Trends in viral hepatitis-related mortality in the United States from 1999 to 2022: A retrospective study.

Abstract

Background: Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality. It is well-documented that viral hepatitis is the leading cause of liver cancer and liver failure, with Hepatitis B and Hepatitis C being the most common viruses associated with these outcomes.

Aim: To study viral hepatitis-related mortality trends from 1999 to 2022, focusing on gender, race/ethnicity, age, region, and urban/rural classifications.

Methods: We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify viral hepatitis-related deaths in the United States from 1999 to 2022. Data on demographic and regional information were analyzed and stratified by gender, race/ethnicity, age, regional, and urban rural classifications. Using the Joinpoint Regression Program (version 4.9.0.0 used, available from the National Cancer Institute, Bethesda, Maryland) the annual percentage change (APC) and average APC (AAPC) were calculated with 95%CI for extracted Age Adjusted Mortality Rates (AAMR).

Results: From 1999 to 2022, there were 389916 viral hepatitis-related deaths in the United States. The overall AAMR increased from 1999 to 2013 (APC: 3.20%; 95%CI: 2.54-3.99; P < 0.001), then declined through 2022 (APC: -5.54%; 95%CI: -6.75 to -4.47; P < 0.001). Males accounted for 70.4% of deaths, with steeper declines in females (AAPC: -0.48%; 95%CI: -0.87 to -0.12; P < 0.05). The American Indian/Alaska Native population had the highest AAMR (AAPC: 2.90%; 95%CI: 2.30 to 3.68; P < 0.001). The population of 65-74 years had the largest increase in overall crude mortality rate (AAPC: 3.20%; 95%CI: 2.77 to 3.85; P < 0.001). Mortality was highest in the West (AAPC: -0.78%; 95%CI -1.28 to -0.29; P < 0.05). Rural AAMR exceeded urban rates after 2015.

Conclusion: This study found significant racial, ethnic, and geographical disparities in viral hepatitis AAMR. Key factors for mortality reduction include patient education, screening, and access to hepatitis vaccination and treatment.