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• W2127661567 abstract "BackgroundSince the mid-1990s, hepatitis A vaccine has been recommended for US children living in historically high-incidence states and for persons with other risk factors or chronic liver disease (CLD). The incidence of hepatitis A has declined dramatically during the era of vaccination, but trends in mortality are largely unknown MethodsUS death certificates from 1990 to 2004 for which hepatitis A was listed as the underlying cause of death were analyzed. Average annual age-adjusted mortality rates during the prevaccine (1990–1995) and post–vaccination recommendation (2000–2004) periods were compared using a Mantel-Haenszel test of association. The number of deaths for which CLD was listed as a contributing cause was determined ResultsOverall, 1436 deaths due to hepatitis A occurred, averaging 96 annually (range, 142 in 1995 to 54 in 2003). CLD contributed to nearly half of these deaths. Mortality rates paralleled incidence rates, beginning to decline in the mid-1990s and achieving low points in 2003 and 2004. Average rates were 32% lower in the post–vaccination recommendation period than in the prevaccine period (P<.01). The decline was more dramatic for states with (45%; P<.001) than without (23%; P=.002) recommendations ConclusionsHepatitis A mortality rates have declined over the past decade. CLD remains an important and preventable contributing cause of death due to hepatitis A" @default.
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• W2127661567 date "2008-05-01" @default.
• W2127661567 modified "2023-10-18" @default.
• W2127661567 title "Declining Hepatitis A Mortality in the United States during the Era of Hepatitis A Vaccination" @default.
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• W2127661567 doi "https://doi.org/10.1086/586899" @default.
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