Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates in a Nationally Representative Survey

[Guest guest]

http://www.annals.org/content/154/5/319.abstract

Original Research

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

N. Ioannou, BMBCh, MS

+ Author Affiliations

From Veterans Affairs Puget Sound Health Care System and University of

Washington, Seattle, Washington.

Abstract

Background: Up-to-date estimates of the prevalence of hepatitis B virus (HBV)

infection, exposure, and immunity are necessary to assess the effectiveness of

ongoing programs aimed at preventing HBV transmission.

Objective: To determine the prevalence and associations of chronic HBV

infection, past exposure, and immunity in the United States from 1999 to 2008.

Design: Nationally representative, cross-sectional household survey.

Setting: U.S. civilian, noninstitutionalized population.

Participants: 39 787 participants in the National Health and Nutrition

Examination Survey (1999 to 2008) aged 2 years or older.

Measurements: Chronic HBV infection was defined by presence of serum HBV surface

antigen and past exposure by serum antibody to hepatitis B core antigen among

persons aged 6 years or older. Infant immunity was defined by presence of serum

antibody to hepatitis B surface antigen among children aged 2 years.

Results: Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had

chronic HBV infection (corresponding to approximately 704 000 persons

nationwide), and 4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately

11 993 000 persons). These estimates are lower (P < 0.001) than estimates of HBV

infection (0.42%) and exposure (5.1%) in the United States reported from 1988 to

1994. Infection and past exposure were very uncommon among persons aged 6 to 19

years. Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to

73.2%]). Adults, including those at high risk for infection, have much lower

rates of immunity.

Limitations: Incarcerated and homeless persons were not sampled. Categorization

of race or ethnicity did not identify high-risk groups, such as persons of Asian

and Pacific Islander descent.

Conclusion: A cohort of children and adolescents is growing up in the United

States with high rates of immunity against HBV and very low rates of infection.

Vaccination of high-risk adults should continue to be emphasized.

Primary Funding Source: The Veterans Affairs Research Enhancement Award Program.

------------------------------------------------------------------

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

ls of Internal Medicine, 03/01/2011

Ioannou GN – A cohort of children and adolescents is growing up in the United

States with high rates of immunity against hepatitis B virus (HBV) and very low

rates of infection. Vaccination of high–risk adults should continue to be

emphasized.

Methods

U.S. civilian, non–institutionalized population was considered.

39,787 participants in the National Health and Nutrition Examination Survey

(1999 to 2008) aged 2 years or older were included.

Chronic HBV infection was defined by presence of serum HBV surface antigen and

past exposure by serum antibody to hepatitis B core antigen among persons aged 6

years or older.

Infant immunity was defined by presence of serum antibody to hepatitis B surface

antigen among children aged 2 years.

Results

Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had chronic

HBV infection (corresponding to approximately 704 000 persons nationwide), and

4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately 11,993 000

persons).

These estimates are lower than estimates of HBV infection (0.42%) and exposure

(5.1%) in the United States reported from 1988 to 1994.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to 73.2%]).

Adults, including those at high risk for infection, have much lower rates of

immunity.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

[Guest guest]

http://www.annals.org/content/154/5/319.abstract

Original Research

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

N. Ioannou, BMBCh, MS

+ Author Affiliations

From Veterans Affairs Puget Sound Health Care System and University of

Washington, Seattle, Washington.

Abstract

Background: Up-to-date estimates of the prevalence of hepatitis B virus (HBV)

infection, exposure, and immunity are necessary to assess the effectiveness of

ongoing programs aimed at preventing HBV transmission.

Objective: To determine the prevalence and associations of chronic HBV

infection, past exposure, and immunity in the United States from 1999 to 2008.

Design: Nationally representative, cross-sectional household survey.

Setting: U.S. civilian, noninstitutionalized population.

Participants: 39 787 participants in the National Health and Nutrition

Examination Survey (1999 to 2008) aged 2 years or older.

Measurements: Chronic HBV infection was defined by presence of serum HBV surface

antigen and past exposure by serum antibody to hepatitis B core antigen among

persons aged 6 years or older. Infant immunity was defined by presence of serum

antibody to hepatitis B surface antigen among children aged 2 years.

Results: Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had

chronic HBV infection (corresponding to approximately 704 000 persons

nationwide), and 4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately

11 993 000 persons). These estimates are lower (P < 0.001) than estimates of HBV

infection (0.42%) and exposure (5.1%) in the United States reported from 1988 to

1994. Infection and past exposure were very uncommon among persons aged 6 to 19

years. Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to

73.2%]). Adults, including those at high risk for infection, have much lower

rates of immunity.

Limitations: Incarcerated and homeless persons were not sampled. Categorization

of race or ethnicity did not identify high-risk groups, such as persons of Asian

and Pacific Islander descent.

Conclusion: A cohort of children and adolescents is growing up in the United

States with high rates of immunity against HBV and very low rates of infection.

Vaccination of high-risk adults should continue to be emphasized.

Primary Funding Source: The Veterans Affairs Research Enhancement Award Program.

------------------------------------------------------------------

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

ls of Internal Medicine, 03/01/2011

Ioannou GN – A cohort of children and adolescents is growing up in the United

States with high rates of immunity against hepatitis B virus (HBV) and very low

rates of infection. Vaccination of high–risk adults should continue to be

emphasized.

Methods

U.S. civilian, non–institutionalized population was considered.

39,787 participants in the National Health and Nutrition Examination Survey

(1999 to 2008) aged 2 years or older were included.

Chronic HBV infection was defined by presence of serum HBV surface antigen and

past exposure by serum antibody to hepatitis B core antigen among persons aged 6

years or older.

Infant immunity was defined by presence of serum antibody to hepatitis B surface

antigen among children aged 2 years.

Results

Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had chronic

HBV infection (corresponding to approximately 704 000 persons nationwide), and

4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately 11,993 000

persons).

These estimates are lower than estimates of HBV infection (0.42%) and exposure

(5.1%) in the United States reported from 1988 to 1994.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to 73.2%]).

Adults, including those at high risk for infection, have much lower rates of

immunity.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

[Guest guest]

http://www.annals.org/content/154/5/319.abstract

Original Research

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

N. Ioannou, BMBCh, MS

+ Author Affiliations

From Veterans Affairs Puget Sound Health Care System and University of

Washington, Seattle, Washington.

Abstract

Background: Up-to-date estimates of the prevalence of hepatitis B virus (HBV)

infection, exposure, and immunity are necessary to assess the effectiveness of

ongoing programs aimed at preventing HBV transmission.

Objective: To determine the prevalence and associations of chronic HBV

infection, past exposure, and immunity in the United States from 1999 to 2008.

Design: Nationally representative, cross-sectional household survey.

Setting: U.S. civilian, noninstitutionalized population.

Participants: 39 787 participants in the National Health and Nutrition

Examination Survey (1999 to 2008) aged 2 years or older.

Measurements: Chronic HBV infection was defined by presence of serum HBV surface

antigen and past exposure by serum antibody to hepatitis B core antigen among

persons aged 6 years or older. Infant immunity was defined by presence of serum

antibody to hepatitis B surface antigen among children aged 2 years.

Results: Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had

chronic HBV infection (corresponding to approximately 704 000 persons

nationwide), and 4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately

11 993 000 persons). These estimates are lower (P < 0.001) than estimates of HBV

infection (0.42%) and exposure (5.1%) in the United States reported from 1988 to

1994. Infection and past exposure were very uncommon among persons aged 6 to 19

years. Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to

73.2%]). Adults, including those at high risk for infection, have much lower

rates of immunity.

Limitations: Incarcerated and homeless persons were not sampled. Categorization

of race or ethnicity did not identify high-risk groups, such as persons of Asian

and Pacific Islander descent.

Conclusion: A cohort of children and adolescents is growing up in the United

States with high rates of immunity against HBV and very low rates of infection.

Vaccination of high-risk adults should continue to be emphasized.

Primary Funding Source: The Veterans Affairs Research Enhancement Award Program.

------------------------------------------------------------------

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

ls of Internal Medicine, 03/01/2011

Ioannou GN – A cohort of children and adolescents is growing up in the United

States with high rates of immunity against hepatitis B virus (HBV) and very low

rates of infection. Vaccination of high–risk adults should continue to be

emphasized.

Methods

U.S. civilian, non–institutionalized population was considered.

39,787 participants in the National Health and Nutrition Examination Survey

(1999 to 2008) aged 2 years or older were included.

Chronic HBV infection was defined by presence of serum HBV surface antigen and

past exposure by serum antibody to hepatitis B core antigen among persons aged 6

years or older.

Infant immunity was defined by presence of serum antibody to hepatitis B surface

antigen among children aged 2 years.

Results

Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had chronic

HBV infection (corresponding to approximately 704 000 persons nationwide), and

4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately 11,993 000

persons).

These estimates are lower than estimates of HBV infection (0.42%) and exposure

(5.1%) in the United States reported from 1988 to 1994.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to 73.2%]).

Adults, including those at high risk for infection, have much lower rates of

immunity.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

[Guest guest]

http://www.annals.org/content/154/5/319.abstract

Original Research

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

N. Ioannou, BMBCh, MS

+ Author Affiliations

From Veterans Affairs Puget Sound Health Care System and University of

Washington, Seattle, Washington.

Abstract

Background: Up-to-date estimates of the prevalence of hepatitis B virus (HBV)

infection, exposure, and immunity are necessary to assess the effectiveness of

ongoing programs aimed at preventing HBV transmission.

Objective: To determine the prevalence and associations of chronic HBV

infection, past exposure, and immunity in the United States from 1999 to 2008.

Design: Nationally representative, cross-sectional household survey.

Setting: U.S. civilian, noninstitutionalized population.

Participants: 39 787 participants in the National Health and Nutrition

Examination Survey (1999 to 2008) aged 2 years or older.

Measurements: Chronic HBV infection was defined by presence of serum HBV surface

antigen and past exposure by serum antibody to hepatitis B core antigen among

persons aged 6 years or older. Infant immunity was defined by presence of serum

antibody to hepatitis B surface antigen among children aged 2 years.

Results: Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had

chronic HBV infection (corresponding to approximately 704 000 persons

nationwide), and 4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately

11 993 000 persons). These estimates are lower (P < 0.001) than estimates of HBV

infection (0.42%) and exposure (5.1%) in the United States reported from 1988 to

1994. Infection and past exposure were very uncommon among persons aged 6 to 19

years. Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to

73.2%]). Adults, including those at high risk for infection, have much lower

rates of immunity.

Limitations: Incarcerated and homeless persons were not sampled. Categorization

of race or ethnicity did not identify high-risk groups, such as persons of Asian

and Pacific Islander descent.

Conclusion: A cohort of children and adolescents is growing up in the United

States with high rates of immunity against HBV and very low rates of infection.

Vaccination of high-risk adults should continue to be emphasized.

Primary Funding Source: The Veterans Affairs Research Enhancement Award Program.

------------------------------------------------------------------

Hepatitis B Virus in the United States: Infection, Exposure, and Immunity Rates

in a Nationally Representative Survey

ls of Internal Medicine, 03/01/2011

Ioannou GN – A cohort of children and adolescents is growing up in the United

States with high rates of immunity against hepatitis B virus (HBV) and very low

rates of infection. Vaccination of high–risk adults should continue to be

emphasized.

Methods

U.S. civilian, non–institutionalized population was considered.

39,787 participants in the National Health and Nutrition Examination Survey

(1999 to 2008) aged 2 years or older were included.

Chronic HBV infection was defined by presence of serum HBV surface antigen and

past exposure by serum antibody to hepatitis B core antigen among persons aged 6

years or older.

Infant immunity was defined by presence of serum antibody to hepatitis B surface

antigen among children aged 2 years.

Results

Among persons aged 6 years or older, 0.27% (95% CI, 0.20% to 0.34%) had chronic

HBV infection (corresponding to approximately 704 000 persons nationwide), and

4.6% (CI, 4.1% to 5.0%) had been exposed to HBV (approximately 11,993 000

persons).

These estimates are lower than estimates of HBV infection (0.42%) and exposure

(5.1%) in the United States reported from 1988 to 1994.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.

Children aged 2 years have high rates of immunity (68.6% [CI, 64.1% to 73.2%]).

Adults, including those at high risk for infection, have much lower rates of

immunity.

Infection and past exposure were very uncommon among persons aged 6 to 19 years.