Numbers

Hepatitis A

A total of 395 cases of hepatitis A were reported in 2023. After a decline in the number of hepatitis A cases in the COVID years 2020 and 2021, the number of cases increased again in 2022 and 2023. However, the numbers are not yet as high as in the 2017-2019 period. Hepatitis A shows seasonality in Belgium, with a higher number of cases after the summer, linked to travellers returning from endemic countries. In 2023, more men were reported with hepatitis A in Belgium, and the 70-79 age group had the highest incidence, followed by the 0-9 age group.

Hepatitis B

• Sciensano’s latest surveillance report on hepatitis B and C in Belgium was published in 2025.
• The incidence of hepatitis B was fluctuating in Belgium, and was estimated at 16,5/100,000 inhabitants in 2022.
• The majority of new diagnoses were among men (57%), and the average age at diagnosis was 46.
• Screening was increasing in all three regions.
• Hepatitis B-related mortality was very low, with 32 deaths from acute or chronic hepatitis B recorded in 2021.
• A systematic review published in 2023 estimated the prevalence of hepatitis B in Belgium at 0,69% in the general population, and 3,51% among migrants.

Hepatitis C

In the general population

• Sciensano’s latest surveillance report on hepatitis B and C in Belgium was published in 2025.
• The incidence of hepatitis C decreased in Belgium, and was estimated at 5,8/100 000 inhabitants in 2022.
• The majority of new diagnoses were among men (60%), and the average age at diagnosis was 50.
• It was estimated that 9 294 persons were treated for hepatitis C in Belgium between 2015 and 2022, including 638 in 2022.
• Screening increased in all three regions.
• Hepatitis C-related mortality was low, with 108 deaths from acute or chronic hepatitis C recorded in 2021.
• A European study published in 2024 estimated the median prevalence of chronic hepatitis B to be 0,18% in Belgium, representing more than 16 000 infected persons, of whom at least 20% would have been infected through injecting drug use.
• In 2019, a study published by Sciensano among others, estimated the seroprevalence of HCV in the general Belgian population at 0.22% and the prevalence of chronic HCV infection at 0.12%. 

In the target groups

• In 2019, 253 people who used injectable drugs and high-risk opiate users took part in a study by Sciensano’s illegal drugs unit and underwent an HCV rapid test. The total unweighted sample average for HCV antibodies was 41.1%. The weighted estimations were around 43.5%. 
• In the same year, Sciensano participated in a multicentre interventional cohort study in Belgian prisons. In total, 886 prisoners were tested in 11 Belgian prisons. The prevalence of HCV antibodies was 5.0%, HCV RNA 2.1% and hepatitis B surface antigen 0.8%.
• A retrospective (2009-2018), multicentre study of people with HIV was published in 2021. Of the 4607 people tested, 7% tested positive for HCV antibodies and 6.3% for HCV RNA.

Hepatitis E

In 2023, the NRC reported 240 cases. The increase in the number of cases of hepatitis E paralleled the increase in the number of tests performed. Increased awareness among physicians for this pathogen led to more test requests and thus more diagnosed cases. Hepatitis E affects more persons older than 50 years.

In 2022, the European Centre for Disease Prevention and Control (ECDC) reported the following:

Hepatitis A:

• a crude infection rate of 1 case per 100,000 population
• an overall male-to-female ratio of 1.3:1
• a higher rate in the 5-14 years age group (20%)
• a similar number of reported cases as in 2020 and 2021, but lower than for the COVID-19 pandemic.

Hepatitis B:

• a crude infection rate of 4.7 cases per 100,000 citizens
• an overall male-female ratio of 1.4:1
• a higher percentage in the 35-44 years age group
• a declining trend in the number of acute cases, probably as a result of the national vaccination programmes
• heterosexual transmission as the most frequent means of transmission (30%) for acute cases, followed by transmission between men who have sex with men (16%) and nosocomial transmission (12%).

Hepatitis C:

• a crude infection rate of 4.1 cases per 100,000 citizens
• an overall male-female ratio of 2:1
• a higher percentage in the 35-44 years age group for men and in the 25-34 years age group for women
• injection drug use is the most frequent means of transmission (61% of the acute cases and 70% of chronic cases).

According to the World Health Organisation:

• Hepatitis A is very common in low- and middle-income countries with poor sanitary conditions, where 90% of children are infected before the age of 10 years (WHO, Hepatitis A) 
• In 2019, 296 million people worldwide were living with chronic hepatitis B, with approximately 1.5 million new infections per year
• In 2019, hepatitis B caused approximately 820,000 deaths, primarily through cirrhosis and hepatocellular carcinoma. (WHO, Hepatitis B)
• In 2019, 58 million people worldwide were living with chronic hepatitis C, with approximately 1.5 million new infections per year
• Hepatitis C caused approximately 290,000 deaths, primarily through cirrhosis and hepatocellular carcinoma (WHO, Hepatitis C)
• 20 million people are infected with hepatitis E every year, of whom about 3.3 million develop symptoms (WHO, Hepatitis E)
• Hepatitis E caused 44 000 deaths in 2015.