- 1Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Background: After decades of decline, US incidence of acute hepatitis B flattened since 2010. In persons aged ≥40 years and in jurisdictions affected by the opioid epidemic, there is an increase in new cases. Data suggest new infections are occurring among US-born persons.
Methods: We used National Health and Nutrition Examination Survey data during 2001-2018 to examine trends and differences in total antibody to hepatitis B virus core antigen (anti-HBc) prevalence in US-born persons. During 2013-2018, the distribution of characteristics was examined. Cochran-Mantel-Haenszel test was used to assess trends.
Results: During 2001-2006, 2007-2012, and 2013-2018, anti-HBc prevalence was 3.5%, 2.5%, and 2.6% among US-born persons, respectively. This corresponded to 5.7 (range, 4.8-6.6) million US-born persons with resolved or current HBV infection during 2013-2018, including 347,100 persons aged 6-29 years. The most pronounced increase and highest anti-HBc prevalence was among persons who reported injection drug use (IDU), which increased from 35.3% during 2001-2006 to 58.4% during 2013-2018 (P=.07).
Conclusions: Anti-HBc prevalence among US-born persons remained flat during the most recent period, coinciding with a doubling of prevalence among persons reporting IDU. These data are consistent with acute hepatitis B surveillance trends, showing increasing incidence in sub-populations where prevention could be strengthened.