S2077 Trends and Disparities in Hepatitis B Mortality in the United States Between 1999-2020

Introduction: To determine trends and disparities in hepatitis-B mortality in American adults older than 25 years between 1999-2020. Methods: Retrospective analysis of Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was performed. For hepatitis-B, International Classification of Diseases-10 codes B16.0-16.2, B16.9, B17.0, B18.0, B18.1 were employed. Age-adjusted mortality rates (AAMR) and crude death rates (CDR) per 100,000 persons were determined. Average annual percentage change (AAPC) was determined using Joinpoint regression. Temporal trends were analyzed in sex, race, geographical distribution and patient age-related mortality. Results: A total of 38,845 deaths from hepatitis-B were reported. AAMRs declined sharply from 1.12 to 0.87 between 1999-2004 (AAPC: -4.45; P< 0.001) followed by a steady decline from 0.87 to 0.69 (AAPC: -1.64; P < 0.001), resulting in an overall AAMR of 0.82 (AAPC: -2.31; P < 0.001). Men had disproportionately higher AAMR (1.28) as compared to women (0.41) and showed a greater decline in mortality (AAPC: -2.62; P < 0.001) than women (AAPC: -2.13; P< 0.001). Among races, NH Asian/Pacific Islanders had a disproportionately higher AAMR (4.04) followed by NH Blacks (1.45), NH American Indians/Alaskan Natives (0.9), Hispanic (0.71), and NH White (0.55). All races saw decline in AAMR, with the greatest decline seen in Hispanic (AAPC: -6.43; P< 0.001). Geographically, AAMRs were highest in West (1.17) followed by South (0.83). All census regions saw a decline in AAMR, with the greatest decline seen for Northeast (AAPC: -3.38; P < 0.001). Metropolitan areas had a higher AAMR (0.84) than nonmetropolitan areas (0.59) and saw a greater decline in AAMR (AAPC: -2.86; P< 0.001) than nonmetropolitan areas (AAPC: -0.55; P = 0.059). Of the 10-year age groups, CDR was highest for 55-64 years (1.46). The age groups of 25-34, 35-44, 45-54, and 55-64 years saw declining AAMRs, with the greatest decline seen for 35-44 years (AAPC: -5.64; P< 0.001). However, 65-74, 75-84, and 85+ years saw an increase in AAMRs, with the greatest increase seen for 85+ years (AAPC: 1.12; P = 0.037). Conclusion: We found a significant decline in hepatitis-B mortality, though persistent disparities exist. Men, NH Asian/Pacific Islanders, residents of West and metropolitan areas experienced disproportionately higher mortality rates. All demographic groups saw decline in mortality except 65-74, 75-84, and 85+ year age groups, which saw increases in mortality.