Estimating new viral hepatitis infections from reported acute cases in the United States

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ID: 332521
2026
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Abstract
Abstract Background New viral hepatitis infections may go unreported because many infections are asymptomatic, some people with symptoms do not seek testing, and gaps in surveillance capacity limit identification of acute cases. We present an updated approach to estimate the burden of new viral hepatitis infections from reported acute cases. Methods We estimated the proportion of new viral hepatitis infections expected to be symptomatic from the literature and the proportion of symptomatic patients expected to seek testing from a national survey. We estimated reporting proportions for new hepatitis A virus (HAV) and hepatitis B virus (HBV) infections from the literature and developed a Poisson regression model to estimate the proportion of new hepatitis C virus (HCV) infections reported as acute cases based on predictors of jurisdictional surveillance capacity. Results Overall multipliers to adjust reported acute cases in 2022 ranged from 1.7 (95% uncertainty interval [95% UI] 1.4–2.3) to 2.7 (2.1–3.9) across jurisdictions for hepatitis A, 5.7 (3.0–20.7) to 9.1 (4.7–33.4) for acute hepatitis B, and 2.8 (2.2–3.9) to 67.3 (30.5–152.8) for acute hepatitis C. Applying these multipliers, estimated numbers of new HAV, HBV, and HCV infections in 2022 nationally were 4,982 (95% UI 4,010–5,052), 15,725 (11,095–31,144), and 39,734 (26,740–50,075), respectively. Conclusions Reported cases might substantially underestimate new viral hepatitis infections, and adjustment factors vary widely by jurisdiction. Our updated approach enables public health officials to estimate the burden of new viral hepatitis infections more accurately for program planning and evaluation.
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Authors Joshua A. Salomon, Brooke Hoots, Shannon M. Casillas, Nicola D. Thompson, Jonathan Tang, Lijia Zheng, Neil Gupta
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag669
URL
https://doi.org/10.1093/ofid/ofag669
Keywords Keywords not found

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