Table 3.7. Number and rates* of deaths with hepatitis C listed as a cause of death^† among residents, by state or jurisdiction — United States, 2015–2019

Table 3.7. Number and rates* of deaths with hepatitis C listed as a cause of death† among residents, by state or jurisdiction — United States, 2015–2019

Source: CDC, National Center for Health Statistics, Multiple Cause of Death 1999–2019 on CDC WONDER Online Database. Data are from the 2015–2019 Multiple Cause of Death files and are based on information from all death certificates filed in the vital records offices of the 50 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 US territories) and fetal deaths are excluded. Numbers are slightly lower than previously reported for 2015–2016 because of NCHS standards that restrict displayed data to US residents. Accessed at http://wonder.cdc.gov/mcd-icd10.html on January 11, 2021. CDC WONDER data set documentation and technical methods can be accessed at https://wonder.cdc.gov/wonder/help/mcd.html#.
* Rates are age-adjusted per 100,000 US standard population during 2000 by 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 1 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 might affect the precision of rates calculated for small numbers of deaths. Missing data are not included.
† Cause of death is defined as 1 of the multiple causes of death and is based on the International Classification of Diseases, 10th Rev. (ICD-10) codes B17.1, and B18.2 (hepatitis C).

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During 2019, a total of 14,242 hepatitis C-associated deaths were reported in the US Multiple Cause of Death data from the National Center for Health Statistics. Although death certificate data can help characterize deaths in the United States associated with hepatitis C, underreporting of hepatitis C as a primary or underlying cause of death occurs. Treatment of hepatitis C with direct-acting antiviral agents and sustained viral response is associated with reductions in mortality among persons with chronic hepatitis C. During 2019, the age-adjusted mortality rate was 3.33 deaths per 100,000 population, an approximate 32% decrease from the corresponding rate during 2015. The highest mortality rates were observed in Oklahoma and the District of Columbia (10.75 and 10.08 deaths per 100,000 population, respectively), whereas the lowest rates were observed in Illinois and Maine (both 1.31 deaths per 100,000 population). Three states (California, Texas, and Florida) had the highest number of hepatitis C-associated deaths reported, accounting for >30% of all the deaths reported nationally during 2019.

Source: Spradling PR, Zhong Y, Moorman AC, et al. The persistence of underreporting of hepatitis C as an underlying or contributing cause of death, 2011–2017. Clin Infect Dis 2021;ciab108. doi: 10.1093/cid/ciab108. Epub ahead of print.

Sahakyan, Y, Lee-Kim V, Bermner KE, et al. Impact of direct-acting antiviral regimens on mortality and morbidity outcomes in patients with chronic hepatitis C: systematic review and meta-analysis. J Viral Hepat 2021. doi: https://doi.org/10.1111/jvh.13482

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