Other Infections

Hospitalizations Due to Hepatitis A Declining in the U.S., CDC Study Finds

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Rates of hospitalization related to hepatitis A virus (HAV) infection decreased in the U.S. from 2002 to 2011, possibly attributable to changing demographics and wider use of the hepatitis A vaccine, researchers reported in the September 29 edition of Hepatology.

Hepatitis A is transmitted through contaminated food and water via the fecal-oral route. While infected people typically recover and do not develop chronic infection (as with hepatitis B or C), it can cause severe acute liver injury, especially in older people and those with other, chronic liver diseases.

Melissa Collier and colleagues from the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC) used National Inpatient Survey discharge data to assess changes in primary hepatitis A hospitalization rates in the U.S. between 2002 and 2011, including changes in demographics, secondary discharge diagnoses, and factors affecting hospitalization duration.

They found that rates of hospitalization for hepatitis A as a principal diagnosis decreased from 0.72 per 100,000 persons in 2000 to 0.29 per 100,000 in 2011. The average age of hospitalized patients increased from 37.6 to 45.5 years, and the percentage of hepatitis A hospitalizations covered by Medicare nearly doubled. No changes were seen, however, in the length of hospital stays or the likelihood of dying from hepatitis A while hospitalized.

"Persons hospitalized for hepatitis A in recent years are older and more likely to have liver diseases and other comorbid medical conditions," the study authors concluded. "Hepatitis A disease and resulting hospitalizations could be prevented through adult vaccination."

Below is an edited excerpt from a media advisory issued by Wiley, publisher of Hepatology, describing the research and its findings.

Hepatitis A Hospitalization Rate Declines in U.S.

November 6, 2014 -- New research reports that the rate of hospitalization due to hepatitis A virus (HAV) infection has significantly declined in the U.S. from 2002 to 2011. Findings published in Hepatology, a journal of the American Associationfor the Study of Liver Diseases, show that older patients and those with chronic liver disease are most likely to be hospitalized for HAV. Vaccination of adults with chronic liver disease may prevent infection with hepatitis A and the need for hospitalization.

The World Health Organization (WHO) estimates that each year 1.4 million individuals worldwide are infected with HAV -- a viral liver disease that is transmitted by ingesting contaminated food or water, or direct contact with someone infected with the virus. While cases of HAV infection have decreased by 90% in the U.S. over the past two decades, there are still about 2,000 new cases each year according to the Centers for Disease Control and Prevention (CDC).

The study led by Dr. Melissa Collier from the Division of Viral Hepatitis at the CDC in Atlanta, Georgia, the present study examines trends in HAV-related hospitalizations in the U.S. Using the National Inpatient Survey discharge data, researchers identified patients hospitalized for primary hepatitis A in the U.S. between 2002 and 2011.

Results show that the rate of hospitalization for HAV infection as a principal diagnosis decreased from 0.72 to 0.29 per 100,000 cases during the study period. During the same time period the average age of hospitalized patients increased from 38 to 46 years, with the percentage of HAV-related hospitalizations covered by Medicare also increasing from 12% to 23%.

Additional analysis found an increase in accompanying diseases (comorbidities) that include liver disease, hypertension, heart disease, metabolic syndromes, and chronic kidney disease. The research team did not report any changes in the length of hospitalization or in-hospital deaths due to hepatitis A, though patients with liver disease required longer hospital stays.

This study found hospitalizations due to illness from hepatitis A have declined. However, this disease seems to be more troublesome for older patients and those with liver disease or other chronic conditions. The authors note that adult vaccination may help prevent hepatitis A and suggest that clinicians consider vaccinating patients in high risk groups.

11/19/14

Reference

MG Collier, X Tong, and F Xu. Hepatitis A hospitalizations in the United States, 2002-2011. Hepatology. September 29, 2014 (Epub ahead of print).

Other Source

Wiley. Hepatitis A Hospitalization Rate Declines in U.S. Media advisory. November 6, 2014.