Doubling of New Hepatitis C Virus Infections in South Dakota American Indian Reservation Counties since 2020

Abstract: Background. American Indian (AI) and Alaska Native individuals experience the highest hepatitis C virus (HCV) infection rates among racial groups in the United States. We hypothesized that, in South Dakota, six counties located on AI reservations might have a distinctive and underexamined epidemiologic pattern of HCV. Methods. Using publicly available data from the South Dakota Department of Health, we analyzed rates of newly identified HCV cases in six reservation counties from 2015–2024. Results. From 2015–2024, 1,282 HCV cases occurred in the six counties. These cases represented 19.6% of the state’s total, whereas the counties represent 4.3% of the state’s population. Case rates doubled in 2021 and 2022 to almost seven times the statewide rate. Discussion. The observed increase in HCV case rates in these South Dakota counties may reflect increased transmission, expanded screening, or both. High-prevalence settings may benefit from tailored interventions aimed at curbing transmission and treating infections.