Issue: August 2019

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July 09, 2019
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Less than 30% of high-risk adults protected from HBV

Issue: August 2019
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National survey data showed that, as of 2014, less than one in three U.S. adults at high risk for hepatitis B infection were protected against the virus, according to a recent study.

“Hepatitis B virus (HBV) infection is an important public health problem: worldwide, chronic HBV infection affects approximately 350 million persons and in the United States, 850,000 persons are estimated to be chronically infected,” Hope King, PhD, MSPH, an epidemiologist in the CDC’s Division of Viral Hepatitis, and colleagues wrote.

“Hepatitis B is preventable through vaccination and an effective vaccine has been available in the United States for 35 years. Since licensure of the vaccine, vaccination has been recommended for persons with a history of sexually transmitted disease (STD), men who have sex with men, persons with HIV infection, heterosexuals with multiple sex partners, and injection drug users. However, estimates from previous studies conducted in different years over an 11-year period (1999–2009) found that only about 24% to 45% of U.S. adults with one or more of these risks for HBV infection had been vaccinated.”

To generate updated percentages, King and colleagues pulled data from the 2003-2014 National Health and Nutrition Examination Surveys, including adults aged 18 to 49 years who were tested for HBV and reported at least one infection risk such as history of STD, sex with men (for male respondents), infection with HIV and injection drug use.

According to the study, to assess trends in protection, they calculated the prevalence of hepatitis B surface antibody indicative of immunity from vaccination among respondents for three 4-year time intervals — 2003-2006, 2007-2010, and 2011-2014.

Results showed that from 2003 to 2014, the prevalence of positive anti-HBs serology was 23.4%, King and colleagues reported. They found that the prevalence increased from 16.3% in 2003-2006 to 27.3% in 2007-2010, but did not change from 2007-2010 to 2011-2014, when it was 28.1%. Factors predicting positive anti-HBs serology included young age, female sex and higher education, the researchers reported.

“Because we found that only 28% of adults at high risk of HBV infection had evidence of protection during 2011-2014, but were able to confirm the importance of several facilitating factors for being protected, these factors can serve as a driving force to improve hepatitis B vaccination coverage,” they wrote.

“Targeted educational campaigns can be developed and implemented to boost awareness, knowledge, and perceived susceptibility of HBV infection among adults at high risk of infection. Dedicated vaccination programs can be established for high-risk adults with particular focus on those at even greater risk within this population such as the uninsured.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.