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The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies.

Abstract

To determine trends in the incidence and epidemiology of acute hepatitis B in the United States we conducted intensive surveillance for viral hepatitis in four sentinel counties from October 1, 1981, to September 30, 1988. The overall incidence of hepatitis B remained relatively constant throughout the study period (average, 13.2 cases per 100,000 population), but disease transmission patterns changed significantly. The proportions of hepatitis B cases accounted for by homosexual activity and health care employment decreased 62% and 75%, respectively; the proportions of cases accounted for by parenteral drug use and heterosexual exposure increased 80% and 38%, respectively. The percentage of patients for whom no risk factor was identified (30% to 40%) did not change over time. These patients tended to belong to minority populations, and their socioeconomic level was low. The decline in the number of hepatitis B cases among homosexual men probably results from the modification of high-risk sexual behavior; the decline among health care workers is due mostly to hepatitis B immunization. The current strategy for prevention of hepatitis B, which targets high-risk groups for immunization, has failed to have a significant impact on the incidence of disease.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, Ga 30333.

    , , , , , , ,

    Source

    JAMA 263:9 1990 Mar 02 pg 1218-22

    MeSH

    Acute Disease
    Adolescent
    Adult
    Female
    Hepatitis B
    Humans
    Incidence
    Male
    Middle Aged
    Population Surveillance
    Risk Factors
    Sex Factors
    United States
    Vaccination

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    2304237

    Citation

    Alter, M J., et al. "The Changing Epidemiology of Hepatitis B in the United States. Need for Alternative Vaccination Strategies." JAMA, vol. 263, no. 9, 1990, pp. 1218-22.
    Alter MJ, Hadler SC, Margolis HS, et al. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA. 1990;263(9):1218-22.
    Alter, M. J., Hadler, S. C., Margolis, H. S., Alexander, W. J., Hu, P. Y., Judson, F. N., ... Moyer, L. A. (1990). The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA, 263(9), pp. 1218-22.
    Alter MJ, et al. The Changing Epidemiology of Hepatitis B in the United States. Need for Alternative Vaccination Strategies. JAMA. 1990 Mar 2;263(9):1218-22. PubMed PMID: 2304237.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. AU - Alter,M J, AU - Hadler,S C, AU - Margolis,H S, AU - Alexander,W J, AU - Hu,P Y, AU - Judson,F N, AU - Mares,A, AU - Miller,J K, AU - Moyer,L A, PY - 1990/3/2/pubmed PY - 1990/3/2/medline PY - 1990/3/2/entrez SP - 1218 EP - 22 JF - JAMA JO - JAMA VL - 263 IS - 9 N2 - To determine trends in the incidence and epidemiology of acute hepatitis B in the United States we conducted intensive surveillance for viral hepatitis in four sentinel counties from October 1, 1981, to September 30, 1988. The overall incidence of hepatitis B remained relatively constant throughout the study period (average, 13.2 cases per 100,000 population), but disease transmission patterns changed significantly. The proportions of hepatitis B cases accounted for by homosexual activity and health care employment decreased 62% and 75%, respectively; the proportions of cases accounted for by parenteral drug use and heterosexual exposure increased 80% and 38%, respectively. The percentage of patients for whom no risk factor was identified (30% to 40%) did not change over time. These patients tended to belong to minority populations, and their socioeconomic level was low. The decline in the number of hepatitis B cases among homosexual men probably results from the modification of high-risk sexual behavior; the decline among health care workers is due mostly to hepatitis B immunization. The current strategy for prevention of hepatitis B, which targets high-risk groups for immunization, has failed to have a significant impact on the incidence of disease. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/2304237/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/263/pg/1218 DB - PRIME DP - Unbound Medicine ER -