Epidemiology of hepatitis C virus infection in Saudi Arabia: a retrospective analysis of national surveillance data, 2006–2021

Background Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma. Long-term epidemiological data from Saudi Arabia remain limited. This study examined 16-year temporal, demographic, and geographic patterns of reported HCV cases.Methods Retrospective data on laboratory-confirmed HCV cases across 20 Saudi health regions (2006–2021) were obtained from the Ministry of Health Statistical Yearbook. National and regional crude incidence rates (CIR) per 100,000 were calculated. Age-specific rates were computed for 2021. Differences across groups were assessed using Kruskal – Wallis and independent-samples t-tests; temporal trends were evaluated using joinpoint regression.Results A total of 39,087 reported HCV cases were recorded (mean: 2,443/year). CIR declined from 12.5 in 2006 to 5.9 in 2021. Joinpoint regression identified a decline during 2006–2015, an increase during 2015–2018, and a decline during 2018–2021. Individuals aged ≥ 45 years accounted for 61.3% of cases. Geographic variation ranged from 17.3 in Jeddah to 0.5 in Hafr Al-Baten.Conclusion Reported HCV notification rates declined, reflecting improved blood safety and infection control. Surveillance, screening, and access to direct-acting antivirals remain essential for national elimination.