Background

Definition

The recommended definition for chronic HCV infection — people who have detectable HCV RNA in plasma or whole blood and the absence of clinical features of acute hepatitis.

Epidemiology

• In 2022, the World Health Organization (WHO) reported that approximately 58 million people had chronic HCV infection, and approximately 1.5 million new infections occurred each year.
• Prevalence — The burden of chronic HCV infection among each of the WHO geographic regions was estimated at:
  • Western Pacific region – 12.7 million (0.6%)
  • European region – 11 million (1.2%)
    • Prevalence highest in Eastern Europe
  • Eastern Mediterranean region – 10.2 million (1.4%)
  • Southeast Asia region – 9.5 million (0.5%)
  • African region – 7.8 million (0.7%)
  • Americas region – 5.7 million (0.6%)
• The four countries with the highest burden of cases are China, Pakistan, India, and Russia because of high overall population, high prevalence, or both.

Risk Factors

• People who inject drugs or who have ever injected drugs
• People in custodial settings
• People with tattoos or body piercing
• People who received a blood transfusion or organ transplant before 1990
• People with coagulation disorders who received blood products or plasma-derived clotting factor treatment products before 1993
• Children born to HCV-infected mothers
• People infected with human immunodeficiency virus (HIV) or hepatitis B virus
• Sexual partners of an HCV-infected person (individuals at higher risk of sexual transmission include men who have sex with men and people with HCV–HIV coinfection)
• People with evidence of liver disease (persistently elevated alanine aminotransferase level)
• People who have had a needle-stick injury