Trends in Hepatitis B Infection and Immunity Among Women of Childbearing Age in the United States

Abstract

Background The current opioid injection drug use epidemic has been associated with an increase in hepatitis C virus infections among women of childbearing age in the United States, but changes in hepatitis B virus (HBV) infections have not been studied. Methods A retrospective analysis of HBV statuses among women of childbearing age nationally and by state was conducted, utilizing the Quest Diagnostics database. Rates of HBV in women born before and after the implementation of universal HBV vaccination recommendations were determined. Results We identified 8 871 965 women tested for HBV from 2011–2017. Nationally, the annual rate of acute HBV infections was stable, but rates increased in Kentucky, Alabama, and Indiana (P < .03). The national prevalence of new, chronic HBV diagnoses decreased significantly, from 0.83% in 2011 to 0.19% in 2017 (P < .0001), but increased in Mississippi, Kentucky, and West Virginia (P ≤ .05). A declining prevalence of HBV seroprotection was evident over time, especially within the birth-dose cohort (which dropped from 48.5% to 38.5%; P < .0001). Conclusions National rates of newly diagnosed acute and chronic HBV infections declined or were stable overall, but increased significantly in specific Appalachian states. The HBV vaccine is effective in decreasing infections, but seroprotection wanes over time. These trends in new infections may be related to increased injection drug use and highlight potential gaps in HBV vaccine protection.

Age-specific seroprotection after Hepatitis B virus vaccination among Korean American pediatric population in Queens, New York

“…The national prevalence of new, chronic HB diagnoses among women of childbearing age in US decreased significantly from .83% in 2011 to .19% in 2017. 25 In the present study, we observed that 3 out of 91 subjects were born to HBsAg-positive mothers and received hepatitis B immunoglobulin (HBIG) and HB vaccine at the day of birth. They were all born in US.…”

Variations in Hepatitis B Vaccine Series Completion by Setting Among Adults at Risk in West Virginia

“…A recent study using national data from Quest Laboratories found a significant increase in the number of reproductive age women in WV testing positive for anti-HBc, a marker of past or current HBV infection. 15 Although the odds of completing the series were highest among LHD family planning clinic participants, the number of women reached was relatively small compared with other settings. Future vaccination efforts should include screening LHD family planning participants for HBV risk factors.…”

Chronic Hepatitis B and HIV Coinfection: a Continuing Challenge in the Era of Antiretroviral Therapy

“…In the Multicenter AIDS Cohort Study, a longitudinal cohort of men who have sex with men in the US, incident HBV infection was nearly 2-fold higher in HIV-infected MSM compared with HIV-uninfected MSM and ART was not found to be completely protective [42]. Nationally in the US, rates of HBV have risen in regions where opioid use has been prevalent [43]. HBV incidence has also been shown to be moderately high in HBV-endemic settings among PLWH with relatively preserved CD4 cell counts [44].…”