Acute Hepatitis B Incidence Double in People With Diabetes

[Guest guest]

http://www.internalmedicinenews.com/news/infectious-diseases/single-article/acut\

e-hepatitis-b-incidence-double-in-people-with-diabetes/bfa8c5e5e1.html

Acute Hepatitis B Incidence Double in People With Diabetes

By: MIRIAM E. TUCKER, Internal Medicine

News Digital Network

03/03/11

ATLANTA – The incidence of acute hepatitis B is nearly twice as high among

adults with diabetes as in those without, according to new data from the Centers

for Disease Control and Prevention.

The finding, presented by Meredith Reilly, M.P.H., at a meeting of the CDC’s

Advisory Committee on Immunization Practices, was based on 2009-2010 data from

four sites (Connecticut, Colorado, Oregon, and New York City) that participate

in the CDC’s Emerging Infection Program. Data from 2006-2008 from New York City

also were included.

Those data were compared with study population denominator data from the

Behavioral Risk Factor Surveillance System.

Overall, the prevalence of diabetes in 2009 was 8.4% among more than 12 million

individuals at the four sites, ranging from 6.3% in Colorado to 10.0% in New

York City. Diabetes prevalence ranged from 5.2% for adults aged 23-59 years, to

18.0% for those aged 60 years and older.

There were 326 reported cases of acute hepatitis B in the study population;

diabetes information was available for 226. Of those patients, 15% (34) had

diabetes and 85% (192) did not. Thus, the diabetes rate among the hepatitis B

cases was nearly double that of the entire study population (15% vs. 8.4%),

noted Ms. Reilly of the CDC’s division of viral hepatitis.

Other reported risk factors for acute hepatitis B were less common among those

with hepatitis B who had diabetes than in both the nondiabetic subjects and the

group of 100 for whom diabetes information was not available. Injection drug use

was reported by 3% of those with diabetes, compared with 7% of those without and

27% of those with unknown diabetes status.

The estimated annual incidence of acute hepatitis B per 100,000 adults aged 23

years and older was 1.4 for those with diabetes versus 0.7 for those without,

for a rate ratio of 1.9. By age, the rate ratio for acute hepatitis B between

those with diabetes and those without was 2.6 for those aged 23-59 years and 2.0

for aged 60 and above. The difference was statistically significant for the

younger cohort but not the older, Ms. Reilly noted.

The Advisory Committee on Immunization Practices is currently considering

whether to recommend the hepatitis B vaccine for individuals with diabetes, an

idea initially triggered by reports of hepatitis B outbreaks traced to improper

infection-control practices associated with use of blood glucose testing and

insulin injection devices in health care settings.

Next steps include results of a cost-effectiveness analysis and seroprotection

studies in residents of assisted living facilities with hepatitis B outbreaks,

along with estimates of current vaccination coverage. The plan is to discuss

implementation strategies and address an evidence-based proposed recommendation

at an upcoming meeting, said Dr. Trudy , also of the CDC’s division of

viral hepatitis.

Dr. and Ms. Reilly are CDC employees with no disclosures.

[Guest guest]

http://www.internalmedicinenews.com/news/infectious-diseases/single-article/acut\

e-hepatitis-b-incidence-double-in-people-with-diabetes/bfa8c5e5e1.html

Acute Hepatitis B Incidence Double in People With Diabetes

By: MIRIAM E. TUCKER, Internal Medicine

News Digital Network

03/03/11

ATLANTA – The incidence of acute hepatitis B is nearly twice as high among

adults with diabetes as in those without, according to new data from the Centers

for Disease Control and Prevention.

The finding, presented by Meredith Reilly, M.P.H., at a meeting of the CDC’s

Advisory Committee on Immunization Practices, was based on 2009-2010 data from

four sites (Connecticut, Colorado, Oregon, and New York City) that participate

in the CDC’s Emerging Infection Program. Data from 2006-2008 from New York City

also were included.

Those data were compared with study population denominator data from the

Behavioral Risk Factor Surveillance System.

Overall, the prevalence of diabetes in 2009 was 8.4% among more than 12 million

individuals at the four sites, ranging from 6.3% in Colorado to 10.0% in New

York City. Diabetes prevalence ranged from 5.2% for adults aged 23-59 years, to

18.0% for those aged 60 years and older.

There were 326 reported cases of acute hepatitis B in the study population;

diabetes information was available for 226. Of those patients, 15% (34) had

diabetes and 85% (192) did not. Thus, the diabetes rate among the hepatitis B

cases was nearly double that of the entire study population (15% vs. 8.4%),

noted Ms. Reilly of the CDC’s division of viral hepatitis.

Other reported risk factors for acute hepatitis B were less common among those

with hepatitis B who had diabetes than in both the nondiabetic subjects and the

group of 100 for whom diabetes information was not available. Injection drug use

was reported by 3% of those with diabetes, compared with 7% of those without and

27% of those with unknown diabetes status.

The estimated annual incidence of acute hepatitis B per 100,000 adults aged 23

years and older was 1.4 for those with diabetes versus 0.7 for those without,

for a rate ratio of 1.9. By age, the rate ratio for acute hepatitis B between

those with diabetes and those without was 2.6 for those aged 23-59 years and 2.0

for aged 60 and above. The difference was statistically significant for the

younger cohort but not the older, Ms. Reilly noted.

The Advisory Committee on Immunization Practices is currently considering

whether to recommend the hepatitis B vaccine for individuals with diabetes, an

idea initially triggered by reports of hepatitis B outbreaks traced to improper

infection-control practices associated with use of blood glucose testing and

insulin injection devices in health care settings.

Next steps include results of a cost-effectiveness analysis and seroprotection

studies in residents of assisted living facilities with hepatitis B outbreaks,

along with estimates of current vaccination coverage. The plan is to discuss

implementation strategies and address an evidence-based proposed recommendation

at an upcoming meeting, said Dr. Trudy , also of the CDC’s division of

viral hepatitis.

Dr. and Ms. Reilly are CDC employees with no disclosures.