US Pharm. 2016;41(4):6.
The National Notifiable Diseases Surveillance System compiles case reports on viral hepatitis. In 2009, the National Immunization Survey noted that 92.4% of preschoolers received vaccinations for hepatitis B and <1% were not vaccinated.
Hepatitis A Virus (HAV): Incidence rates of HAV have been varying cyclically every 10 to 15 years. After peaking in 1995, the rate dropped in both males and females and in all age groups until 2011, then increased by 14% between 2012 and 2013 (0.6 cases/100,000 population). In 2013, HAV prevalence was highest in persons aged 30 to 39 years (0.74/100,000) and lowest in those aged 0 to 9 years (0.14/100,000). Since 2008, the rate of HAV has been consistently higher in Asians/Pacific Islanders (0.57 cases/100,000 in 2013) than in other racial/ethnic groups. HAV-related mortality rates were higher in males (0.03 deaths/100,000) compared with females (0.01 deaths/100,000). Unlike hepatitis B virus (HBV) and hepatitis C virus (HCV), HAV does not cause chronic infection.
HBV: The incidence rate of acute HBV declined until 1990, but then increased by 5.4% between 2012 and 2013. The CDC estimates that nearly 19,800 individuals are affected. This trend may be due to increased drug- and healthcare-related outbreaks. Although the risk of developing chronic HBV decreases with age, infection is more common in persons who acquired HBV at birth (90%) than in those who acquired it at ages 1 to 5 years (30%-50%) or as adults (5%). Of the estimated 700,000 to 1.4 million cases of chronic HBV, about one-half of patients were Asians/Pacific Islanders and 47% to 70% were born in other countries. In 2014, the U.S. Preventive Services Task Force and the CDC recommended HBV testing for persons born in countries where HBV infection is endemic. HBV vaccine is effective for high-risk individuals aged <60 years and is also recommended for persons aged ≥60 years.
HCV: HCV is transmitted primarily through injection drug use, needlestick injuries, and inadequate infection control in healthcare settings. Although acute HCV declined in persons aged >19 years until 2003 and remained steady (0.3/100,000) until 2010, it increased 2.5-fold by 2013. The largest increases occurred in patients aged 20 to 29 years (168%) and 30 to 39 years (126%). Prevalence was highest in patients aged 20 to 29 years (2.01 cases/100,000) and lowest in patients aged >60 years (0.10 cases/100,000). From 2012 to 2013, acute HCV rates decreased 14.3% in American Indians/Alaska Natives and 20% in Asians/Pacific Islanders, but increased in non-Hispanic blacks (33.3%), non-Hispanic whites (28.1%), and Hispanics (4.8%). Currently, 3.2 million people in the United States have chronic HCV.
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