Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2025; 17(5): 106940
Published online May 27, 2025. doi: 10.4254/wjh.v17.i5.106940
Trends in viral hepatitis-related mortality in the United States from 1999 to 2022: A retrospective study
Lizette Ahlers, Benjamin Kash, Taylor Billion, Mohsin Mirza, Abubakar Tauseef
Lizette Ahlers, Benjamin Kash, Taylor Billion, Mohsin Mirza, Abubakar Tauseef, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE 68178, United States
Author contributions: Ahlers L retrieved and analyzed data from the CDC WONDER database and drafted the manuscript; Kash B assisted with data retrieval and manuscript preparation; Billion T, Tauseef A, Mirza M contributed to the innovation of the idea, data analysis, restructuring of the manuscript, and final revisions.
Institutional review board statement: This study did not involve patients, volunteers, or animals. The research was conducted using publicly available and de-identified database records from the CDC Wonder database, which does not contain any personal or identifying information. Therefore, institutional review board approval and informed consent were not required for this study.
Informed consent statement: This study did not involve patients, volunteers, or animals. The research was conducted using publicly available and de-identified database records from the CDC Wonder database, which does not contain any personal or identifying information. Therefore, ethical approval and informed consent were not required for this study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The dataset analyzed in this study is publicly available through CDC WONDER database. All information is de-identified. No additional data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lizette Ahlers, Department of Internal Medicine, Creighton University School of Medicine, 2616 Burt St, Omaha, NE 68178, United States. lizetteahlers@creighton.edu
Received: March 11, 2025
Revised: April 6, 2025
Accepted: May 7, 2025
Published online: May 27, 2025
Processing time: 77 Days and 11.3 Hours
Abstract
BACKGROUND

Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality. It is well-documented that viral hepatitis is the leading cause of liver cancer and liver failure, with Hepatitis B and Hepatitis C being the most common viruses associated with these outcomes.

AIM

To study viral hepatitis-related mortality trends from 1999 to 2022, focusing on gender, race/ethnicity, age, region, and urban/rural classifications.

METHODS

We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify viral hepatitis-related deaths in the United States from 1999 to 2022. Data on demographic and regional information were analyzed and stratified by gender, race/ethnicity, age, regional, and urban rural classifications. Using the Joinpoint Regression Program (version 4.9.0.0 used, available from the National Cancer Institute, Bethesda, Maryland) the annual percentage change (APC) and average APC (AAPC) were calculated with 95%CI for extracted Age Adjusted Mortality Rates (AAMR).

RESULTS

From 1999 to 2022, there were 389916 viral hepatitis-related deaths in the United States. The overall AAMR increased from 1999 to 2013 (APC: 3.20%; 95%CI: 2.54-3.99; P < 0.001), then declined through 2022 (APC: -5.54%; 95%CI: -6.75 to -4.47; P < 0.001). Males accounted for 70.4% of deaths, with steeper declines in females (AAPC: -0.48%; 95%CI: -0.87 to -0.12; P < 0.05). The American Indian/Alaska Native population had the highest AAMR (AAPC: 2.90%; 95%CI: 2.30 to 3.68; P < 0.001). The population of 65-74 years had the largest increase in overall crude mortality rate (AAPC: 3.20%; 95%CI: 2.77 to 3.85; P < 0.001). Mortality was highest in the West (AAPC: –0.78%; 95%CI –1.28 to –0.29; P < 0.05). Rural AAMR exceeded urban rates after 2015.

CONCLUSION

This study found significant racial, ethnic, and geographical disparities in viral hepatitis AAMR. Key factors for mortality reduction include patient education, screening, and access to hepatitis vaccination and treatment.

Keywords: Viral hepatitis; Mortality; Trends; Hepatitis; Center for disease control wonder database

Core Tip: This study examines disparities in viral hepatitis-related mortality across gender, racial/ethnic, age-group and geographical groups in the United States from 1999 to 2022. Various factors have contributed to the decrease in viral hepatitis-related mortality during this time such as direct-acting antivirals in the treatment for hepatitis C virus, and vaccinations in the prevention of hepatitis B virus. However, social determinants of health have contributed to persistent mortality, and in some cases increases in mortality, despite prevention and treatment options, emphasizing the need for targeted public health interventions.