Trends and Disparities in Chronic Hepatitis-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: Chronic hepatitis caused 1.1 million deaths in 2019 and 1.3 million in 2022 according to World Health Organization. These results underline the impact of behavioral, environmental and cultural factors despite available testing and treatment. This study analyzes trends in chronic hepatitis-related mortality from 1999 to 2020, using age-adjusted mortality rates (AAMR) to identify patterns across demographic and regional populations. Methods: Data from Centers for Disease Control Wonder database, examining chronic hepatitis-related death trends from 01/1999 to 12/2020, using International Classification of Diseases-10 code K73.0., was collected. AAMRs per 100,000 population and average annual percentage change (AAPC) were calculated. Annual percentage change (APC) with 95% Confidence Interval (CI) was assessed to understand AAMR trends. Mortality rates were standardized to the 2000 United States Population and Joinpoint was used for regression analysis across various demographics. Age trends were studied in pediatric, young adults, middle adults, and older adults groups. The Monte Carlo Permutation Procedure (MCPP) analyzed mortality trends. Statistically significant results were determined with a P-value < 0.05. Results: From 1999 to 2020, there were 8,862 chronic hepatitis B related deaths. Mortality declined, with age-adjusted rates (AAR) showing a consistent decrease. The APC was -2.46 from 1999-2002, -31.0 from 2002-2005, and -2.86 from 2005-2020. A significant decrease was seen in Northeast and Midwest. Females experienced a steeper decline from 2002-2005 (APC: -41.39, P=0.003883, CI [-57.94, -18.32]), while males declined from 2001-2007 (APC: -13.23, P=0.000405, CI [-17.99, -8.20]). Black individuals had higher mortality with a significant decrease until 2007 (APC: -17.90, P=0.000019, CI [-23.53, -11.85]), while White individuals saw declines from 2002-2005 (APC: -31.16, P=0.006319, CI [-46.37, -11.64]). Urban areas showed significant drops from 2002-2005 (APC: -31.10, P=0.009090, CI [-47.09, -10.27]). High mortality was seen in the 65-74-year group before 2002 but evened out across age groups afterward (Figure 1). Conclusion: This study reveals a decline in chronic hepatitis-related mortality from 1999 to 2020 with disparities across gender, race, and regions. Females and Black individuals experienced higher but decreasing mortality rates and urban areas saw substantial drops, especially from 2002 to 2005. Even then, high mortality persisted in the 65-74 age group before 2002. Targeted public health interventions are essential to address these disparities and disease burden. (Table Presented).

Volume

119

Issue

10

First Page

S1227

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