National Progress Report 2020 Goal: Reduce the rate of hepatitis C-related deaths to 4.17 per 100,000 population

Age-adjusted rate* of hepatitis C-related deaths

Bar chart for years 2010-2020, charting rate per 100,000, starting at 4.65 in 2010, peaking at 5.03 by 2013, then declining to 4.45 in 2016 and then projected downward to 4.17 by 2020.

Source: CDC, National Vital Statistics System (12)
*Rates are age-adjusted per 100,000 U.S. standard population in 2000.
†Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Disease, 10th Revision (ICD-10) codes B17.1 and B18.2.

Summary of Findings

The age-adjusted hepatitis C-related mortality rate increased each year from 2010 through 2013, but began to decline in 2014. In 2016, the decline was large enough to bring the observed hepatitis C-related death rate below the 2016 annual target of 4.73 deaths per 100,000 U.S. population.

Reduction needed to meet 2020 goal: A 6.3% further reduction from the death rate reported in 2016 is needed to meet the 2020 goal of 4.17 deaths per 100,000 U.S. population.

This reduction can best be achieved by

  • Increasing the proportion of persons receiving recommended testing for hepatitis C.
  • Increasing the proportion of currently infected persons who are referred for care and receive appropriate treatment.
  • Fostering collaborations that increase hepatitis C drug affordability, cost savings for payers, and access for patients.
  • Disseminating tools (e.g., telemedicine models) that help health-care systems expand their capacity to identify, link to care, and treat persons living with hepatitis C.
  • Implementing educational campaigns to encourage testing and dispel myths about who is at increased risk for hepatitis C virus (HCV) infection.
  • Using case surveillance and electronic health records to ensure HCV-infected persons are identified and linked to care.

Technical Notes

Data Sources: CDC, National Vital Statistics System (NVSS)

Numerator: Number of death records with a report of hepatitis C listed as the underlying or one of multiple causes of death

Denominator: Total U.S. Census population

Indicator Notes: (1-3) Death certificates are completed for all deaths registered in the United States. Information for death certificates is provided to funeral directors or cremation organizations by attending physicians, medical examiners, and coroners. Death certificates are filed in vital statistics offices within each state and the District of Columbia.  Through the NVSS, information from death certificates is compiled by CDC to produce national multiple-cause-of-death data; causes of death are coded in accordance with the International Classification of Diseases, Tenth Revision. (4) National multiple-cause mortality data from NVSS were obtained and analyzed, and those death records with a report of hepatitis C (ICD-10: B17.1 or B18.2) listed as the underlying or one of the multiple (e.g., contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis C divided by the total U.S. Census population. Rates for race/ethnicity, sex, and overall total were standardized to the age distribution of the U.S. standard population in 2000.

Goal Setting: The goal of reducing the number of deaths from viral hepatitis C from 19,659 in 2014 to 16,370 in 2020 was set in CDC’s Viral Hepatitis Strategic Plan, 2016-2020 Cdc-pdf[PDF – 17 pages], and a similar goal was defined in HHS’s National Viral Hepatitis Action Plan, 2017-2020 Cdc-pdf[PDF – 84 pages]External. Death counts are susceptible to changes in the distribution of the underlying population, potentially confounding trends over time. As such, for this report, a proportional reduction goal was applied to the 2014 rate (5.01 deaths per 100,000 U.S. population) instead of the count. Annual targets assume a constant (linear) rate of change from the observed baseline (2014) to the 2020 goal.

Limitations: Mortality data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial/ethnic populations in U.S. Census data, and underreporting of viral hepatitis as causes of death on death certificates.

References

  1. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance—United States, 2016. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2018. Available at: https://www.cdc.gov/hepatitis/statistics/2016surveillance/pdfs/2016HepSurveillanceRpt.pdf Cdc-pdf[PDF – 75 pages].
  2. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance—United States, 2014. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2016. Available at: https://www.cdc.gov/hepatitis/statistics/2014surveillance/pdfs/2014HepSurveillanceRpt_Rev2016-09-26.pdf Cdc-pdf[PDF – 65 pages]
  3. National Center for Health Statistics. National Vital Statistics System (NVSS), mortality data. Available at: http://www.cdc.gov/nchs/deaths.htm
  4. World Health Organization. International Classification of Diseases, 10th Revision. Geneva: World Health Organization; 1998. Available at: http://www.who.int/classifications/icd/en/External