HBV rates rising in women from same U.S. regions with drug-related HCV

Issue: November/December 2018

SAN FRANCISCO — U.S. states in the Appalachian region demonstrated increased rates of hepatitis B among women despite overall national rates of acute and chronic HBV remaining stable or declining among women and children, according to data presented at The Liver Meeting 2018.

“Hepatitis C prevalence among women of childbearing age has increased over the last year due to the injection drug use epidemic,” Tatyana Kushner, MD, from the Icahn School of Medicine at Mount Sinai in New York, said in her presentation. “This increase has been most pronounced in women and infants — implying mother-to-child transmission — especially across the central Appalachian region in the United States. However, national rates of hepatitis B have not been examined in this group of women of childbearing age and children recently.”

To analyze the rates of HBV prevalence among women and children, Kushner and colleagues gathered data on four subgroups of women aged 15 years to 44 years and children aged up to 2 years. These groups included patients with chronic HBV; patients with acute HBV; patients with HBV exposure; and those with HBV immunity.

Although the national prevalence of new chronic HBV infections decreased significantly between 2011 and 2017 from 0.83% to 0.19% (P < .0001), prevalence increased in Mississippi, Kentucky and West Virginia (P .05). National acute HBV prevalence remained unchanged in most states but increased in Kentucky, Alabama and Indiana (P < .03).

The researchers also found a significant rise in the prevalence of HBV core antibody in Kentucky, Mississippi, West Virginia, Ohio and Maryland.

The children cohort data showed that 90% had immunity to HBV and prevalence of exposure among those tested remained stable at a mean of 4.9%. Mean levels of acute (0.22%) and chronic HBV diagnoses (0.01%) also remained stable.

“Certain states in the Appalachian region have demonstrated increases in HBV among women. This is the same region where we have seen an increase in HCV, which suggests injection drug use may be contributing to an increase in HBV among women as well,” Kushner said. “In addition, HBV vaccine immunity appears to wane over time. This does require further study, but repeat anti-[HBV serologic] testing and booster HBV vaccine in high-risk groups such as injection drug users may be warranted.” – by Talitha Bennett

Reference:

Kushner T, et al. Abstract 214. Presented at: The Liver Meeting 2018; Nov. 9-13, 2018; San Francisco.

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Disclosure: Kushner reports no relevant financial disclosures.