of acute hepatitis C, by state or jurisdiction ― United States, 2014–2018

Table 3.1
State 2014
No.		 2014
Rate*		 2015
No.		 2015
Rate*		 2016
No.		 2016
Rate*		 2017
No.		 2017
Rate*		 2018
No.		 2018
Rate*
Alabama 35 0.7 70 1.4 32 0.7 17 0.3 52 1.1
Alaska N N N N N N N N N N
Arizona U U U U U U U U U U
Arkansas 13 0.4 2 0.1 — — 1 0.0 10 0.3
California 73 0.2 59 0.2 60 0.2 103 0.3 114 0.3
Colorado 33 0.6 40 0.7 35 0.6 42 0.7 46 0.8
Connecticut — — — — 17 0.5 9 0.3 10 0.3
Delaware U U 4 0.4 25 2.6 4 0.4 U U
District of Columbia U U U U U U U U U U
Florida 93 0.5 126 0.6 236 1.1 357 1.7 435 2.0
Georgia 57 0.6 84 0.8 93 0.9 100 1.0 84 0.8
Hawaii — — — — — — — — — —
Idaho 6 0.4 4 0.2 7 0.4 8 0.5 4 0.2
Illinois 27 0.2 31 0.2 21 0.2 39 0.3 93 0.7
Indiana 122 1.8 138 2.1 146 2.2 191 2.9 266 4.0
Iowa U U U U U U U U U U
Kansas 28 1.0 22 0.8 15 0.5 19 0.7 13 0.4
Kentucky 176 4.0 119 2.7 103 2.3 83 1.9 164 3.7
Louisiana 22 0.5 24 0.5 5 0.1 7 0.1 8 0.2
Maine 31 2.3 30 2.3 25 1.9 21 1.6 23 1.7
Maryland 42 0.7 38 0.6 35 0.6 32 0.5 38 0.6
Massachusetts 228 3.4 249 3.7 424 6.2 327 4.8 110 1.6
Michigan 78 0.8 83 0.8 107 1.1 152 1.5 142 1.4
Minnesota 40 0.7 37 0.7 51 0.9 57 1.0 60 1.1
Mississippi U U U U U U U U U U
Missouri 6 0.1 8 0.1 24 0.4 49 0.8 74 1.2
Montana 13 1.3 15 1.5 20 1.9 14 1.3 8 0.8
Nebraska 2 0.1 8 0.4 2 0.1 2 0.1 2 0.1
Nevada 6 0.2 12 0.4 16 0.5 35 1.2 19 0.6
New Hampshire N N N N N N 25 1.9 25 1.8
New Jersey 113 1.3 130 1.5 122 1.4 125 1.4 96 1.1
New Mexico 16 0.8 40 1.9 18 0.9 16 0.8 22 1.0
New York 126 0.6 121 0.6 179 0.9 188 0.9 236 1.2
North Carolina 111 1.1 144 1.4 82 0.8 114 1.1 149 1.4
North Dakota — — — — 1 0.1 1 0.1 10 1.3
Ohio 105 0.9 122 1.1 187 1.6 159 1.4 282 2.4
Oklahoma 45 1.2 35 0.9 32 0.8 46 1.2 28 0.7
Oregon 15 0.4 13 0.3 19 0.5 35 0.8 14 0.3
Pennsylvania 69 0.5 129 1.0 225 1.8 224 1.7 249 1.9
Rhode Island U U U U U U U U U U
South Carolina 4 0.1 5 0.1 10 0.2 13 0.3 15 0.3
South Dakota — — — — 20 2.3 19 2.2 19 2.2
Tennessee 123 1.9 173 2.6 150 2.3 142 2.1 157 2.3
Texas 47 0.2 48 0.2 40 0.1 35 0.1 46 0.2
Utah 38 1.3 30 1.0 76 2.5 81 2.6 120 3.8
Vermont 4 0.6 1 0.2 5 0.8 9 1.4 4 0.6
Virginia 54 0.6 52 0.6 43 0.5 62 0.7 47 0.6
Washington 82 1.2 63 0.9 62 0.9 52 0.7 101 1.3
West Virginia 62 3.4 63 3.4 94 5.1 102 5.6 70 3.9
Wisconsin 49 0.9 64 1.1 103 1.8 94 1.6 134 2.3
Wyoming U U U U U U 5 0.9 22 3.8
Total 2,194 0.7 2,436 0.8 2,967 1.0 3,216 1.0 3,621 1.2
Source: CDC, National Notifiable Diseases Surveillance System.
* Rate per 100,000 population.
† For case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-acute/
N: Not reportable. The disease or condition was not reportable by law, statue, or regulation in the reporting jurisdiction.
U: Unavailable. The data are unavailable.

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Figure 3.2. Rates of reported acute hepatitis C, by state* — United States, 2017–2018

Figure 3.2. The horizonal bar chart shows the distribution of rates of reported acute hepatitis C by state for the years 2017 and 2018 compared to the 2018 United States average rate of 1.2 cases per 100,000 population. Indiana and West Virginia had the highest rate of reported acute hepatitis C in 2018.

Source: CDC, National Notifiable Diseases Surveillance System.
*Excludes Alaska, Arizona, Delaware, District of Columbia, Hawaii, Iowa, Mississippi, and Rhode Island.

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Figure 3.3. Rates of reported acute hepatitis C, by state or jurisdiction — United States, 2018

Figure 3.3. This map displays rates of acute hepatitis C by state or jurisdiction for 2018. States are grouped and shaded based on acute hepatitis C rates (cases per 100,000 per population). States for which there were no data on acute hepatitis C cases are grouped separately.

Color
Key		 Cases/100,000
Population		 States
Color Key Table for Figure 3.3
0-0.3 AR, CA, CT, ID, LA, NE, OR, SC, TX
>0.3-0.9 CO, GA, IL, KS, MD, MT, NV, OK, VT, VA
>0.9-1.3 AL, MN, MO, NJ, NM, NY, ND, WA
>1.3-2.2 FL, ME, MA, MI, NH, NC, PA
>2.2-4.0 IN, KY, OH, SD, TN, UT, WV, WI, WY
Data Not Available AK, AZ, DE, DC, HI, IA, MS, RI

Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 3.4. Rates of reported acute hepatitis C, by age group — United States, 2003–2018

Figure 3.4. The line graph shows trends in rates of acute hepatitis C by age groups (0 – 19 years, 20 – 29 years, 30 – 39 years, 40 – 49 years, 50 – 59 years, and 60 years and older) for 2003 through 2018. Apart from age group aged 0-19 years, the rates of acute hepatitis C have increased during the time period. There was a greater increase in reported acute hepatitis C cases for the 20 – 29 and 30 – 39 age groups, relative to other age groups.

Age (years) 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Data points for Figure 3.4.
0-19 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1
20-29 0.5 0.4 0.4 0.5 0.5 0.6 0.7 0.8 1.2 1.7 2.0 2.2 2.4 2.7 2.8 3.1
30-39 0.5 0.4 0.4 0.5 0.5 0.5 0.5 0.6 0.8 1.1 1.4 1.7 1.7 2.2 2.3 2.6
40-49 0.6 0.5 0.4 0.4 0.5 0.5 0.4 0.3 0.4 0.7 0.8 0.7 0.9 1.2 1.1 1.3
50-59 0.3 0.3 0.2 0.3 0.3 0.4 0.2 0.3 0.3 0.4 0.5 0.4 0.6 0.6 0.8 0.9
60+ 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.3 0.4
Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 3.5. Rates of reported acute hepatitis C, by sex — United States, 2003–2018

Figure 3.5. This line graph displays trends in rates of acute hepatitis C for males and females from 2003 through 2018. From 2010 through 2020, the rates of acute hepatitis C have increased for both males and females. Rates for males were higher than rates for females for all years except 2008 and 2009 when the rates were close.

Sex 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Data points for Figure 3.5.
Male 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.4 0.7 0.8 0.8 0.9 1.1 1.2 1.3
Female 0.3 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.5 0.7 0.7 0.7 0.9 0.9 1.0
Source: CDC, National Notifiable Diseases Surveillance System.

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Figure 3.6. Rates of reported acute hepatitis C, by race/ethnicity — United States, 2003–2018

Figure 3.6. This line graph shows trends in rates of acute hepatitis C by race/ethnicity from 2003 through 2018. The race/ethnicity classifications are American Indian/Alaska Native, Asian/Pacific Islander, Black non-Hispanic, White non-Hispanic, and Hispanic. Apart from Asian/Pacific Islanders, rates have increased for all race/ethnicity groups since 2012. There was a small increase in acute hepatitis C among Asian/Pacific Islanders in 2018.

Race/
Ethnicity		 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Data points for Figure 3.6.
American Indian/ Alaska Native 0.4 0.7 0.3 0.7 0.6 0.8 0.6 1.0 1.1 2.0 1.7 1.3 1.8 3.1 2.9 3.6
Asian/Pacific Islander 0.1 0.1 0.0 0.1 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2
Black, Non-Hispanic 0.3 0.2 0.1 0.2 0.2 0.2 0.1 0.1 0.1 0.2 0.2 0.2 0.3 0.3 0.5 0.6
White, Non-Hispanic 0.3 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.5 0.6 0.8 0.8 0.9 1.1 1.2 1.3
Hispanic 0.2 0.1 0.2 0.1 0.2 0.1 0.1 0.1 0.2 0.2 0.2 0.3 0.3 0.4 0.4 0.5
Source: CDC, National Notifiable Diseases Surveillance System.

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Table 3.2. Number and rate* of reported cases† of acute hepatitis C, by demographic characteristics and region — United States 2014–2018

Table 3.2
State 2014
No.		 2014
Rate*		 2015
No.		 2015
Rate*		 2016
No.		 2016
Rate*		 2017
No.		 2017
Rate*		 2018
No.		 2018
Rate*
Total§ 2,194 0.7 2,436 0.8 2,967 1.0 3,216 1.0 3,621 1.2
Age group (years)
0–19 88 0.1 99 0.1 86 0.1 103 0.1 81 0.1
20–29 918 2.2 999 2.4 1,135 2.7 1,189 2.8 1,310 3.1
30–39 643 1.7 682 1.7 868 2.2 937 2.3 1,070 2.6
40–49 282 0.7 337 0.9 452 1.2 441 1.1 494 1.3
50–59 166 0.4 240 0.6 264 0.6 332 0.8 366 0.9
60+ 70 0.1 77 0.1 141 0.2 185 0.3 295 0.4
Sex
Male 1,167 0.8 1,334 0.9 1,627 1.1 1,775 1.2 2,012 1.3
Female 1,025 0.7 1,093 0.7 1,310 0.8 1,431 0.9 1,605 1.0
Race/ethnicity
American Indian/ Alaskan Native 29 1.3 39 1.7 70 3.1 67 2.9 83 3.6
Asian/Pacific Islander 11 0.1 16 0.1 25 0.1 23 0.1 29 0.2
Black, Non-Hispanic 74 0.2 112 0.3 130 0.3 202 0.5 231 0.6
White, Non-Hispanic 1,569 0.8 1,724 0.9 2,109 1.1 2,227 1.2 2,405 1.3
Hispanic 124 0.2 148 0.3 191 0.4 234 0.4 280 0.5
HHS Region
Region 1 263 3.0 280 3.2 471 3.8 391 2.8 172 1.2
Region 2 239 0.8 251 0.9 301 1.0 313 1.1 332 1.2
Region 3 227 0.8 286 1.0 422 1.4 424 1.4 404 1.4
Region 4 599 1.0 721 1.2 706 1.1 826 1.3 1,056 1.7
Region 5 421 0.8 475 0.9 615 1.2 692 1.3 977 1.9
Region 6 143 0.4 149 0.4 95 0.2 105 0.2 114 0.3
Region 7 36 0.3 38 0.3 41 0.4 70 0.6 89 0.8
Region 8 84 0.8 85 0.8 152 1.4 162 1.4 225 1.9
Region 9 79 0.2 71 0.2 76 0.2 138 0.3 133 0.3
Region 10 103 0.8 80 0.6 88 0.7 95 0.7 119 0.9
Source: CDC, National Notifiable Diseases Surveillance System.
* Rate per 100,000 population.
† For the case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-acute/
§ Numbers reported in each category may not add up to the total number of reported cases in a year due to cases with missing data or, in the case of race/ethnicity, cases categorized as “Other.”
Health and Human Services Regions were categorized according to the grouping of states and U.S. Territories assigned under each of the ten Department of Health and Human Services regional offices (https://www.hhs.gov/about/agencies/iea/regional-offices/index.html). For the purposes of this report, regions with US territories (Region 2 and Region 9) contain data from states only.

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HEPATITIS C – RISK BEHAVIORS AND EXPOSURES

Figure 3.7. Availability of information on risk behaviors/exposures* associated with reported cases of acute hepatitis C — United States, 2018

Color Key with three items listed. Risk identified*, No risk identified, and Risk data missing
Figure 3.7. The pie chart provides information on the availability of risk behaviors/exposures for reported cases of acute hepatitis C for 2018. At least one risk behavior/exposure was identified for 37% of cases, no risk was identified for 14% of cases, and risk data were missing for 49% of cases.

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Table 3.3. Reported risk behaviors/exposures† among reported cases of acute hepatitis C — United States, 2018

Risk behaviors/exposures Risk identified* No risk identified Risk data missing
Table 3.3
Injection drug use 1,102 433 2,086
Multiple sex partners 212 462 2,947
Surgery 124 832 2,665
Sexual contact§ 105 278 3,238
Needlestick 91 781 2,749
Men who have sex with men 33 277 1,702
Household contact (non-sexual)§ 30 353 3,238
Dialysis patient 18 1,041 2,562
Occupational 7 1,145 2,469
Transfusion 1 956 2,664
Source: CDC, Nationally Notifiable Diseases Surveillance System.
* Case reports with at least one of the following risk behaviors/ exposures reported 6 weeks to 6 months prior to symptom onset: 1) injection drug use; 2) sexual contact with suspected/confirmed hepatitis C patient; 3) men who have sex with men; 4) multiple sex partners; 5) occupational exposure to blood; 6) dialysis patient; 7) receive blood transfusion; and 8) underwent surgery.
† Reported cases may include more than one risk behavior/exposure.
§ Cases with more than one type of contact reported were categorized according to a hierarchy: 1) sexual contact; 2) household contact (non-sexual).
A total of 2,012 acute hepatitis C cases were reported among males in 2018.

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Table 3.4. Number of newly reported cases* of perinatal hepatitis C, by state or jurisdiction — United States, 2018

Table 3.4
State Perinatal Hepatitis C
Alabama —
Alaska 1
Arizona —
Arkansas 1
California 14
Colorado 2
Connecticut —
Delaware U
District of Columbia —
Florida 36
Georgia 3
Hawaii —
Idaho —
Illinois 6
Indiana 20
Iowa —
Kansas 1
Kentucky —
Louisiana 3
Maine —
Maryland 3
Massachusetts 10
Michigan 11
Minnesota 1
Mississippi —
Missouri —
Montana 1
Nebraska —
Nevada 2
New Hampshire —
New Jersey 10
New Mexico —
New York 3
North Carolina —
North Dakota —
Ohio 44
Oklahoma —
Oregon —
Pennsylvania 20
Rhode Island U
South Carolina —
South Dakota —
Tennessee 4
Texas N
Utah 4
Vermont —
Virginia 8
Washington 4
West Virginia —
Wisconsin 2
Wyoming —
Total 214

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Table 3.5. Number of newly reported cases** of chronic hepatitis C, by state or jurisdiction — United States, 2018

Table 3.5
State Chronic Hepatitis C
Alabama N
Alaska 872
Arizona U
Arkansas N
California –
Colorado 2,871
Connecticut 1,897
Delaware U
District of Columbia U
Florida 16,193
Georgia 5,451
Hawaii U
Idaho 872
Illinois 4,965
Indiana N
Iowa 1,498
Kansas 1,272
Kentucky N
Louisiana 6,640
Maine 888
Maryland 3,882
Massachusetts 4,772
Michigan 4,058
Minnesota 1,225
Mississippi –
Missouri 4,658
Montana 967
Nebraska 696
Nevada U
New Hampshire 224
New Jersey 3,882
New Mexico 956
New York 8,047
North Carolina N
North Dakota 717
Ohio 10,582
Oklahoma 1,569
Oregon 3,000
Pennsylvania 12,874
Rhode Island U
South Carolina 3,071
South Dakota 422
Tennessee 9,949
Texas N
Utah 1,012
Vermont 463
Virginia 4,772
Washington 5,219
West Virginia 4,832
Wisconsin 2,090
Wyoming 355
Total 137,713

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Source: CDC, National Notifiable Diseases Surveillance System.
* For case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-perinatal-infection/
** For case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-chronic/
—: No reported cases. The reporting jurisdiction did not submit any cases to CDC.
N: Not reportable. The disease or condition was not reportable by law, statue, or regulation in the reporting jurisdiction.
U: Unavailable. The data are unavailable.

Figure 3.8. Number of newly reported* chronic hepatitis C cases† by sex and age — United States, 2018 (N=137,713)

Figure 3.8. The graph shows the number of newly reported chronic hepatitis C cases by sex and age in the United States for 2018. The graph shows a bimodal distribution with peaks in the 20 to 40 year and 55-68 years age groups. Rates of chronic hepatitis C were consistently higher for males than for females.

This graph shows the number of newly reported chronic hepatitis C cases by sex and age in the United States for 2018. Males overall had higher rates of hepatitis C than females. Both males and females showed a biphasic pattern of new infections, with infections rising throughout late teens and early twenties, decreasing through the twenties and thirties, rising again in the late forties through early sixties, then declining for the remaining years.
Source: CDC, National Notifiable Diseases Surveillance System.
* During 2018, cases of chronic hepatitis C were either not reportable by law, statute, or regulation; not reported; or otherwise unavailable to CDC from Alabama, Arizona, Arkansas, California, Delaware, District of Columbia, Hawaii, Indiana, Kentucky, Mississippi, Nevada, North Carolina, Rhode Island, and Texas.
† Only confirmed, newly diagnosed, chronic hepatitis C cases are included. For the complete case definition, see https://wwwn.cdc.gov/nndss/conditions/hepatitis-c-chronic/case-definition/2016/.

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Table 3.6. Number and rate* of deaths with hepatitis C listed as a cause of death† among U.S. residents, by jurisdiction and year ― United States, 2014–2018

Table 3.6
State 2014
No.		 2014
Rate*		 2015
No.		 2015
Rate*		 2016
No.		 2016
Rate*		 2017
No.		 2017
Rate*		 2018
No.		 2018
Rate*
Alabama 246 3.97 187 3.08 166 2.63 188 2.97 167 2.54
Alaska 60 7.13 41 4.95 50 5.38 38 4.38 40 5.00
Arizona 553 6.90 567 6.90 500 5.81 480 5.45 348 3.84
Arkansas 160 4.39 183 5.01 184 4.91 169 4.43 150 3.86
California 3,409 7.66 3,245 7.19 2,917 6.33 2,630 5.58 2,391 4.98
Colorado 352 5.49 362 5.51 385 5.74 386 5.62 387 5.48
Connecticut 156 3.25 153 3.20 123 2.52 130 2.61 89 1.72
Delaware 50 3.91 45 3.41 47 3.63 49 3.80 34 2.33
District of Columbia 92 13.21 101 13.93 95 13.37 83 11.42 70 9.40
Florida 1,266 4.71 1,270 4.62 1,222 4.26 1,222 4.16 1,005 3.34
Georgia 426 3.58 396 3.26 368 2.98 344 2.66 326 2.46
Hawaii 87 4.99 68 3.70 70 3.75 67 3.48 49 2.42
Idaho 110 5.44 99 4.79 115 5.40 84 3.82 108 4.87
Illinois 364 2.33 399 2.56 354 2.18 288 1.72 279 1.67
Indiana 263 3.26 270 3.26 295 3.60 269 3.16 259 2.98
Iowa 112 3.04 125 3.19 109 2.67 122 3.01 98 2.40
Kansas 126 3.62 141 4.11 148 4.20 141 3.83 130 3.48
Kentucky 250 4.70 270 5.09 269 5.05 306 5.58 319 5.77
Louisiana 400 7.25 396 7.15 383 6.60 382 6.49 352 5.92
Maine 59 3.42 57 3.05 40 1.87 32 1.60 34 1.69
Maryland 335 4.42 366 4.84 327 4.32 340 4.41 352 4.44
Massachusetts 303 3.65 317 3.71 261 2.98 267 3.00 211 2.33
Michigan 511 3.88 512 3.77 415 3.06 368 2.61 384 2.72
Minnesota 245 3.50 234 3.40 240 3.28 235 3.19 209 2.81
Mississippi 171 4.82 162 4.57 183 5.08 159 4.38 141 3.70
Missouri 314 4.13 275 3.50 258 3.23 247 3.06 244 3.09
Montana 55 3.77 77 5.76 75 5.71 68 4.89 76 5.36
Nebraska 77 3.49 82 3.60 78 3.25 79 3.29 72 3.26
Nevada 181 5.33 173 4.80 181 4.97 153 4.00 140 3.59
New Hampshire 62 3.18 65 3.28 68 3.57 57 2.90 64 3.36
New Jersey 446 3.93 400 3.52 378 3.24 342 2.90 309 2.64
New Mexico 205 8.29 195 8.05 203 8.12 175 6.70 163 6.30
New York 1,092 4.42 979 3.89 789 3.06 701 2.71 615 2.40
North Carolina 495 4.08 532 4.19 511 3.92 460 3.44 426 3.11
North Dakota 24 2.78 32 3.55 20 2.25 23 2.88 23 2.52
Ohio 567 3.78 559 3.70 546 3.58 541 3.48 480 3.16
Oklahoma 523 11.62 510 11.02 538 11.46 555 11.84 534 11.00
Oregon 563 10.79 514 9.68 491 8.90 518 9.24 466 8.03
Pennsylvania 629 3.73 726 4.18 564 3.28 563 3.15 417 2.37
Rhode Island 104 7.70 97 7.26 89 6.57 76 5.15 91 6.37
South Carolina 271 4.38 294 4.67 299 4.51 302 4.51 259 3.70
South Dakota 31 3.18 35 3.33 37 3.46 29 2.56 30 2.80
Tennessee 554 6.83 592 7.27 482 5.89 469 5.57 517 6.01
Texas 1,860 6.41 1,996 6.72 1,886 6.12 1,888 6.03 1,708 5.30
Utah 91 3.34 98 3.47 85 2.98 68 2.29 78 2.59
Vermont 33 3.86 43 4.87 35 3.72 40 4.44 30 3.32
Virginia 335 3.27 330 3.15 327 3.03 290 2.68 272 2.48
Washington 644 7.21 651 7.06 517 5.53 528 5.46 466 4.76
West Virginia 110 4.72 107 4.65 118 4.85 116 4.94 108 4.90
Wisconsin 205 2.70 208 2.78 214 2.70 145 1.82 151 1.90
Wyoming 36 4.77 30 3.95 38 4.89 41 5.50 42 5.84
Total 19,613 5.01 19,566 4.91 18,093 4.42 17,253 4.13 15,713 3.72
Source: CDC, National Center for Health Statistics, Multiple Cause of Death 1999–2018 on CDC WONDER Online Database. Data are from the 2014–2018 Multiple Cause of Death files and are based on information from all death certificates filed in the vital records offices of the fifty states and the District of Columbia through the Vital Statistics Cooperative Program. Deaths of nonresidents (e.g., nonresident aliens, nationals living abroad, residents of Puerto Rico, Guam, the Virgin Islands, and other U.S. Territories) and fetal deaths are excluded. Numbers are slightly lower than previously reported for 2013–2016 due to NCHS standards which restrict displayed data to U.S. residents. Accessed at http://wonder.cdc.gov/mcd-icd10.html on February 14, 2020. CDC WONDER dataset documentation and technical methods can be accessed at https://wonder.cdc.gov/wonder/help/mcd.html#.
* Rates are age-adjusted per 100,000 U.S. standard population in 2000 using the following age group distribution (in years): <1, 1–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and 85+. For age-adjusted death rates, the age-specific death rate is rounded to one decimal place before proceeding to the next step in the calculation of age-adjusted death rates for NCHS Multiple Cause of Death on CDC WONDER. This rounding step may affect the precision of rates calculated for small numbers of deaths. Missing data are not included.
† Cause of death is defined as one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B17.1, and B18.2 (hepatitis C).

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Figure 3.9. Rate of deaths with hepatitis C listed as a cause of death among U.S. residents, by jurisdiction and year — United States, 2018

Figure 3.9. The map shows rate of deaths with hepatitis C listed as a cause of death by states in 2018. States are grouped and shaded based on reported rate of deaths per 100,000population. States with unreliable data are grouped separately.

Color
Key		 Cases/100,000
Population		 States
Color Key Table for Figure 3.9
0-2.49 CT, DE, GA, HI, IL, IA, ME, MA, NY, PA, VA, WI
>2.49-3.12 AL, IN, MI, MN, MO, NJ, NC, ND, SD, UT
>3.12-3.85 AZ, FL, KS, MS, NE, NV, NH, OH, SC, VT
>3.85-5.49 AK, AR, CA, CO, ID, MD, MT, TX, WA, WV
>5.49-11.00 DC, KY, LA, NM, OK, OR, RI, TN, WY

Source: CDC, National Center for Health Statistics, Multiple Cause of Death 2018 on CDC WONDER Online Database.

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Table 3.7. Number and rate* of deaths with hepatitis C listed as a cause of
death† among U.S. residents, by demographic characteristics, region, and year — United States, 2014–2018

Table 3.7
Demographic
characteristic		 2014
No.		 2014
Rate*
(95% CI)		 2015
No.		 2015
Rate*
(95% CI)		 2016
No.		 2016
Rate*
(95% CI)		 2017
No.		 2017
Rate*
(95% CI)		 2018
No.		 2018
Rate*
(95% CI)
Age group (years)
0–34 162 0.11
(0.09-0.13)		 196 0.13
(0.11-0.15)		 164 0.11
(0.09-0.13)		 180 0.12
(0.10-0.14)		 212 0.14
(0.12-0.16)
35–44 549 1.36
(1.24-1.47)		 592 1.46
(1.34-1.58)		 532 1.31
(1.20-1.43)		 507 1.24
(1.13-1.35)		 499 1.21
(1.10-1.31)
45–54 4,108 9.45
(9.16-9.74)		 3,659 8.47
(8.20-8.75)		 3,026 7.07
(6.82-7.32)		 2,556 6.03
(5.80-6.27)		 2,040 4.90
(4.69-5.11)
55–64 9,976 24.89
(24.40-25.38)		 9,678 23.68
(23.20-24.15)		 9,011 21.73
(21.28-22.18)		 8,275 19.70
(19.28-20.13)		 7,297 17.26
(16.87-17.66)
65–74 3,382 12.81
(12.38-13.24)		 4,009 14.55
(14.10-15.00)		 4,071 14.22
(13.78-14.66)		 4,397 14.81
(14.38-15.25)		 4,429 14.52
(14.10-14.95)
75+ 1,431 7.21
(6.84-7.58)		 1,431 7.08
(6.71-7.45)		 1,288 6.25
(5.91-6.59)		 1,329 6.28
(5.94-6.61)		 1,235 5.63
(5.32-5.94)
Race/ethnicity
White, Non-Hispanic 12,438 4.42
(4.34-4.50)		 12,329 4.35
(4.27-4.43)		 11,389 3.95
(3.88-4.03)		 10,781 3.70
(3.63-3.78)		 9,858 3.35
(3.28-3.42)
Black, Non-Hispanic 3,535 8.12
(7.85-8.39)		 3,602 8.13
(7.86-8.40)		 3,360 7.42
(7.16-7.68)		 3,262 7.03
(6.79-7.28)		 2,978 6.31
(6.08-6.54)
Hispanic 2,792 6.90
(6.63-7.16)		 2,737 6.48
(6.23-6.74)		 2,510 5.76
(5.53-6.00)		 2,399 5.29
(5.08-5.51)		 2,190 4.64
(4.44-4.84)
Asian/ Pacific Islander, Non-Hispanic 419 2.43
(2.19-2.67)		 415 2.32
(2.09-2.55)		 384 2.03
(1.82-2.24)		 368 1.86
(1.67-2.05)		 300 1.43
(1.27-1.60)
American Indian / Alaska Native, Non-Hispanic 287 10.05
(8.86-11.24)		 324 11.45
(10.18-12.73)		 285 9.80
(8.63-10.97)		 299 10.24
(9.04-11.44)		 264 9.05
(7.93-10.17)
Sex
Male 13,962 7.38
(7.26-7.51)		 14,043 7.27
(7.15-7.40)		 12,815 6.48
(6.36-6.59)		 12,287 6.12
(6.01-6.23)		 11,242 5.53
(5.42-5.63)
Female 5,651 2.82
(2.75-2.90)		 5,523 2.71
(2.63-2.78)		 5,278 2.54
(2.47-2.61)		 4,966 2.32
(2.26-2.39)		 4,471 2.09
(2.02-2.15)
DHHS Region
Region 1: Boston 717 3.77
(3.48-4.05)		 732 3.78
(3.50-4.07)		 616 3.10
(2.85-3.35)		 602 2.97
(2.72-3.21)		 519 2.56
(2.33-2.79)
Region 2: New York 1,538 4.27
(4.05-4.49)		 1,379 3.78
(3.58-3.98)		 1167 3.12
(2.94-3.30)		 1,043 2.76
(2.59-2.93)		 924 2.48
(2.31-2.64)
Region 3: Philadelphia 1,551 3.95
(3.75-4.15)		 1,675 4.17
(3.96-4.37)		 1,478 3.68
(3.48-3.87)		 1,441 3.53
(3.35-3.72)		 1,253 3.04
(2.87-3.22)
Region 4: Atlanta 3,679 4.61
(4.46-4.76)		 3,703 4.53
(4.38-4.68)		 3,500 4.18
(4.03-4.32)		 3,450 4.03
(3.89-4.16)		 3,160 3.60
(3.47-3.72)
Region 5: Chicago 2,155 3.23
(3.10-3.37)		 2,182 3.24
(3.11-3.38)		 2,064 3.01
(2.88-3.15)		 1,846 2.63
(2.51-2.75)		 1,762 2.52
(2.40-2.64)
Region 6: Dallas 3,148 6.94
(6.69-7.18)		 3,280 7.08
(6.83-7.33)		 3,194 6.69
(6.45-6.92)		 3,169 6.54
(6.31-6.77)		 2,907 5.85
(5.64-6.07)
Region 7: Kansas City 629 3.96
(3.40-3.99)		 623 3.58
(3.29-3.87)		 593 3.31
(3.04-3.59)		 589 3.24
(2.97-3.51)		 544 3.04
(2.78-3.30)
Region 8: Denver 589 4.44
(4.07-4.80)		 634 4.67
(4.30-5.04)		 640 4.69
(4.32-5.06)		 615 4.38
(4.02-4.73)		 636 4.45
(4.09-4.80)
Region 9: San Francisco 4,230 7.30
(7.07-7.52)		 4,053 6.84
(6.63-7.05)		 3,668 6.08
(5.88-6.28)		 3,330 5.37
(5.19-5.56)		 2,928 4.63
(4.46-4.80)
Region 10: Seattle 1,377 8.10
(7.66-8.54)		 1,305 7.49
(7.08-7.91)		 1,173 6.56
(6.17-6.94)		 1,168 6.38
(6.01-6.76)		 1,080 5.79
(5.43-6.14)
Overall 19,613 5.01
(4.93-5.08)		 19,566 4.91
(4.84-4.98)		 18,093 4.42
(4.36-4.49)		 17,253 4.13
(4.07-4.20)		 15,713 3.72
(3.66-3.78)
Source: CDC, National Center for Health Statistics, Multiple Cause of Death 1999–2018 on CDC WONDER Online Database. Data are from the 2014–2018 Multiple Cause of Death files and are based on information from all death certificates filed in the vital records offices of the fifty states and the District of Columbia through the Vital Statistics Cooperative Program. Deaths of nonresidents (e.g., nonresident aliens, nationals living abroad, residents of Puerto Rico, Guam, the Virgin Islands, and other U.S. Territories) and fetal deaths are excluded. Numbers are slightly lower than previously reported for 2013–2016 due to NCHS standards which restrict displayed data to U.S. residents. Accessed at http://wonder.cdc.gov/mcd-icd10.html on February 14, 2020. CDC WONDER dataset documentation and technical methods can be accessed at https://wonder.cdc.gov/wonder/help/mcd.html#.
* Rates for race/ethnicity, sex, and the overall total are age-adjusted per 100,000 U.S. standard population in 2000 using the following age group distribution (in years): <1, 1–4, 5–14, 15–24, 2 SYMFONISK 5–34, 35–44, 45–54, 55–64, 65–74, 75–84, and 85+. Missing data are not included. For age-adjusted death rates, the age-specific death rate is rounded to one decimal place before proceeding to the next step in the calculation of age-adjusted death rates for NCHS Multiple Cause of Death on CDC WONDER. This rounding step may affect the precision of rates
calculated for small numbers of deaths.
† Cause of death is defined as one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B17.1, and B18.2 (hepatitis C).

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