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Viral Hepatitis contribures to the burden of chronic liver disease in the USA

This month's issue of the American Journal of Gastroenterology examines the contribution of viral hepatitis to the burden of chronic liver disease in the United States.

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Chronic liver disease (CLD) is increasingly recognized as a major public health problem.

However, in the United States, there are few nationally representative data on the contribution of viral hepatitis as an etiology of chronic liver disease.

Dr Henry Roberts and colleagues from Georgia, USA applied a previously used International Classification of Diseases, Ninth Revision, Clinical Modification-based definition of chronic liver disease cases to the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey databases for 2006–2010.

The researchers estimated the mean number of chronic liver disease visits per year, prevalence ratio of visits by patient characteristics, and the percentage of chronic liver disease visits attributed to viral hepatitis and other selected etiologies.

From 2006 to 2010, almost 50% of chronic liver disease-related ambulatory visits were attributed to viral hepatitis B and C
American Journal of Gastroenterology

An estimated 6.0 billion ambulatory care visits occurred in the United States from 2006 to 2010, of which an estimated 25.8 million were chronic liver disease-related.

The team observed that among adults aged 45–64 years, Medicaid and Medicare recipients were 3.9, and 2.3 times more likely to have a chronic liver disease-related ambulatory visit than those with private insurance, respectively.

In the United States, from 2006 to 2010, almost 50% of all chronic liver disease-related ambulatory visits were attributed solely to viral hepatitis B and C diagnoses.

Dr Roberts' team concludes, "In this unique application of health-care utilization data, we confirm that viral hepatitis is an important etiology of chronic liver disease in the United States, with hepatitis B and C contributing approximately one-half of the chronic liver disease burden."

"Chronic liver disease ambulatory visits in the United States disproportionately occur among adults, aged 45–64 years, who are primarily minorities, men, and Medicare or Medicaid recipients."

Am J Gastroenterol 2014; 109: 387–393
14 March 2014

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