With the advent of all oral direct-acting antiviral drugs (DAAs) with a low incidence of side effects and very high success rates, we are entering an exciting new era in the treatment of hepatitis C virus (HCV), and now the major goal is the elimination of this viral infection. However, at least in Latin America, there are multiple barriers that must be attended.

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Introduction Chronic hepatitis C (CHC) is considered an important public health challenge. Traditionally identified risk factors have undergone an epidemiological transition where other risk factors have become the main cause of new infections. Objective To describe risk factors associated to hepatitis C positivity through the evaluation of the epidemiological profile in hepatitis‐C high‐risk populations. Methods Cross‐sectional study was conducted as part of an HCV screening program in Mexican population. All participants answered an HCV risk‐factor questionnaire and took a rapid test (RT). All patients reactive to the test were subject to HCV PCR (polymerase chain reaction) confirmation. A logistic regression model was used to examine associations between HCV infection and risk factors. Results The study included 297 631 participants that completed a risk factor questionnaire and underwent an HCV rapid test (RT). In total, 12 840 (4.5%) were reactive to RT and 9257 (3.2% of participants) were confirmed as positives by PCR test. Of these, 72.9% had at least one risk factor and 10.8% were in prison. Most common risk factors were history of acupuncture/tattooing/piercing (21%), intravenous drug use (15%) and high‐risk sexual practices (12%). Logistic regressions found that having at least one risk factor increased the probability of having an HCV‐positive result by 20% (OR = 1.20, 95% CI: 1.15–1.26), compared to the population without risk factors. Conclusions We identified 3.2% of HCV‐viremic subjects, all associated with risk factors and older age. Screening and diagnosis of HCV in high‐risk populations (including underserved populations) should be more efficient.