Atlanta—Even though nearly a decade has passed since breakthrough treatments that clear the viral infection became available in the United States, most hepatitis C patients have not benefited from them, according to the CDC.

The CDC says its new study underscores the urgent need for a proposed national program seeking to eliminate the infection in the U.S.

Estimates suggest that more than 2 million patients in the U.S. have hepatitis C, which if left untreated, can lead to liver failure and liver cancer. Even with the availability of a safe and effective oral cure, hepatitis C contributed to the deaths of more than 14,800 people in 2020, the CDC noted.

“Tens of thousands of Americans with hepatitis C are getting liver cancer, suffering liver failure, or dying because they can’t access lifesaving medicine,” said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV, Viral Hepatitis, STD [sexually transmitted disease], and TB [tuberculosis] Prevention. “In our nation, no one should have to live knowing a cure for their potentially deadly disease is available, but out of reach.”

The article in the Morbidity & Mortality Weekly Report stated that approximately 2.4 million adults were estimated to have hepatitis C virus (HCV) infection in the U.S. during 2013 to 2016. The Viral Hepatitis National Strategic Plan for the U.S. calls for more than 80% of patients with hepatitis C to achieve viral clearance by 2030.

During January 1, 2013, to December 31, 2021, 1,719,493 individuals were identified as ever having been infected with HCV, and during January 1, 2013, to December 31, 2022, 88% of those ever infected were classified as having received viral testing. Among those who received viral testing, 69% were classified as having initial infection, and among those with initial infection, 34% were classified as cured or cleared (treatment-induced or spontaneous). Of those treated, 7% were categorized as having persistent infection or reinfection.

“Among the 1.0 million persons with evidence of initial infection, approximately one-third had evidence of viral clearance (cured or cleared),” the CDC authors wrote. “This simplified national HCV clearance cascade identifies substantial gaps in cure nearly a decade since highly effective direct-acting antiviral (DAA) agents became available and will facilitate the process of monitoring progress toward national elimination goals. It is essential that increased access to diagnosis, treatment, and prevention services for persons with hepatitis C be addressed to prevent progression of disease and ongoing transmission and achieve national hepatitis C elimination goals.”

The article pointed out that an 8- to 12-week short-course of well-tolerated, oral-only treatment with DAA agents is recommended for nearly all persons with HCV infection and results in a cure in more than 95% of cases.

“The new CDC study indicates jarringly low numbers of people with known hepatitis C virus infection are being cured and provides the first clear picture of the small proportion of people without health insurance who have been cured,” according to a press release.

The data indicated the proportions of people cured were:

• Low overall across all age and insurance groups analyzed
• Lowest among people without health insurance or with Medicaid coverage, as well as adults aged younger than 40 years—a group that has the highest rates of new hepatitis C infection
• Highest among people aged 60 years and older with Medicare or commercial insurance, yet still less than one-half had been cured.

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