2021 Viral Hepatitis Surveillance Report

Key points

  • After annual increases during 2015–2019, the rate of hepatitis A decreased 43% from 2020 to 2021.
  • The rate of acute hepatitis B abruptly decreased during 2020 and again decreased by 14% from 2020 to 2021.
  • The number of acute hepatitis C cases has doubled during 2014–2020, and the rate increased 7% from 2020 to 2021.
2021 Hepatitis Surveillance Report Overview

Purpose

Did you know?

Tens of thousands of people are newly infected with viral hepatitis every year in the United States. It is a serious public health threat that kills thousands of Americans annually and is a leading cause of liver cancer. Hepatitis A and hepatitis B are vaccine-preventable and hepatitis C can be cured.

Hepatitis is an inflammation of the liver most often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. While each can produce similar symptoms, each hepatitis virus affects the liver differently, has different routes of transmission and infection, and typically affects different populations.

Fortunately, effective vaccines are available to help prevent hepatitis A and hepatitis B. Although no vaccine is available for hepatitis C, life-saving treatment can cure the virus. Learn more about the different viral hepatitis types.

The impact of COVID-19

The findings in this report should be interpreted with caution. The number of viral hepatitis cases reported to CDC in 2020 and 2021 may be lower than in years before the COVID-19 pandemic began. The decrease may be related to fewer people seeking healthcare and being tested for viral hepatitis during the COVID-19 pandemic.

Learn more about how the COVID-19 pandemic impacted data reporting.

Report overview and citation

The Viral Hepatitis Surveillance Report – United States, 2021 is published by the Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services, Atlanta, Georgia.

Data are presented for the cases of viral hepatitis infection from January 1, 2021–December 31, 2021. All material contained in this report is in the public domain and may be used and reprinted without special permission; however, citing this report is appreciated.

Guidance for citing this report

Centers for Disease Control and Prevention. Viral Hepatitis Surveillance Report – United States, 2021. https://www.cdc.gov/hepatitis-surveillance-2021/about/index.html. Published August 2023. Accessed [date].

How the data are used

The Viral Hepatitis Surveillance Report – United States, 2021 represents the ongoing, systematic collection, analysis, and interpretation of viral hepatitis-related data. The surveillance process is essential to monitor trends that inform planning, implementation, and evaluation that are needed to reverse increasing current trends and improve viral hepatitis public health policy and practice.

Key findings

Variations of disease rates by race or ethnicity may reflect systemic cultural, behavioral, environmental, and social factors.

Hepatitis A

During 2021, 50 states reported 5,728 hepatitis A cases corresponding to 11,500 estimated infections.

Hepatitis A cases decreased during 2021

-43%

After annual increases during 2015–2019, the rate of hepatitis A decreased 43% from 2020 to 2021.

See hepatitis A surveillance.

Hepatitis B

During 2021, 47 states reported 2,045 acute hepatitis B cases corresponding to an estimated 13,300 infections, and 40 states reported a total of 14,229 newly reported chronic hepatitis B cases.

Acute hepatitis B cases decreased during 2021

-14%

The rate of acute hepatitis B abruptly decreased during 2020 and again decreased by 14% from 2020 to 2021.

  • Rate of chronic hepatitis B cases is highest in non-Hispanic Asian/Pacific Islander (API) populations: The rate of newly reported chronic hepatitis B cases among non-Hispanic API persons and non-Hispanic Black persons were 14.2 times and 4.1 times, respectively, the rate among non-Hispanic White persons.
  • Rate of hepatitis B-associated deaths is highest in non-Hispanic API populations: The death rate for hepatitis B among non-Hispanic API and non-Hispanic Black persons were nearly 10 times and 2.6 times, respectively, the death rate among non-Hispanic White persons.

See hepatitis B surveillance.

Hepatitis C

During 2021, 42 states reported a total of 5,023 acute hepatitis C cases corresponding to 69,800 estimated infections, and 43 states reported a total of 107,540 newly reported chronic hepatitis C cases.

Acute hepatitis C cases increased during 2021

7%

The number of acute hepatitis C cases has doubled during 2014–2020, and the rate increased 7% from 2020 to 2021.

  • Acute hepatitis C and injection drug use as a risk factor: Injection drug use was the most commonly reported risk factor for persons with acute hepatitis C (57%) with risk information present.
  • Rate of hepatitis C-associated deaths is highest in non-Hispanic American Indian/Alaska Native (AI/AN) and non-Hispanic Black persons: The death rates for hepatitis C among non-Hispanic AI/AN persons and non-Hispanic Black persons were 3.4 times and 1.7 times, respectively, the death rate among non-Hispanic White persons.

See hepatitis C surveillance.

Quick links

Additional viral hepatitis reports