Hepatitis C becomes the leading infectious disease killer in the USA.

Hepatitis C (HCV) has become the leading infectious disease killer in the United States of America (USA), exceeding the combined total deaths of 60 other diseases, including HIV and tuberculosis. HCV is a major co-morbidity for people living with HIV.

According to the Centers for Disease Control (CDC), the large majority of these infections are among ‘baby boomers’ (born between 1945 and 1960), who were infected as a result of unsafe medical procedures in the post-World War II era. An estimated 3.5 million Americans are living with HCV, with roughly half unaware of their status. 

Alarmingly, the CDC has declared a ‘new wave’ of HCV among people who inject drugs, with the number of acute HCV infections doubling to 2,194 cases over the last ten years. Most of these new cases occurred among young white people with a history of injecting, residing in rural and suburban parts of the middle and eastern USA.

Deaths from HCV first surpassed HIV in 2007 when a reported 15,106 people died, compared to 12,734 deaths from HIV. Since then, HCV-related mortality has increased annually – with 19,659 people dying from HCV in 2014. As HCV has few noticeable symptoms, underreporting is a real concern, meaning the actual number may be significantly higher. From 2003, deaths from HCV have increased by 78%.

HCV is both a preventable and curable disease. Improved healthcare procedures mean that infections from blood transfusions or immunisations are rare, if not completely eliminated. Harm reduction measures mean that people who use drugs can access clean injecting equipment to prevent the transmission of blood-borne infections such as HIV and HCV.

Novel antiviral treatment is now available that can cure most cases of HCV – but many are priced out of accessing it. 

The CDC calls for increased implementation of HCV programmes, including regular testing for HCV and HIV; improved linkages to care for people who test positive; and increased access to harm reduction services, to curb the HCV epidemic in the country.