Identification of acute vaccine-preventable hepatitis in individuals with chronic hepatitis in British Columbia between 1991 and 2007

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The Canadian Journal of Infectious Diseases & Medical Microbiology

Original Article Spring 2011, Volume 22 Issue 1: 10-14

Identification of acute vaccine-preventable hepatitis in individuals with

chronic hepatitis in British Columbia between 1991 and 2007

L Fang, A Yu, JA Buxton

BACKGROUND: In British Columbia (BC), hepatitis A virus (HAV) and hepatitis B

virus (HBV) vaccines are provincially funded for persons with chronic hepatitis

infections. PurPoSE: To assess the effectiveness of BC public health follow-up

of HBV and hepatitis C virus (HCV) cases and immunization policy by determining

the number of vaccine-preventable acute hepatitis infections reported following

a chronic HBV or HCV diagnosis, by examining demographic characteristics and by

observing temporal trends.

METHODS: All newly identified cases of HAV, HBV and HCV between 1991 and October

2007 were extracted from the BC integrated Public Health Information System and

linked to ascertain cases of hepatitis suprainfection.

RESULTS: Between 1991 and October 2007, 30 BC residents with chronic HBV and 104

with HCV were subsequently diagnosed with HAV. Acute HBV was identified in 162

persons previously diagnosed with HCV. Significantly more men than women

developed hepatitis suprainfection (P<0.0001), but women were of a younger age

when they were diagnosed with HAV (P=0.02) and acute HBV (P=0.0002). HAV

suprainfection cases among those with HCV peaked in 1998 at 33 cases and

declined to zero cases in 2007. In comparison, HBV suprainfection among

individuals with chronic HCV peaked in 1996 at 26 cases and declined to two

cases in 2007.

DISCUSSION: Cases of HAV and acute HBV have declined among HCV-infected

individuals. However, despite the availability of publicly funded vaccines for

high-risk groups, a substantial number of acute HBV infections post-HCV

identification are still identified, indicating that follow-up and vaccination

coverage should be improved in these populations.