Health Insurance Reimbursement Data

Nationwide

Number of HCV antibody tests reimbursed in the public and private sectors

In 2024, 5.164 million HCV antibody (Ab) screening tests (procedure 3784 of the Nomenclature of Medical Laboratory Procedures) were performed and reimbursed by all health insurance plans.

From 2014 to 2024, the total number of HCV Ab screening tests increased annually by between 4% and 11%, except in 2020, when it decreased by 8% due to the COVID-19 pandemic (-7% in the private sector and -15% in the public sector). Starting in 2021, it increased again: 11% between 2020 and 2021, 5% between 2021 and 2022, 8% between 2022 and 2023, and 4% between 2023 and 2024.

The number of tests increased similarly in both the private and public sectors between 2014 and 2024. As a reminder, screening tests performed during hospitalization in a public facility are not included in the public sector data.

Number of people tested for HCV antibodies in the public and private sectors

Between 2014 and 2024, the number of people tested for anti-HCV antibodies rose from 2.805 million in 2014 to approximately 4.475 million in 2024, representing a 60% increase. Consistent with the trends observed in the number of annual tests, the number of people tested increased each year through 2019 (+35% between 2014 and 2019), decreased between 2019 and 2020 (-8%), and then increased again starting in 2021: between 4% and 9% each year.

Over the entire period, 62% of those tested were women. This proportion remained constant during the 2014–2024 period.

In 2024, as was the case throughout the 2014–2024 period, the most represented age group was 20–39-year-olds, among both women (62%) and men (45%).

At the regional and departmental levels

HCV antibody screening rate

In 2024, the HCV antibody screening rate (number of tests per 1,000 people living in France) was 75 tests per 1,000 inhabitants in France. This rate was higher in the overseas departments and regions (DROM) (119/1,000) than in mainland France (74/1,000).

In mainland France:

• The Île-de-France (99/1,000), Provence-Alpes-Côte d’Azur (PACA) (91/1,000), and Occitanie (80/1,000) had the highest screening rates, while the Bourgogne-Franche-Comté (55/1,000) and Centre-Val-de-Loire (56/1,000) regions had the lowest rates.

• The departments of Paris (154/1,000), Alpes-Maritimes (110/1,000), Seine-Saint-Denis (101/1,000), and Hérault (98/1,000) had the highest rates. The lowest rates were observed in Creuse (41/1,000), Indre (45/1,000), and Orne (46/1,000).

Compared to 2023, screening test rates recorded in 2024 were on the rise in all regions, with a more significant increase (+8%) in Corsica and (+7%) in Bourgogne-Franche-Comté. Over the same period, the departments of Ariège (18%) and Mayenne (11%) recorded the largest increases.

In the Overseas Territories:

In 2024, HCV antibody screening rates were highest in Martinique (174/1,000) and Guadeloupe (153/1,000), and lowest in Mayotte (28/1,000). They were 106 per 1,000 in Réunion and 143 per 1,000 in French Guiana.

Rate of people tested for anti-HCV antibodies

For the year 2024, the rate of people tested for anti-HCV antibodies (number of people tested relative to the French population) was 65 people per 1,000 nationwide. This rate was higher in the DROMs (102 per 1,000) than in mainland France (64 per 1,000).

In mainland France:

• The highest rates of people tested were in the Île-de-France region (83 per 1,000), the PACA region (79 per 1,000), and the Occitanie region (69 per 1,000). The rates were lowest in Centre-Val de Loire (49/1,000) and Bourgogne-Franche-Comté (50/1,000).

• The departments of Paris (119/1,000), Alpes-Maritimes (95/1,000), Seine-Saint-Denis (85/1,000), and Hérault (84/1,000) recorded the highest rates of people tested. The lowest rates were in Creuse (37/1,000) and Indre (40/1,000).

In the Overseas Territories:

Martinique (148/1,000), followed by Guadeloupe (133/1,000), had the highest rates of people tested, while Mayotte had the lowest rate (25/1,000). In French Guiana and Réunion, the rates were 120 per 1,000 and 92 per 1,000, respectively.

Number of people tested for HCV RNA in the public and private sectors

The number of people tested for HCV RNA increased between 2014 and 2017, from 105,089 to 112,620 (+7%), but has been declining since then (-37%), with a particularly sharp drop between 2019 and 2020 (-22%). In 2024, the number of people tested was 71,045.

It should be noted that the data do not allow for distinguishing between the various indications for performing this test (detection of viral replication following a positive HCV serology, pre-treatment evaluation, treatment monitoring, etc.).

In 2024, the majority of people tested for HCV RNA were men (58%), and 48% of men and 38% of women were between the ages of 50 and 69.

HCV RNA Testing Rate

The rate of people tested for HCV RNA (number of people tested relative to the number of people living in France) was 1.04 people per 1,000 inhabitants in 2024, at the national level. This rate was higher in mainland France (1.05 per 1,000) than in the overseas departments and regions (0.65 per 1,000).

In mainland France:

• The highest rates of people tested were in Île-de-France (1.49/1,000) and PACA (1.49/1,000), while the lowest rates were observed in Pays de la Loire (0.54/1,000) and Hauts-de-France (0.67/1,000).

• The departments of Paris (2.81/1,000), Hérault (2.33/1,000), and Provence (2.01/1,000) had the highest rates of people tested. The lowest rates were observed in Mayenne (0.39/1,000) and Ardennes (0.42/1,000).

In the Overseas Territories:

The rate of people tested was highest in Martinique (1.28 per 1,000). It was lowest in Mayotte (0.15 per 1,000). The rate was 0.56 in French Guiana, 0.61 in Réunion, and 0.67 in Guadeloupe.

The LaboHEP Survey

The LaboHEP survey is a retrospective cross-sectional survey conducted periodically since 2010 among public and private clinical laboratories. The data collected pertain to the number of HCV antibody (Ab) and HBs antigen (Ag) screening tests performed and the number of individuals newly diagnosed as positive for these markers in the MBL (individuals testing positive for the first time in the responding MBL) during the year in question.
The data presented pertain to the latest survey on screening activity for the year 2021 (with a comparison to the 2016 estimates from the previous survey). All public and private LBMs, totaling 4,303, were contacted; of these, 2,557 participated in the survey, representing a participation rate of 59%, which was higher among public LBMs (80%) than among private LBMs (58%).

In 2021, according to estimates from the LaboHEP survey:

• 5.1 million [95% CI: 4.9–5.4] anti-HCV antibody screening tests were performed, including 3.9 million [95% CI: 3.7–4.1] in private LBMs (76%) and 1.2 million [95% CI: 1.0–1.4] in public LBMs. This number represents a 24% increase compared to 2016 (4.1 million).

• Relative to the population living in France, this figure corresponds to an anti-HCV antibody screening rate of 76 per 1,000 inhabitants. It is higher in Île-de-France (101 per 1,000), particularly in Paris (201 per 1,000) and Val-de-Marne (102 per 1,000), in Provence-Alpes-Côte d’Azur (92 per 1,000), as well as in the overseas departments and regions (DROM): 189 per 1,000 in French Guiana, 148 per 1,000 in Martinique, and 147 per 1,000.

• The number of people testing positive for anti-HCV antibodies is estimated at 34,185 [95% CI: 30,862–37,509], an increase of 13% compared to 2016. This figure does not reflect the number of people newly diagnosed with anti-HCV antibodies in France in 2021, as the same person who tests positive for the first time in different laboratories is counted multiple times.

Relative to the population living in France, this figure corresponds to an estimated rate of 51 per 100,000 inhabitants diagnosed with anti-HCV antibodies. In metropolitan France, this rate was highest in Île-de-France (90 per 100,000), particularly in the departments of Paris (173 per 100,000), Val-de-Marne (109 per 100,000), and Seine-Saint-Denis (97 per 100,000), as well as in Provence-Alpes-Côte d’Azur (75 per 100,000), specifically in Alpes-Maritimes (187/100,000) and Vaucluse (104/100,000), and in Occitanie (57/100,000), particularly in Hérault (80/100,000). In the overseas departments and regions (DROM), estimated rates ranged from 142 per 100,000 in French Guiana to 25 and 26 per 100,000, respectively, for Réunion and Mayotte.

• The positivity rate for anti-HCV antibody tests is estimated at 0.67%, a slight decrease compared to 2016 (0.73%). It is higher in public-sector medical laboratories (1.18%) than in private ones (0.51%) and in metropolitan France (0.70%) than in the overseas departments and regions (0.41%).

See Géodes:

• Number of anti-HCV antibody screening tests, LaboHEP Survey

• Anti-HCV antibody screening rate (per 1,000 inhabitants), LaboHEP Survey

• Number of first-time positive anti-HCV antibody tests in the laboratory, LaboHEP Survey

• Rate of first-time positive anti-HCV antibody tests in the laboratory (per 100,000 inhabitants), LaboHEP Survey

CeGIDD Activity Data

Established in 2018 by Santé publique France, the SurCeGIDD surveillance system provides individual data on screening and diagnostic activities at the Free Centers for Information, Screening, and Diagnosis of HIV, Viral Hepatitis, and STIs (CeGIDD).

In 2024, 221 CeGIDDs (73.4%) out of the 301 facilities surveyed submitted their individual data, representing a total of 667,161 consultations: 74.7% from mainland regions outside Île-de-France (IDF), 16.2% from the IDF, and 8.7% from the Overseas Departments and Regions (DROM). Nearly two-thirds (65.6%) came from hospital-based CeGIDDs and 34.4% from non-hospital-based CeGIDDs.

The clients seen had a median age of 27 years (interquartile range [IQR]: 22–37), were predominantly cisgender men (65.4%), and three-quarters were born in France (75.5%). Based on their reported sexual practices over the past 12 months, 38.6% of the patients were heterosexual men, 32.6% were heterosexual women, 24.1% were men who have sex with men (MSM), and 2.8% were women who have sex with women (WSW). The majority (83.6%) had health insurance with or without a supplemental plan; 9.0% were covered by PUMA (Universal Health Coverage), C2S (Solidarity-Based Supplementary Health Insurance), or AME (State Medical Aid); and 7.1% had no health coverage.

In total, 187,046 anti-HCV antibody (Ab) tests were performed by the responding CeGIDDs. Of these tests, 0.6% were positive. This positivity rate was higher among cisgender men (0.6%) than among cisgender women (0.4%) and transgender individuals (0.4%). Clients aged 50–59 and 60 and older had the highest positivity rates, both among cisgender men (1.4% and 1.5%, respectively) and cisgender women (2.1% and 2.4%, respectively). Among transgender individuals, the rate was highest for those aged 50–59 (2.0% out of 49 tested). Regarding sexual practices over the past 12 months, MSM had the highest positivity rates (0.5%). The positivity rate was higher among clients born abroad (1.1%) compared to those born in France (0.4%), regardless of gender, age group, or sexual practices reported over the past 12 months (except among transgender individuals: 0% among 401 foreign-born individuals tested vs. 0.5% among 580 French-born individuals tested).

Geographically, the positivity rate was 0.4% among patients residing in the Île-de-France region, 0.6% among those in the rest of mainland France, and 0.3% among those residing in the overseas departments and regions (DROM).

Of the 1,081 patients who tested positive for anti-HCV antibodies, 390 were tested for HCV RNA; of these, 131 (33.6%) tested positive, indicating an active infection. HCV RNA positivity was higher among cisgender men compared to cisgender women (34.3% vs. 31.6%), among those aged 30–39 (46.7%), those aged ≥60 (35.7%), and among clients born abroad compared to those born in France (39.6% vs. 24.2%). Regarding sexual practices over the past 12 months, this positivity rate was 34.9% for heterosexual men, 25.7% for MSM, and 17.2% for heterosexual women and FSWs.

• Learn more about epidemiological surveillance within the CEGIDDs

Other screening data

The proportion of people in the general population reporting a history of hepatitis C screening is available through the following surveys:

• Health Barometer Surveys

• 2010 KABP Survey

Decrease in the number of people unaware of their infection

In 2004, the national prevalence survey estimated that 100,868 [95% CI: 58,534–143,202] of the 232,200 people with chronic hepatitis C were unaware of their infection, or 43.4%.
This estimate was updated to 74,102 (plausibility interval: 64,290–83,283) undiagnosed cases of chronic hepatitis C for the year 2014.

In 2016, among the general metropolitan population (the “Barotest” virology component of the 2016 France Public Health Barometer), it was estimated that 25,892 people with chronic hepatitis C were undiagnosed (95% CI: 5,873–74,474).

See also:

• French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

• Prevalence of chronic hepatitis C and B, and history of screening in the general population in 2016: contribution to a new screening strategy, Public Health France Barometer-BaroTest

• Estimate of the number of undiagnosed cases of chronic hepatitis C in France in 2014. Implications for recommendations on expanded screening

• Prevalence of hepatitis B and C in France in 2004. December 2006