Worldwide Hepatitis Statistics

Incidence and Prevalence of the 5 Types of Hepatitis

If you or a loved one have some form of viral hepatitis, you might be wondering how many people have the disease. Here's a look at the prevalence and incidence of the five different types of hepatitis in the United States and worldwide.

The hepatitis C virus
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Hepatitis Infections in the U.S. and Worldwide

If you've been diagnosed with one of the forms of hepatitis, you aren't alone. It's thought that roughly two percent of people in the United States are living with a chronic hepatitis B or hepatitis C infection, not to mention the other three forms. Hepatitis can cause illness or death due to both the symptoms of the infection and to complications that may develop.

Worldwide, hepatitis (especially hepatitis B and hepatitis C) was responsible for 1.34 million deaths in 2015. The World Health Organization (WHO) also reports that deaths from hepatitis have increased 22 percent since 2000.

Hepatitis B and hepatitis C are responsible for 96 percent of deaths from viral hepatitis of any kind worldwide and cause an estimated 78 percent of all liver cancer and 57 percent of all liver cirrhosis.

Prevention and Treatment Are Progressing

These numbers may sound terrifying, but significant progress is being made in both the prevention and treatment of the various forms of hepatitis.

Vaccination is now available for both hepatitis A and hepatitis B, and since hepatitis D only occurs when a hepatitis B infection is present, this leaves only hepatitis C and hepatitis E in need of a vaccination for prevention. In addition, a better understanding and management of the risk factors for the disease can effectively reduce many cases.

There Is No 'Worst' Type of Hepatitis

While some types of hepatitis are more likely to be fatal or cause chronic long-term problems, there is really is not one type of hepatitis that is worse than another when it comes to individual people.

For example, though there are many more deaths from hepatitis B than hepatitis A, an individual person may fare better with hepatitis B than hepatitis A. The severity of these diseases depends on many factors, including access to good medical care, whether or not a carrier state develops, and much more.

Incidence vs. Prevalence

Before discussing specific numbers and statistics, it's helpful to talk about how these numbers are reported.

The incidence of an infection refers to how many new cases of a disease are diagnosed in a particular year. For example, the yearly incidence of hepatitis A refers to the number of people diagnosed with hepatitis A over a year's time in a particular location.

The prevalence of an infection, in contrast, refers to the number of people living with a disease. This includes not just people who are diagnosed in a particular year, but those who had been diagnosed in the past but continue to live with the disease.


The Five Types of Viral Hepatitis

Hepatitis A Statistics

Unlike other forms of hepatitis which may have a chronic state, hepatitis A infection (as well as hepatitis E) occurs only as an acute illness, meaning once you have had the infection, it doesn't chronically take root in the body. You will either get over the infection or die from the infection (and most people survive.) The disease often presents with symptoms of jaundice, like yellowing of the skin, and flu-like symptoms which resolve over time, but in rare cases can lead to liver failure and death.

Incidence of hepatitis A in the U.S.: In 2017, there were 3,366 cases of hepatitis A reported in the United States with an estimated number more than double that.

Deaths in the U.S.: There were 91 reported deaths related to hepatitis A in the U.S. in 2017.

Worldwide: WHO estimates that Hepatitis A was the cause of death for 7,134 people in 2016.

How it's spread: Hepatitis A is spread orally, through water or food contaminated with the virus by small undetected amounts of stool from an infected person. The incubation period, which is the period between exposure and the onset of symptoms, is usually around a month, but can present anywhere from 15 to 50 days, and the infection may be diagnosed with a blood test.

Hepatitis B Statistics

Hepatitis B infections can be best understood by breaking the disease down into acute infections and chronic infections.

Acute versus chronic infections: When you're initially exposed to hepatitis B, symptoms usually appear around 45 days to six months later. This is called the incubation period. Roughly 70 percent of people will have symptoms with an acute hepatitis B infection.

For many people, especially adults and older children, the virus will be cleared from the body after this initial infection. In contrast, around six percent of adults, 30 percent of children, and roughly 90 percent of infants exposed at birth will not clear the virus and will develop a chronic hepatitis B infection. These people are considered carriers since the virus remains in their blood and those who are exposed to their blood may develop the disease.

Acute hepatitis B incidence in the U.S.: In 2017 there were 3,409 new cases of hepatitis B reported in the United States, but it's estimated that 22,200 new cases occurred since many people don't show symptoms and the illness is not reported.

Chronic hepatitis B prevalence in the U.S.: It's thought that there are 850,000 to 2.2 million people living with chronic hepatitis B in the United States as of 2016.

Deaths in the U.S.: In 2014 there were 1843 deaths in which hepatitis B was listed on the death certificate.

Worldwide: It's believed that 240 million people are infected with the hepatitis B virus worldwide, with 786,000 people dying from complications of the disease each year. Hepatitis B is the leading cause of liver cirrhosis worldwide.

How it's spread: Hepatitis B is transmitted by direct exposure to blood or semen contaminated by the virus. Symptoms can vary from mild or none all the way to liver failure and death. Treatment of the acute infection is mostly supportive care, with drugs such as antiviral medications and interferon used to treat chronic disease.

Hepatitis C Statistics

Like hepatitis B, hepatitis C also has both acute and chronic states, although hepatitis C is much more likely than hepatitis B to become a chronic infection; around 55 to 85 percent of people go on to develop chronic hepatitis C. The incubation period for the disease can vary from two weeks to six months, and around 80 percent of people do not have any symptoms during the acute phase of the illness. Around 90 percent of chronic hepatitis C infections may be curable with antiviral medications. Though there isn't currently a vaccine available, research into immunization is in progress.

Acute hepatitis C incidence in the U.S.: In 2014 there were 2,194 reported new cases of hepatitis C in the United States but 30,000 estimated new cases.

Chronic hepatitis C prevalence in the U.S.: It's estimated that between 2.7 and 3.9 million people are living with chronic hepatitis C infections in the United States.

Deaths in the U.S.: In 2014, hepatitis C was listed as a cause of death on 19,659 death certificates in the U.S. The most common age of the people who died is between 55 and 64.

Worldwide: WHO estimates that 71 million people are infected with hepatitis C worldwide. Many people with the disease go on to develop cirrhosis or liver cancer, and the disease contributes to 399,000 deaths worldwide each year.

How it's spread: Hepatitis C, like hepatitis B, is spread by exposure to blood or semen.

Hepatitis D Statistics

Hepatitis D infection (also called delta agent) is similar to other forms of hepatitis, but it can only infect those who are already infected with the hepatitis B virus. The infection has two forms: Co-infection in which you're infected with both hepatitis D and hepatitis B at the same time, and superinfection, in which hepatitis D infection occurs after you're already infected with hepatitis B. Coinfection is usually acute (similar to a hepatitis A infection), while superinfection with hepatitis D acts more like hepatitis B and can go on to cause cirrhosis and death. Superinfection is usually suspected when someone with hepatitis B becomes increasingly ill rapidly.

Hepatitis D incidence in the U.S.: Hepatitis D is uncommon in the United States.

Worldwide: It's thought that hepatitis D affects around 15 million people worldwide.

How it's spread: Like hepatitis B and C, it's spread by contact with bodily fluids such as infected blood and semen.

Hepatitis E Statistics

Hepatitis E infection is most similar to hepatitis A in that it only has an acute state and is usually a self-limited disease. Like hepatitis A, however, some people may go on to develop fulminant hepatitis (acute liver failure) and die from the disease.

Hepatitis E incidence in the U.S.: Hepatitis E infection is relatively rare in the United States.

Worldwide: There are an estimated 20 million new hepatitis E infections each year worldwide, and it's a serious problem in East and South Asia. Of these, 3.3 million turn into acute symptoms.

Deaths: An estimated 44,000 people died in 2015 from hepatitis E infections worldwide. It can be a very dangerous disease for pregnant women.

How it's spread: Hepatitis E is transmitted by the fecal-oral route (contaminated food and water and poor hygiene similar to hepatitis A) and usually causes digestive tract symptoms.

Vaccinations Work

Given the large number of people who are affected by some form of hepatitis, it's important to be familiar with the different types of the disease. For those at risk, vaccines are now available for both hepatitis A and hepatitis B, and since hepatitis D only occurs along with hepatitis B, many of these diseases are now preventable with vaccination.

Consider Getting Tested

Since hepatitis C is often asymptomatic during the acute phase, there are many people who carry the infection but are unaware. If you have any risk factors, ask your healthcare provider to test you for the disease. That said, many people develop the infection without any obvious risk factors, and it's now recommended that everyone born between 1945 and 1965 be tested for the disease.

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By Charles Daniel
 Charles Daniel, MPH, CHES is an infectious disease epidemiologist, specializing in hepatitis.