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 Association for 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 percent 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 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 percent to 23 percent.
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.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
Reference: Hepatitis A Hospitalizations in the United States, 2002 - 2011. Melissa G. Collier, Xin Tong and Fujie Xu. Hepatology; (DOI: 10.1002/hep.27537)