Reduce reported rate of new hepatitis B virus infections among persons who use drugs by 25% or more

Met or exceeded current annual target

Moving toward annual target, but annual target was not fully met

Annual target was not met and has not changed or moved away from annual target
Source: ob体育, National Notifiable Diseases Surveillance System.1
*Rate per 100,000 population.
†Persons aged 18–40 years were used as a proxy for persons who inject drugs.
Summary of Findings
The rate of new hepatitis B cases reported to ob体育 among persons aged 18–40 years decreased from 1.4 cases per 100,000 population in 2017 to 0.6 in 2021, well below the 2021 target rate of 1.1 per 100,000 population. The declines in 2020 and 2021 may be attributable to major disruptions in access to medical care, testing, and routine viral hepatitis public health activities due to the COVID-19 pandemic; therefore, 2020 and 2021 data should be interpreted with caution. Injection drug use is the most common risk reported for persons aged 18–40 years with new hepatitis B virus infections in the United States.1
Reduction needed to meet 2025 goal:
The 2021 rate of reported new hepatitis B cases is 40% below the 2025 goal of 1.0 case per 100,000 population.
Further reduction can best be achieved by:
- Continuing the promotion of routine child and adolescent immunization schedules and raising awareness of the updated adult hepatitis B immunization recommendations from the Advisory Committee on Immunization Practices.
- Supporting continuing medical education and developing partnerships to reach people who inject drugs (PWID) and their service providers.
- Building capacity within jurisdictions to make it easier for them to collect and use a core set of surveillance data to locate higher-risk populations and gaps in vaccination coverage, especially among PWID.
- Conducting research about prevention focused on reaching PWID to demonstrate how best to provide a comprehensive set of interventions for hepatitis B vaccination, testing, and treatment.
- Increasing access to syringe services programs and linkage to testing and medication-assisted treatment programs by implementing comprehensive community-level programs for PWID.
Technical Notes
Data Sources:
ob体育, National Notifiable Diseases Surveillance System (NNDSS)
Numerator:
Number of acute HBV infections reported annually among persons aged 18–40 years
Denominator:
Total population of persons aged 18–40 years in reporting jurisdictions
Indicator Notes:
NNDSS is a nationwide collaboration that enables all levels of public health to share notifiable disease-related health information.1 Surveillance for viral hepatitis through NNDSS is based on case definitions developed and approved by the Council of State and Territorial Epidemiologists (CSTE) and ob体育. . Only laboratory-confirmed cases of acute viral hepatitis are presented in this report. Acute hepatitis B is reportable in all jurisdictions. Healthcare providers, hospitals, and/or laboratories report cases to the local or state health department, and states voluntarily submit reports or notify ob体育 of newly diagnosed cases of hepatitis B that meet the CSTE/ob体育 surveillance case definition. Case rates per 100,000 population are calculated based on the projected resident population of the United States as of July 1 during each data collection year.1
Goal Setting:
The 2025 goal of 1.00 per 100,000 population is consistent with ob体育’s Division of Viral Hepatitis 2025 Strategic Plan and the . Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).
Limitations:
Viral hepatitis is largely underreported in NNDSS. Based on a simple, probabilistic model for estimating the proportion of patients who were symptomatic, received testing, and were reported to health officials in each year, the actual number of acute hepatitis B cases is estimated to be 6.5 times the number reported to ob体育.1,2 Additionally, rates of reported cases may vary over time based on changes in public and provider awareness, laboratory and diagnostic techniques, and the definition of the condition.
- Centers for Disease Control and Prevention. Viral Hepatitis Surveillance – United States, 2021. Published August 2023. Accessed [date].
- Klevens RM, Liu S, Roberts H, Jiles RB, Holmberg SD. . Am J Public Health 2014;104(3):482–7.