Epidemiology of Acute Hepatitis B in the United States From Population-Based Surveillance, 2006-2011

Clin Infect Dis. 2015 Aug 15;61(4):584-92. doi: 10.1093/cid/civ332. Epub 2015 Apr 22.

Abstract

Background: An estimated 20 000 new hepatitis B virus (HBV) infections occur each year in the United States. We describe the results of enhanced surveillance for acute hepatitis B at 7 federally funded sites over a 6-year period.

Methods: Health departments in Colorado, Connecticut, Minnesota, Oregon, Tennessee, 34 counties in New York state, and New York City were supported to conduct enhanced, population-based surveillance for acute HBV from 2006 through 2011. Demographic and risk factor data were collected on symptomatic cases using a standardized form. Serum samples from a subset of cases were also obtained for molecular analysis.

Results: In the 6-year period, 2220 acute hepatitis B cases were reported from the 7 sites. For all sites combined, the incidence rate of HBV infection declined by 19%, but in Tennessee incidence increased by 90%, mainly among persons of white race/ethnicity and those aged 40-49 years. Of all reported cases, 66.1% were male, 57.1% were white, 58.4% were aged 30-49 years, and 60.1% were born in the United States. The most common risk factor identified was any drug use, notably in Tennessee; healthcare exposure was also frequently reported. The most common genotype for all reported cases was HBV genotype A (82%).

Conclusions: Despite an overall decline in HBV infection, attributable to successful vaccination programs, a rise in incident HBV infection related to drug use is an increasing concern in some localities.

Keywords: drug use; genotype; hepatitis B; incidence; surveillance.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Demography
  • Epidemiological Monitoring
  • Ethnicity
  • Female
  • Genotype
  • Hepatitis B / epidemiology*
  • Hepatitis B virus / classification
  • Hepatitis B virus / genetics
  • Hepatitis B virus / isolation & purification
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult