Despite the advancements in the diagnostics and therapeutics of hepatitis C, the mortality trends from the hepatitis C virus (HCV) have remained a national burden. We aimed to investigate the mortality trends of hepatitis viruses specifically hepatitis C virus in the United States population from 1999 to 2023.

In this retrospective analysis, spanning from 1999 to 2023, we examined mortality trends using national mortality datasets among individuals infected with any hepatitis virus. We aimed to analyze these trends in mortality among United States (US) residents by demographic characteristics including age, gender, race/ethnicity, and geographic characteristics like urbanization and census region. The national mortality data from the multiple causes of death files in the CDC WONDER Database were queried by applying the ICD-10 codes as B16-B19 to identify death certificates listing viral hepatitis as one of the listed causes. Trends in age-adjusted mortality rate (AAMR) were assessed and results were expressed as annual percentage changes (APC), average APC, and 95% confidence intervals (CI).

The crude mortality rate for HCV from 1999 to 2023 was found to be 4.66 per 100,000 US population and AAMR was 4.07 per 100,000 US population. Mortality rates for HCV were found to be highest for the male gender, age group 55–74 years, American Indians or Alaskan Natives, West US Census Region, and Medium to small metropolitan areas (although non-metropolitan areas equally showed upgoing trends as high as the medium to small metropolitan areas, with AAPC of + 4.61 and + 4.70 respectively). Geographically, states in the top 90th percentile for HCV-associated mortality included the District of Columbia, Oklahoma, Oregon, New Mexico, Washington, and California.

Our study highlights key demographic and geographic disparities in HCV mortality which is the most prevalent among all hepatitis viruses in the United States, underscoring the urgent need for targeted interventions.