A new report from the Iowa Department of Health shows the state has seen a major uptick in the hepatitis C virus (HCV) rate over the last two decades, with new diagnoses of the liver virus tripling across the region since 2000, KIMT reports.

However, state health authorities say the increase is a sign that local efforts are making headway in controlling Iowa’s hepatitis C epidemic, since it suggests that more Iowans than ever are being tested and getting linked to care.

According to the Iowa Department of Health’s latest HCV surveillance report, released this month, the number of new hepatitis C diagnoses in the state rose from 754 in 2000 to 2,235 in 2015. The surveillance study also shows that almost two thirds of new diagnoses were among baby boomers, individuals between 45 and 62 years old.

Additionally, state HCV stats show that the number of Iowans between ages 18 and 30 who tested positive for hepatitis C has more than quadrupled since 2009. Among this group, over 51 percent of individuals reported past injection drug use.

Iowa’s surveillance stats closely mirror hepatitis C trends across the country, suggesting that the people most at-risk for an undiagnosed HCV infection are either baby boomers (who may have received blood transfusions or other invasive medical care before the advent of widespread hepatitis C testing) or injection drug users, many of whom have become addicted in the midst of the modern U.S. opioid epidemic.

Iowa health authorities estimate that between 35,865 and 136,900 people are currently living with hepatitis C across the state and that between 15,330 and 117,174 of these cases remain undiagnosed.

In response to the report, the Iowa Department of Health is continuing to urge those individuals born between 1945 and 1965, recipients of blood transfusions or organ transplants before 1992 and anyone who has ever injected drugs to get tested for hepatitis C at least once.