1Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA.
2Tennessee Department of Health, Nashville, TN.
3New York Department of Health and Mental Hygiene, Queens, NY.
4Connecticut Department of Public Health, Hartford, CT.
5Oregon Health Authority, Portland, OR.
6Minnesota Department of Health, Minneapolis, MN.
7Colorado Department of Public Health and Environment, Denver, CO.
8New York State Department of Public Health, Albany, NY.
An estimated 20,000 new hepatitis B virus (HBV) infections occur each year in the United States. We describe the results of enhanced surveillance for acute hepatitis B at seven federally funded sites over a six-year period.
Health departments in Colorado, Connecticut, Minnesota, Oregon, Tennessee, 34 counties in New York state, and New York City were supported to conduct enhanced, population-based surveillance for acute HBV from 2006 through 2011. Demographic and risk factor data were collected on symptomatic cases using a standardized form. Sera from a subset of cases were also obtained for molecular analysis.
In the six-year period, 2,220 acute hepatitis B cases were reported from the seven sites. For all sites combined, the incidence rate of HBV infection declined by 19%, but in Tennessee incidence increased by 90%, mainly among persons of white race/ethnicity and those aged 40-49 years. Of all reported cases, 66.1% were male, 57.1% were white, 58.4% were aged 30-49 years, and 60.1% were born in the United States. The most common risk factor identified was any drug use, notably in Tennessee; healthcare exposure was also frequently reported. The most common genotype for all reported cases was HBV genotype A (82%).
Despite an overall decline in HBV infection, attributable to successful vaccination programs, a rise in incident HBV infection related to drug use is an increasing concern in some localities.