Changes in the epidemiology of hepatitis A in Spain (2005–2008): trends of acute hepatitis A hospitalizations, comorbidities, and costs associated with the hospitalization.

INTRODUCTION: The objective of this study is to analyze data related to hospitalization, comorbidities, median stays and costs associated with the hospitalization cases of hepatitis A in Spain, during the 2005-2008 periods.
METHODS: A retrospective study of the characteristics of acute hepatitis A patients admitted to Spanish hospitals was performed using the minimum basic dataset. Costs were calculated using the diagnosis-related groups for the disease.
RESULTS: The total number of hospitalized patients diagnosed with acute hepatitis A was 2395 (2.66/100,000 inhabitants); 61.5% were diagnosed in men. The highest rate corresponds to the group aged 20-39 years (4.01/100,000 inhabitants). When compared with year 2005 ascending tendencies in hospitalization was found for the year 2008 (incidence rate ratio 1.36 confidence interval 95% 1.32-1.39). Twenty-four deaths (1%) were reported out of the total of hospitalized patients. The median hospital stay was 5 days. An increase of cost from euro 1.272.608 in the year 2005 to euro 2.586.657 in 2008 was observed. Therefore, the total cost derived from these hospitalizations, above the retail price index, has increased by 90%.
CONCLUSION: The incidence of hospitalized patients diagnosed with acute hepatitis A in Spain has remained stable from 2005 to 2007 and increased significantly in the year 2008. Therefore, a change in the epidemiology of hepatitis A may be taking place in Spain and this disease could become a public problem in the young adult population. It is necessary to conduct a cost-effectiveness study to assess the need for including hepatitis A in the universal immunizations schedule.