How Many People Have Hepatitis?

How Common is Hepatitis in the U.S. and Worldwide?

The hepatitis C virus.
How many people in the U.S. and worldwide are infected each year or living with hepatitis infections?. Laguna Design/Getty Images

If you or a loved one have some form of viral hepatitis, you might be wondering how many people have the disease. How common are the five different types of hepatitis in the U.S. and worldwide?

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 speak of the other forms.

Worldwide, hepatitis (especially hepatitis B and hepatitis C) is thought to be responsible for 2.7 percent of all deaths.

Hepatitis can cause illness or death due to both the symptoms of the infection and due to complications that may develop. Worldwide it's felt that 57 percent of all liver cirrhosis, and 78 percent of liver cancers are related to chronic infection with hepatitis B or hepatitis C.

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.

How Common is Hepatitis? - 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 the 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.

Which Type of Hepatitis is Worst?

A common question people ask is "which type of hepatitis is the worst?" or "which type of hepatitis is the bad kind?"

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.

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 someone has had the infection, it does not chronically take root in the body.

A person will either "get over the infection" or die from the infection (and most people survive.) The disease often presents with symptoms of jaundice (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 2014, there were 1,239 cases of hepatitis A reported in the United States with an estimated number of 2,500. In other words, twice as many people are expected to develop the disease as those who have the disease officially diagnosed and reported.

Deaths from hepatitis A - There were 76 reported deaths related to hepatitis A in the U.S. in 2014.

Hepatitis A is spread orally, through water or food contaminated with the virus. The incubation period (the period between exposure and the onset of symptoms) is usually around two to six weeks, 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 vs chronic infections - When a person is initially exposed to hepatitis B, symptoms usually appear around (the incubation period) 45 days to six months later. 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.

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.

Acute hepatitis B incidence in the U.S. - In 2014 there were 2,953 new cases of hepatitis B reported in the United States, but it's estimated that 19,200 new cases occurred (it's thought the actual rate is 6.48 times the reported rate.)

Chronic hepatitis B prevalence in the U.S. - It's thought that there are 800,000 to two 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 thought that 240 million people are infected with the hepatitis B virus worldwide, with 686,000 people dying from complications of the disease each year. Hepatitis B is the leading cause of liver cirrhosis worldwide.

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 is not currently a vaccine available, research into immunization is in progress.

Acute hepatitis C incidence in the U.S. - In 2014 (statistics released in 2016) there were 2,194 reported new cases of hepatitis C in the United States but 30,000 estimated new cases (estimated cases almost 14 times more common than reported cases.)

Chronic hepatitis C prevalence in the U.S. - It's thought 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 these people is between 55 and 64.

Worldwide - It's estimated that 130 to 150 million people are infected with hepatitis C worldwide. Many people with the disease go on to develop cirrhosis or liver cancer, and the disease is felt to contribute to 700,000 deaths worldwide each year.

Hepatitis D Statistics

Hepatitis D infection (also called delta agent) is similar to other forms of hepatitis, but can only infect those who are already infected with the hepatitis B virus. Like hepatitis B and C it is spread by contact with bodily fluids such as infected blood and semen.

The infection has two forms. Co-infection in which someone is infected with both hepatitis D and hepatitis B at the same time, and superinfection, in which hepatitis D infection occurs after someone is 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. It 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.

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 the develop fulminant hepatitis (acute liver failure) and die from the disease. It is spread by the fecal oral route (contaminated food and water and poor hygiene similar to hepatitis A) and usually causes digestive tract symptoms.

Hepatitis E in the U. S. - Hepatitis E infection is relatively rare in the United Sates.

Worldwide - There are an estimated 20 million new hepatitis C infections each year worldwide, and it is a serious problem in East Asia and South Asia. Of these, close to three million of these infections are worldwide.

Deaths - It's estimated that close to 60 thousand people die each year from hepatitis E infections each year. It can be a very dangerous disease for pregnant women, as almost 20 percent of those infected during their 3rd trimester of pregnancy will die from the disease.

What Should You Do with This Information?

Given the large number of people who are affected by some form of hepatitis, it is 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.

Learn about the risk factors for these conditions, and what you may be able to do to reduce your risk.

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 doctor 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.

Sources:

Centers for Disease Control and Prevention. Hepatitis A Questions and Answers for the Public. Updated 10/03/16. https://www.cdc.gov/hepatitis/hav/afaq.htm#UScommon

Centers for Disease Control and Prevention. Viral Hepatitis. Statistics and Surveillance. Updated 05/19/2016. https://www.cdc.gov/hepatitis/statistics/

World Health Organization. Hepatitis C. Updated July 2016. < href=http://www.who.int/mediacentre/factsheets/fs164/en/>http://www.who.int/mediacentre/factsheets/fs164/en/,/sub>

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