Reduce reported rate of hepatitis B-related deaths by 20% or more

Summary of Findings

There has been progress in reducing hepatitis B-related deaths since 2013. The age-adjusted hepatitis B-related mortality rate decreased from 0.46 per 100,000 population in 2017 to 0.42 in 2019, but increased to 0.45 in 2020, above the target rate of 0.42. The increase in age-adjusted hepatitis B-related mortality observed during 2020 may have been affected by the overall increase in US mortality during 2020 due to the COVID-19 pandemic; therefore, 2020 data should be interpreted with caution.

Reduction needed to meet 2025 goal:

An 18% reduction from the 2020 rate of hepatitis B-related deaths is needed to meet the 2025 goal of 0.37 deaths per 100,000 population.

This reduction can best be achieved by:

• Increasing access to testing for hepatitis B.
• Increasing access to care and appropriate treatment for persons living with chronic hepatitis B infection.
• Developing trainings, technical assistance, and tools for primary-care and other health care providers to support implementation of hepatitis B testing and referral to care.
• Using digital technology and telemedicine models to expand access to specialty health care providers.
• Developing innovative and useful clinical decision support tools that increase implementation of hepatitis B screening, testing, and linkage to care.
• Conducting cost-benefit analyses to determine how payer policies can be revised to expand access to hepatitis B services.
• Supporting research and development for new and more effective anti-viral therapies with the goal of a functional cure for hepatitis B.

Technical Notes

Data Sources:
CDC, National Vital Statistics System (NVSS)

Numerator:
Number of death records with a report of hepatitis B listed as the underlying or one of the multiple causes of death

Denominator:
Total US Census population

Indicator Notes:
(1) Death certificates are completed for all deaths registered in the United States. Information for death certificates is provided to funeral directors or cremation organizations by attending physicians, medical examiners, and coroners. Death certificates are filed in vital statistics offices within each state and the District of Columbia. Through the NVSS, information from death certificates is compiled by CDC to produce national multiple-cause-of-death data; causes of death are coded in accordance with the International Classification of Diseases, Tenth Revision. (2) National multiple-cause mortality data from NVSS were obtained and analyzed, and those death records with a report of hepatitis B (ICD-10: B16, B17.0, B18.0, or B18.1) listed as the underlying or one of the multiple (i.e., contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis B among U.S. residents of the 50 states and District of Columbia divided by the total US Census population using the bridged-race postcensal estimates of the July 1 resident population. Rates were standardized to the age distribution of the 2000 US Standard Population.

Goal Setting:
The 2025 goal of 0.37 hepatitis B-related deaths per 100,000 population is consistent with CDC’s Division of Viral Hepatitis 2025 Strategic Plan and HHS’s 2021-2025 Viral Hepatitis National Strategic Plan. Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).

Limitations:
Mortality data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial/ethnic populations in US Census data and underreporting of viral hepatitis as a cause of death on death certificates.