Differences in the severity of the opioid epidemic are likely driving at least some of the wide variations in the estimated proportion of each state population living with hepatitis C virus (HCV).

Publishing their findings in JAMA Network Open, researchers factored into statistical models data on the HCV epidemic drawn from the National Health and Nutrition Examination (NHANES) survey. They conducted other literature reviews and analyses to provide state-level estimates about the epidemic in populations not included in the NHANES survey.

Between 2013 and 2016, an estimated 0.84 percent of the noninstitutionalized U.S. population, or 2,035,100 people, had hep C. An additional 231,600 institutionalized individuals had HCV, for an adjusted national prevalence of 0.93 percent.

Nine states were home to 51.9 percent of the U.S. hep C population. These were California (318,900 people with HCV), Texas (202,500), Florida (151,000), New York (116,000), Pennsylvania (93,900), Ohio (89,600), Michigan (69,100), Tennessee (69,100) and North Carolina (66,400). Five of these states are in Appalachia, a hotbed of the opioid epidemic.

Overall, the statewide median prevalence of HCV was 0.88 percent. Of the 13 states in the Western United States, 10 had a prevalence above this median.

The 10 jurisdictions with the highest HCV prevalence, three of them Appalachian, were Washington, DC, (2.32 percent), Oklahoma (1.71 percent), New Mexico (1.61 percent), Oregon (1.48 percent), West Virginia (1.35 percent), Louisiana (1.3 percent) Tennessee (1.28 percent), Kentucky (1.16 percent), Rhode Island (1.16 percent) and Arizona (1.1 percent).

Progress toward hepatitis C elimination is theoretically possible with the right investments in prevention, diagnosis, and cure,” the study authors concluded. “The urgency for action and the resources necessary will vary by jurisdiction.”

To read the study, click here.

To read a press release about the study, click here.