No Risk, Severe Consequence: Hepatitis C Criminalization in Indiana Involves Only Non-Transmissible Exposures.

This study analyzes the enforcement of viral hepatitis criminalization in the United States. Indiana is one of nine states with laws criminalizing viral hepatitis exposure. Using a legal epidemiological approach, we reviewed court records and probable cause affidavits to identify prosecutions involving people living with hepatitis C virus (HCV) under Indiana's Battery by Bodily Fluid and Waste law between 2011 and 2025. We identified 94 cases involving 98 HCV exposure incidents and assessed transmission risk using a novel HCV Transmission Risk Classification Framework. None of the incidents alleged conduct posing a plausible risk of HCV transmission; most involved saliva exposure through spitting (72.5%). Defendants were primarily white (94.7%), male (61.7%), and 18-68 years old. Case filings peaked in 2018-2019 but persisted through 2025. Hepatitis prosecutions operated largely independently of HIV criminalization. Our findings suggest the need for infectious disease law reform to align with current transmission science.