OBJECTIVES: To evaluate the prevalence of advanced liver disease outcomes within a large US database of commercially-insured individuals diagnosed with chronic hepatitis C virus (HCV) infection. METHODS: This study was based on 2007-2011 IMS LifeLink claims data which includes adjudicated health claims data for 74 million patients and over 75 commercial health plans.  ICD-9 codes were used to identify patients with chronic HCV and advanced liver disease outcomes. Trends in prevalence of these outcomes over time were also examined. RESULTS: In 2011, the prevalence rates of advanced liver disease such as non-decompensated liver disease (20.48% vs. 0.10%), decompensated cirrhosis (15.11% vs. 0.46%), hepatocellular carcinoma (3.43% vs. 0.03%), liver transplant (2.58% vs. 0.01%), were higher (all statistically significant, p<0.0001) in the chronic HCV population than the non-HCV population. Five-year prevalence trends of complications stayed stable, with the exception of decompensated cirrhosis and hepatocellular carcinoma. The prevalence of decompensated cirrhosis increased from 11.16% to 15.11% for chronic HCV patients and 0.31% to 0.46% in non-HCV patients.  The prevalence of hepatocellular carcinoma increased from 2.3% to 3.43% for chronic HCV patients and 0.02% to 0.03% in non-HCV patients. CONCLUSIONS: Evaluation of a large US database of commercially-insured individuals indicates that chronic HCV patients have a greater prevalence of advanced liver disease compared with non-HCV patients. The 5-year prevalence trend of decompensated cirrhosis has increased for both chronic HCV patients and non-HCV patients.