In the United States, the annual number of newly acquired acute hepatitis C virus (HCV) infections has declined from an estimated 180,000 in the mid-1980s to an estimated 28,000 in 1995. The prevalence of anti-HCV in the general population of the United States is 1.8%, corresponding to an estimated 3.9 million Americans infected with HCV. An estimated 8,000 to 10,000 deaths each year result from HCV-associated chronic liver disease. The costs of acute and chronic hepatitis C are considerable. In 1992, the estimated total annual cost of acute and chronic hepatitis C was >$600 million.

The prevalence of anti-HCV is highly variable in the United States population. The highest rates are found among injection drug users and hemophilia patients (60%-90%); moderate rates among hemodialysis patients (20%); and lower rates among persons with high-risk sexual behaviors or sexual or household exposure to persons with chronic HCV infection (1%-10%), as well as among health care workers (1%-2%). The lowest rates of anti-HCV are found among volunteer blood donors (<0.5%).

HCV infection affects persons of all ages, but most acute cases of hepatitis C and the highest seroprevalence of HCV infection are found among young adults. The highest proportion of both incident cases and prevalent infections is among whites, but the highest incidence and prevalence rates are among nonwhite racial/ethnic groups. Although the incidence of acute hepatitis C has declined, there is a large reservoir of chronically infected Americans who can serve as a source of transmission to others and who are at risk of the severe consequences of chronic liver disease.