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2. Regional Differences in Hepatitis C–Related Hospitalization Rates, United States, 2012-2019.

Author

Hofmeister, Megan G., Zhong, Yuna, Moorman, Anne C., Teshale, Eyasu H., Samuel, Christina R., and Spradling, Philip R.

Subjects
HEPATITIS C prevention, SECONDARY analysis, HOSPITAL care, CENSUS, POPULATION geography, DESCRIPTIVE statistics, HEPATITIS C, SOCIODEMOGRAPHIC factors, MEDICAID, COMORBIDITY, DISEASE complications, SYMPTOMS
Abstract

Objectives: In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)–related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination. Methods: We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease–related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions. Results: During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region. Conclusions: HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission. [ABSTRACT FROM AUTHOR]

Published
2025
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3. Evolving Characteristics of Decedents With Hepatitis A Listed as a Cause of Death, United States, 2011–2021.

Author

Hofmeister, Megan G., Ly, Kathleen N., Yin, Shaoman, and Spradling, Philip R.

Subjects
HEPATITIS A virus, HEPATITIS A, HEPATITIS A vaccines, VACCINATION coverage, VIRUS diseases
Abstract

Hepatitis A is a vaccine‐preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person‐to‐person transmission have been widespread in the United States since 2016. We used public‐use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A‐listed deaths during non‐outbreak (2011–2015) and outbreak (2017–2021) periods and assessed the median age at death among decedents with and without hepatitis A‐listed deaths during the outbreak period. From the non‐outbreak period to the outbreak period, hepatitis A‐listed deaths more than doubled (from 369 to 801), while the hepatitis A‐listed age‐adjusted mortality rate increased 150% (p < 0.001). When compared with the non‐outbreak period, hepatitis A‐listed decedents during the outbreak period were more frequently male, aged 18–49 years, non‐Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A‐listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non‐outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A‐listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017–2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Progress in Testing for and Treatment of Hepatitis C Virus Infection Among Persons Who Inject Drugs — Georgia, 2018

Author

Stvilia, Ketevan, Spradling, Philip R., Asatiani, Alexander, Gogia, Maka, Kutateladze, Khatuna, Butsashvili, Maia, Zarkua, Jaba, Tsertsvadze, Tengiz, Sharvadze, Lali, Japaridze, Maia, Kuchuloria, Tinatin, Gvinjilia, Lia, Tskhomelidze, Irinka, Gamkrelidze, Amiran, Khonelidze, Irma, Sergeenko, David, Shadaker, Shaun, Averhoff, Francisco, and Nasrullah, Muazzam

Published
2019

10. Comparison of ICD-9 Codes for Depression and Alcohol Misuse to Survey Instruments Suggests These Codes Should Be Used with Caution

Author

Boscarino, Joseph A., Moorman, Anne C., Rupp, Loralee B., Zhou, Yueren, Lu, Mei, Teshale, Eyasu H., Gordon, Stuart C., Spradling, Philip R., Schmidt, Mark A., Trinacty, Connie Mah, Zhong, Yuna, Holmberg, Scott D., Holtzman, Deborah, Holmberg, Scott D., Teshale, Eyasu H., Spradling, Philip R., Moorman, Anne C., Xing, Jim, Zhong, Yuna, Gordon, Stuart C., Nerenz, David R., Lu, Mei, Lamerato, Lois, Li, Jia, Rupp, Loralee B., Akkerman, Nonna, Oja-Tebbe, Nancy, Zhang, Talan, Trudeau, Sheri, Zhou, Yueren, Boscarino, Joseph A., Daar, Zahra S., Smith, Robert E., Daida, Yihe G., Trinacty, Connie M., Wong, Carmen P., Schmidt, Mark A., Donald, Judy L., Keast, Erin M., and For the Chronic Hepatitis Cohort Study (CheCS) Investigators

Published
2017
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16. Temporal Trends in Hepatitis C–Related Hospitalizations, United States, 2000–2019.

Author

Hofmeister, Megan G, Zhong, Yuna, Moorman, Anne C, Samuel, Christina R, Teshale, Eyasu H, and Spradling, Philip R

Subjects
AGE distribution, HEPATITIS C, ANTIVIRAL agents, RACE, MEDICAL care use, HOSPITAL care, MEDICAID
Abstract

Background Hospitalization burden related to hepatitis C virus (HCV) infection is substantial. We sought to describe temporal trends in hospitalization rates before and after release of direct-acting antiviral (DAA) agents. Methods We analyzed 2000–2019 data from adults aged ≥18 years in the National Inpatient Sample. Hospitalizations were HCV-related if (1) hepatitis C was the primary diagnosis, or (2) hepatitis C was any secondary diagnosis with a liver-related primary diagnosis. We analyzed characteristics of HCV-related hospitalizations nationally and examined trends in age-adjusted hospitalization rates. Results During 2000–2019, there were an estimated 1 286 397 HCV-related hospitalizations in the United States. The annual age-adjusted hospitalization rate was lowest in 2019 (18.7/100 000 population) and highest in 2012 (29.6/100 000 population). Most hospitalizations occurred among persons aged 45–64 years (71.8%), males (67.1%), White non-Hispanic persons (60.5%), and Medicaid/Medicare recipients (64.0%). The national age-adjusted hospitalization rate increased during 2000–2003 (annual percentage change [APC], 9.4%; P <.001) and 2003–2013 (APC, 1.8%; P <.001) before decreasing during 2013–2019 (APC, −7.6%; P <.001). Comparing 2000 to 2019, the largest increases in hospitalization rates occurred among persons aged 55–64 years (132.9%), Medicaid recipients (41.6%), and Black non-Hispanic persons (22.3%). Conclusions Although multiple factors likely contributed, overall HCV-related hospitalization rates declined steadily after 2013, coinciding with the release of DAAs. However, the declines were not observed equally among age, race/ethnicity, or insurance categories. Expanded access to DAA treatment is needed, particularly among Medicaid and Medicare recipients, to reduce disparities and morbidity and eliminate hepatitis C as a public health threat. [ABSTRACT FROM AUTHOR]

Published
2023
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32. Hepatitis A Hospitalization Costs, United States, 2017

Author

Hofmeister, Megan G., Yin, Shaoman, Aslam, Maria V., Teshale, Eyasu H., and Spradling, Philip R.

Subjects
United States. Centers for Disease Control and Prevention, Hepatitis A -- Prevention, Hepatitis A vaccines, Health care costs, Epidemiology, Vaccines, Hospital patients, Medical economics, Homelessness, Diseases, Investments, Health
Abstract

The introduction of hepatitis A vaccine has dramatically changed the epidemiology of hepatitis A in the United States. After vaccine licensure in 1995, hepatitis A incidence declined substantially; 3,366 hepatitis [...]

Published
2020
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39. Lower Rates of Emergency Department Visits and Hospitalizations Among Patients With Chronic Hepatitis C With Sustained Virological Response to Interferon-Free Direct-Acting Antiviral Therapy (2014–2018).

Author

Gordon, Stuart C, Teshale, Eyasu H, Spradling, Philip R, Moorman, Anne C, Boscarino, Joseph A, Schmidt, Mark A, Daida, Yihe G, Rupp, Loralee B, Trudeau, Sheri, Zhang, Jiaqi, Lu, Mei, and Investigators, CHeCS

Subjects
HOSPITAL emergency services, CHRONIC hepatitis C, ANTIVIRAL agents, INTERFERONS, MEDICAL care use, TREATMENT effectiveness, HOSPITAL care, MEDICAL appointments
Abstract

We compared rates of emergency department visits and hospitalizations between patients with hepatitis C virus who achieved sustained virological response after direct-acting antiviral therapy (case patients) and matched controls. Among 3049 pairs, case patients demonstrated lower rates of liver-related emergency department visits (P = .01) than controls; all-cause and liver-related hospitalization rates and number of hospitalized days were also lower in case patients (P < . 001). [ABSTRACT FROM AUTHOR]

Published
2022
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40. Incidence of Malignancies Among Patients With Chronic Hepatitis B in US Health Care Organizations, 2006-2018.

Author

Spradling, Philip R, Xing, Jian, Zhong, Yuna, Rupp, Loralee B, Moorman, Anne C, Lu, Mei, Teshale, Eyasu H, Schmidt, Mark A, Daida, Yihe G, Boscarino, Joseph A, and Gordon, Stuart C

Subjects
*HEPATITIS B, *LIVER tumors, *HEPATITIS viruses, *DISEASE incidence, *MEDICAL care, *RESEARCH funding, *CHRONIC hepatitis B, *HEPATOCELLULAR carcinoma, *DISEASE complications
Abstract

Hepatitis B virus (HBV) infection causes hepatocellular carcinoma but its association with other cancers is not well established. We compared age-adjusted incidence of primary cancers among 5773 HBV-infected persons with US cancer registries during 2006-2018. Compared with the US population, substantially higher incidence among HBV-infected persons was observed for hepatocellular carcinoma (standardized rate ratio [SRR], 30.79), gastric (SRR, 7.95), neuroendocrine (SRR, 5.88), cholangiocarcinoma (SRR, 4.62), and ovarian (SRR, 3.72) cancers, and non-Hodgkin lymphoma (SRR, 2.52). Clinicians should be aware of a heightened potential for certain nonhepatic malignancies among hepatitis B patients, as earlier diagnosis favors improved survival. [ABSTRACT FROM AUTHOR]

Published
2022
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41. Severe or fatal liver injury in 50 patients in the United States taking rifampin and pyrazinamide for latent tuberculosis infection

Author

Ijaz, Kashef, Jereb, John A., Lambert, Lauren A., Bower, William A., Spradling, Philip R., McElroy, Peter D., Iademarco, Michael F., Navin, Thomas R., and Castro, Kenneth G.

Subjects
Liver diseases -- Drug therapy, Tuberculosis -- Drug therapy, Health, Health care industry, Pyrazinamide (Medication) -- Usage, Rifampin (Medication) -- Usage
Published
2006

42. Psychosocial Obstacles to Hepatitis C Treatment Initiation Among Patients in Care: A Hitch in the Cascade of Cure.

Author

Spradling, Philip R., Zhong, Yuna, Moorman, Anne C., Rupp, Loralee B., Lu, Mei, Gordon, Stuart C., Teshale, Eyasu H., Schmidt, Mark A., Daida, Yihe G., Boscarino, Joseph A., Holmberg, Scott D, Teshale, Eyasu H, Spradling, Philip R, Moorman, Anne C, Xing, Jian, Gordon, Stuart C, Nerenz, David R, Lamerato, Lois, Li, Jia, and Rupp, Loralee B

Subjects
HEPATITIS C treatment, PATIENT care, MEDICAL care, ELECTRONIC health records, CIRRHOSIS of the liver
Abstract

There are limited data examining the relationship between psychosocial factors and receipt of direct‐acting antiviral (DAA) treatment among patients with hepatitis C in large health care organizations in the United States. We therefore sought to determine whether such factors were associated with DAA initiation. We analyzed data from an extensive psychological, behavioral, and social survey (that incorporated several health‐related quality of life assessments) coupled with clinical data from electronic health records of patients with hepatitis C enrolled at four health care organizations during 2017‐2018. Of 2,681 patients invited, 1,051 (39.2%) responded to the survey; of 894 respondents eligible for analysis, 690 (77.2%) initiated DAAs. Mean follow‐up among respondents was 9.2 years. Compared with DAA recipients, nonrecipients had significantly poorer standardized scores for depression, anxiety, and life‐related stressors as well as poorer scores related to physical and mental function. Lower odds of DAA initiation in multivariable analysis (adjusted by age, race, sex, study site, payment provider, cirrhosis status, comorbidity status, and duration of follow‐up) included Black race (adjusted odds ratio [aOR], 0.59 vs. White race), perceived difficulty getting medical care in the preceding year (aOR, 0.48 vs. no difficulty), recent injection drug use (aOR, 0.11 vs. none), alcohol use disorder (aOR, 0.58 vs. no alcohol use disorder), severe depression (aOR, 0.42 vs. no depression), recent homelessness (aOR, 0.36 vs. no homelessness), and recent incarceration (aOR, 0.34 vs. no incarceration). Conclusion: In addition to racial differences, compared with respondents who initiated DAAs, those who did not were more likely to have several psychological, behavioral, and social impairments. Psychosocial barriers to DAA initiation among patients in care should also be addressed to reduce hepatitis C‐related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Published
2021
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44. Use of the International Classification of Diseases, 9th revision, coding in identifying chronic hepatitis B virus infection in health system data: implications for national surveillance

Author

Mahajan, Reena, Moorman, Anne C, Liu, Stephen J, Rupp, Loralee, Klevens, R Monina, Holmberg, Scott D, Teshale, Eyasu H, Spradling, Philip R, Moorman, Anne C, Gordon, Stuart C, Nerenz, David R, Lu, Mei, Lamerato, Lois, Rupp, Loralee B, Akkerman, Nonna, Oja-Tebbe, Nancy, Cogan, Chad M, Larkin, Dana, Boscarino, Joseph A, Daar, Zahra S, Leader, Joe B, Smith, Robert E, Nakasato, Cynthia C, Vijayadeva, Vinutha, Sylva, Kelly E, Parker, John V, Schmidt, Mark M, Permanente-Hawaii, Kaiser, Henkle, Emily M, Dodge, Tracy L, and Keast, Erin M

Published
2013
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49. Estimated Prevalence and Number of Persons With Isolated Antibody to Hepatitis B Core Antigen and Associated Occult Hepatitis B, United States, 2001-2018.

Author

Spradling, Philip R, Xing, Jian, Harris, Aaron M, and Ly, Kathleen N

Subjects
*HEPATITIS associated antigen, *HEPATITIS B, *HEALTH & Nutrition Examination Survey, *IMMUNOGLOBULINS, *VIRAL antigens, *RESEARCH, *LIVER tumors, *DNA, *RESEARCH methodology, *HEPATITIS viruses, *EVALUATION research, *SURVEYS, *COMPARATIVE studies, *DISEASE prevalence, *VIRAL antibodies
Abstract

Persons with isolated antibody to hepatits B virus (HBV) core antigen (IAHBc) may have occult HBV infection (OBI), which is associated with reactivation and potential risk for hepatocellular carcinoma and HBV transmission. We used National Health and Nutrition Examination Survey data to estimate US IAHBc prevalence and published studies of IAHBc-associated OBI prevalence to estimate OBI burden. During 2001-2018, the prevalence of IAHBc was 0.8% (approximately 2.1 million persons), and the OBI burden range was 35 500-83 600 persons. These data support the need for more robust estimates of IAHBc-associated OBI prevalence in the general US population. [ABSTRACT FROM AUTHOR]

Published
2022
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