Prevalence of chronic hepatitis B virus (HBV) infection in U.S. households: National Health and Nutrition Examination Survey (NHANES), 1988‐2012

Abstract

The number of persons with chronic hepatitis B virus (HBV) infection in the UnitedStates is affected by diminishing numbers of young persons who are susceptible because of universal infant vaccination since 1991, offset by numbers of HBV-infected persons migrating to the United States from endemic countries. The prevalence of HBV infection was determined by serological testing and analysis among noninstitutionalized persons age 6 years and older for: antibody to hepatitis B core antigen (anti-HBc), indicative of previous HBV infection; hepatitis B surface antigen (HBsAg), indicative of chronic (current) infection; and antibody to hepatitis B surface antigen (anti-HBs), indicative of immunity from vaccination. These prevalence estimates were analyzed in three periods of the National Health and Nutrition Examination Survey (NHANES): 1988-1994 (21,260 persons); 1999-2008 (29,828); and 2007-2012 (22,358). 2) million noninstitutionalized U.S. residents having ever been infected with HBV. The overall prevalence of chronic HBV infection has remained constant since 1999: 0.3% (95% CI: 0.2-0.4), and since 1999, prevalence of chronic HBV infection among non-Hispanic blacks has been 2-to 3-fold greater than the general population. An estimated 3.1% (1.8%-5.2%) of non-Hispanic Asians were chronically infected with HBV during 2011-2012, which reflects a 10-fold greater prevalence than the general population. Adjusted prevalence of vaccine-induced immunity increased 16% since 1999, and the number of persons (mainly young) with serological evidence of vaccine protection from HBV infection rose from 57.8 (95% CI: 55.4-60.1) million to 68.5 (95% CI: 65.4-71.2) million. Conclusion: Despite increasing immune protection in young persons vaccinated in infancy, an analysis of chronic hepatitis B prevalence in racial and ethnic populations indicates that during 2011-2012, there were 847,000 HBV infections (which included 400,000 non-Hispanic Asians) in the noninstitutionalized U.S. population. (HEPATOLOGY 2016;63:388-397) U nder-recognized and underdiagnosed, chronic hepatitis B (CHB) affects an estimated 400 million persons worldwide and accounts for 600,000 hepatitis B virus (HBV)-related deaths each year. 1,2 Knowledge of the number of HBV-infected persons living in the United States is essential for public health policy planning. The number of persons chronically infected with HBV has varied in the literature, ranging from 730,000 (95% confidence interval [CI]: 550,000-940,000) 3 to 2.2 million. 3,4 There are several

Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

“…It is estimated that as few as 33% of people with HBV and 54% of people with HCV are aware of their infection status. [4][5][6] • Left undiagnosed and untreated, HBV and HCV can cause liver disease including cirrhosis (scarring of the liver), and liver cancer. 6 • Liver cancer death rates are growing faster than death rates for all other types of cancer.…”

“…Beginning in 1991, immunization programs for infants and adolescents have resulted in substantial declines in the incidence of HBV infection among young people. 4 HBV is spread in several ways: through sexual contact; sharing needles, syringes, or other drug-injection equipment; from mother to child at the time of birth; in health care settings if equipment such as glucose monitors or supplies are shared; or through incidental household exposures to blood. 13,22,23 HBV is extremely infectious; thus, it is easily transmitted, even in microscopic amounts of blood or body fluids.…”

“…African Americans aged 20-59 years are 1.6 times more likely to be chronically infected and African Americans aged 60 years or older are 10 times more likely to be chronically infected with HCV compared to all other races. 4 In 2014, chronic liver disease and cirrhosis, which often relate to HCV infection, were among the top 10 leading causes of death among African Americans 45 to 64 years of age.…”

The changing epidemiology of hepatocellular carcinoma in Asia versus United States and Europe

“…Data from national US surveys indicated that around 0.9-2.2 million people have chronic HBV infection and 2.7-3.5 million people suffer from chronic HCV infection [30][31][32][33] . Nevertheless, with the implementation of [34] .…”

Profiling Neutrophil–to–Lymphocyte Ratio Changes in Response to Nucleoside Analog Therapy for Chronic Hepatitis B Infection

“…Despite increased vaccination rates, chronic HBV prevalence has remained fairly consistent due to immigration of patients from areas of endemicity (5). Treatment of chronic HBV infection has been shown to reduce hepatic fibrosis, reverse cirrhosis, and reduce the development of hepatocellular carcinoma (HCC) (6).…”