BACKGROUND: Since the mid-1990s, hepatitis A vaccine has been recommended for US children living in historically high-incidence states and for persons with other risk factors or chronic liver disease (CLD). The incidence of hepatitis A has declined dramatically during the era of vaccination, but trends in mortality are largely unknown. METHODS: US death certificates from 1990 to 2004 for which hepatitis A was listed as the underlying cause of death were analyzed. Average annual age-adjusted mortality rates during the prevaccine (1990-1995) and post-vaccination recommendation (2000-2004) periods were compared using a Mantel-Haenszel test of association. The number of deaths for which CLD was listed as a contributing cause was determined. RESULTS: Overall, 1436 deaths due to hepatitis A occurred, averaging 96 annually (range, 142 in 1995 to 54 in 2003). CLD contributed to nearly half of these deaths. Mortality rates paralleled incidence rates, beginning to decline in the mid-1990s and achieving low points in 2003 and 2004. Average rates were 32% lower in the post-vaccination recommendation period than in the prevaccine period (P < .01). The decline was more dramatic for states with (45%; P < .001) than without (23%; P = .002) recommendations. CONCLUSIONS: Hepatitis A mortality rates have declined over the past decade. CLD remains an important and preventable contributing cause of death due to hepatitis A.
BACKGROUND: Since the mid-1990s, hepatitis A vaccine has been recommended for US children living in historically high-incidence states and for persons with other risk factors or chronic liver disease (CLD). The incidence of hepatitis A has declined dramatically during the era of vaccination, but trends in mortality are largely unknown. METHODS: US death certificates from 1990 to 2004 for which hepatitis A was listed as the underlying cause of death were analyzed. Average annual age-adjusted mortality rates during the prevaccine (1990-1995) and post-vaccination recommendation (2000-2004) periods were compared using a Mantel-Haenszel test of association. The number of deaths for which CLD was listed as a contributing cause was determined. RESULTS: Overall, 1436 deaths due to hepatitis A occurred, averaging 96 annually (range, 142 in 1995 to 54 in 2003). CLD contributed to nearly half of these deaths. Mortality rates paralleled incidence rates, beginning to decline in the mid-1990s and achieving low points in 2003 and 2004. Average rates were 32% lower in the post-vaccination recommendation period than in the prevaccine period (P < .01). The decline was more dramatic for states with (45%; P < .001) than without (23%; P = .002) recommendations. CONCLUSIONS:Hepatitis A mortality rates have declined over the past decade. CLD remains an important and preventable contributing cause of death due to hepatitis A.
Authors: V Papaevangelou; Z Alexopoulou; C Hadjichristodoulou; G Kourlamba; A Katsioulis; K Theodoridou; V Spoulou; M Theodoridou Journal: Hum Vaccin Immunother Date: 2016-05-04 Impact factor: 3.452
Authors: Ricardo Arraes de Alencar Ximenes; Celina Maria Turchi Martelli; Marcos Amaku; Ana Marli C Sartori; Patricia Coelho de Soárez; Hillegonda Maria Dutilh Novaes; Leila Maria Moreira Beltrão Pereira; Regina Célia Moreira; Gerusa Maria Figueiredo; Raymundo Soares de Azevedo Journal: PLoS One Date: 2014-05-20 Impact factor: 3.240
Authors: Anke L Stuurman; Cinzia Marano; Eveline M Bunge; Laurence De Moerlooze; Daniel Shouval Journal: Hum Vaccin Immunother Date: 2016-10-27 Impact factor: 3.452
Authors: Lei Cao; Pi Liu; Pan Yang; Qiang Gao; Hong Li; Yao Sun; Ling Zhu; Jianping Lin; Dan Su; Zihe Rao; Xiangxi Wang Journal: PLoS Biol Date: 2019-04-30 Impact factor: 8.029