This article is more than 5 years old. Information may no longer be current.
HAV hospitalizations increase significantly since 1999
Click Here to Manage Email Alerts
The incidence of hepatitis A virus infection in the United States declined significantly from 1999 to 2011, yet the rate of hospitalizations related to HAV more than tripled during that period, according to CDC researchers.
“The increasing proportion of hospitalizations is likely explained by the convergence of two factors,” the researchers wrote in Journal of Infectious Diseases. “[First] the susceptible population is now more likely to consist of older adults, and [second] HAV infection among older adults results in more severe disease. Exposure to the virus is not limited to groups previously identified to be at high risk, such as travelers, because food importations to the United States have increased over time and can be the source of HAV.”
Using data from the National Notifiable Diseases Surveillance System and the US Multiple Cause of Death database, the researchers identified HAV cases from 1999 to 2011. They calculated the incidence, the rate of hospitalizations and death related to HAV. They also evaluated the comortalities among deaths of patients with and without HAV to identify those frequently associated with HAV.
There was a continual decline in HAV incidence, from six cases per 100,000 population in 1999 to 0.4 cases per 100,000 population in 2011. The incidence declined among all age groups, but the most dramatic declines were among the 0-19 years age group, from 7.1 cases to 0.29 cases per 100,000, and among the 20-39 years age group, from 8.39 cases to 0.58 cases per 100,000. The incidence was highest among individuals aged 0 to 39 years in 1999, but in 2011, the incidence was highest among individuals aged 80 years and older.
The rate of HAV-related hospitalization increased from 7.3% in 1999 to 24.5% in 2011. The number of HAV-related deaths was less than 1% throughout the period, but the mean age of individuals at death increased from 48 years in 1999 to 76.2 years in 2011. In 2011, decedents with HAV often died of another liver-related condition: 39.4% died of hepatitis (excluding HAV), 28.2% died of fibrosis, cirrhosis and other liver diseases, and 8.5% died of alcohol-related liver disease.
“We found that decedents with hepatitis A frequently had liver-related conditions mentioned on their death certificate and that they died at relatively young ages,” the researchers wrote. “Although hepatitis A does not cause chronic infection, HAV infection in older persons results in more-severe adverse consequences, including death. These data support the fact that HAV infection can worsen the severity of disease and lead to early mortality.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts