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Prevalence of diagnosed chronic hepatitis B infection among U.S. Medicaid enrollees, 2000-2007

Dana D Byrne1, Craig W Newcomb2, Dean M Carbonari3

  • 1Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia; Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Annals of Epidemiology
|April 8, 2014
PubMed

Insights

This study estimated chronic hepatitis B (CHB) prevalence in U.S. Medicaid enrollees. Diagnosed CHB infection affected 15.6 per 10,000 individuals, highlighting the need for public health surveillance.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Chronic hepatitis B (CHB) infection is a significant public health concern.
  • Population-based data on diagnosed CHB prevalence in the U.S. are limited.
  • Accurate estimation of CHB prevalence is crucial for effective public health strategies.

Purpose of the Study:

  • To estimate the prevalence of diagnosed chronic hepatitis B (CHB) infection among U.S. Medicaid enrollees.
  • To validate the accuracy of CHB diagnoses within Medicaid databases.
  • To provide population-based data on CHB prevalence in five U.S. states.

Main Methods:

  • Defined CHB infection by two outpatient diagnoses recorded >6 months apart.
  • Confirmed diagnosis accuracy using a random sample review by two clinicians.
  • Calculated positive predictive value (PPV) for the CHB definition.
  • Estimated period prevalence of diagnosed CHB infection adjusting for PPV and sensitivity.

Main Results:

  • The CHB definition demonstrated high accuracy (PPV 96.3%).
  • An estimated 31,046 CHB cases were diagnosed among over 31 million Medicaid enrollees.
  • The adjusted prevalence of diagnosed CHB infection was 15.6 per 10,000 Medicaid enrollees.

Conclusions:

  • A definition of two outpatient CHB diagnoses >6 months apart reliably identifies confirmed CHB cases.
  • The prevalence of diagnosed CHB infection among U.S. Medicaid enrollees is 15.6 per 10,000.
  • These findings underscore the importance of robust surveillance for CHB in vulnerable populations.
Abstract

Keywords:
Hepatitis BPrevalenceViral hepatitis

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