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Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015

CONTEXT: In Pennsylvania, reporting of viral hepatitis B (HBV) and viral hepatitis C (HCV) infections to CDC has been mandated since 2002. Underreporting of HBV and HCV infections has long been identified as a problem. Few reports have described the accuracy of state surveillance case registries for...

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Autores principales: Roberts, Henry, Boktor, Sameh W., Waller, Kirsten, Daar, Zahra S., Boscarino, Joseph A., Dubin, Perry H., Suryaprasad, Anil, Moorman, Anne C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553716/
https://www.ncbi.nlm.nih.gov/pubmed/31170165
http://dx.doi.org/10.1371/journal.pone.0217455
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author Roberts, Henry
Boktor, Sameh W.
Waller, Kirsten
Daar, Zahra S.
Boscarino, Joseph A.
Dubin, Perry H.
Suryaprasad, Anil
Moorman, Anne C.
author_facet Roberts, Henry
Boktor, Sameh W.
Waller, Kirsten
Daar, Zahra S.
Boscarino, Joseph A.
Dubin, Perry H.
Suryaprasad, Anil
Moorman, Anne C.
author_sort Roberts, Henry
collection PubMed
description CONTEXT: In Pennsylvania, reporting of viral hepatitis B (HBV) and viral hepatitis C (HCV) infections to CDC has been mandated since 2002. Underreporting of HBV and HCV infections has long been identified as a problem. Few reports have described the accuracy of state surveillance case registries for recording clinically-confirmed cases of HBV and HCV infections, or the characteristics of populations associated with lower rates of reporting. OBJECTIVE: The primary objective of the current study is to estimate the proportion of HBV and HCV infections that went unreported to the Pennsylvania Department of Health (PDoH), among patients in the Geisinger Health System of Pennsylvania. As a secondary objective, we study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest: sex, age group, race/ethnicity, rural status, and year of initial diagnosis. DESIGN: Per medical record review, the study population was limited to Geisinger Health System patients, residing in Pennsylvania, who were diagnosed with a chronic HBV and/or HCV infection, between 2001 and 2015. Geisinger Health System patient medical records were matched to surveillance records of confirmed cases reported to the Pennsylvania Department of Health (PDoH). To quantify the extent that underreporting occurred among the Geisinger Health System study participants, we calculated the proportion of study participants that were not reported to PDoH as confirmed cases of HBV or HCV infections. An analysis of adjusted prevalence ratio estimates was conducted to study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest. RESULTS: Geisinger Health System patients living with HBV were reported to PDoH 88.4% (152 of 172) of the time; patients living with HCV were reported to PDoH 94.6% (2,257 of 2,386) of the time; and patients who were co-infected with both viruses were reported to PDoH 72.0% (18 of 25) of the time. Patients living with HCV had an increased likelihood of being reported if they were: less than or equal to age 30 vs ages 65+ {PR = 1.2, [95%CI, (1.1, 1.3)]}, and if they received their initial diagnosis of HCV during the 2010–2015 time period vs the 1990–1999 time period {PR = 1.08, [95%CI, (1.05, 1.12)]}. CONCLUSION: The findings in this study are promising, and suggests that PDoH has largely been successful with tracking and monitoring viral hepatitis B and C infections, among persons that were tested for HBV and/or HCV. Additional efforts should be placed on decreasing underreporting rates of HCV infections among seniors (ages 65 and over), and persons who are co-infected with HBV and HCV.
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spelling pubmed-65537162019-06-17 Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015 Roberts, Henry Boktor, Sameh W. Waller, Kirsten Daar, Zahra S. Boscarino, Joseph A. Dubin, Perry H. Suryaprasad, Anil Moorman, Anne C. PLoS One Research Article CONTEXT: In Pennsylvania, reporting of viral hepatitis B (HBV) and viral hepatitis C (HCV) infections to CDC has been mandated since 2002. Underreporting of HBV and HCV infections has long been identified as a problem. Few reports have described the accuracy of state surveillance case registries for recording clinically-confirmed cases of HBV and HCV infections, or the characteristics of populations associated with lower rates of reporting. OBJECTIVE: The primary objective of the current study is to estimate the proportion of HBV and HCV infections that went unreported to the Pennsylvania Department of Health (PDoH), among patients in the Geisinger Health System of Pennsylvania. As a secondary objective, we study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest: sex, age group, race/ethnicity, rural status, and year of initial diagnosis. DESIGN: Per medical record review, the study population was limited to Geisinger Health System patients, residing in Pennsylvania, who were diagnosed with a chronic HBV and/or HCV infection, between 2001 and 2015. Geisinger Health System patient medical records were matched to surveillance records of confirmed cases reported to the Pennsylvania Department of Health (PDoH). To quantify the extent that underreporting occurred among the Geisinger Health System study participants, we calculated the proportion of study participants that were not reported to PDoH as confirmed cases of HBV or HCV infections. An analysis of adjusted prevalence ratio estimates was conducted to study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest. RESULTS: Geisinger Health System patients living with HBV were reported to PDoH 88.4% (152 of 172) of the time; patients living with HCV were reported to PDoH 94.6% (2,257 of 2,386) of the time; and patients who were co-infected with both viruses were reported to PDoH 72.0% (18 of 25) of the time. Patients living with HCV had an increased likelihood of being reported if they were: less than or equal to age 30 vs ages 65+ {PR = 1.2, [95%CI, (1.1, 1.3)]}, and if they received their initial diagnosis of HCV during the 2010–2015 time period vs the 1990–1999 time period {PR = 1.08, [95%CI, (1.05, 1.12)]}. CONCLUSION: The findings in this study are promising, and suggests that PDoH has largely been successful with tracking and monitoring viral hepatitis B and C infections, among persons that were tested for HBV and/or HCV. Additional efforts should be placed on decreasing underreporting rates of HCV infections among seniors (ages 65 and over), and persons who are co-infected with HBV and HCV. Public Library of Science 2019-06-06 /pmc/articles/PMC6553716/ /pubmed/31170165 http://dx.doi.org/10.1371/journal.pone.0217455 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Roberts, Henry
Boktor, Sameh W.
Waller, Kirsten
Daar, Zahra S.
Boscarino, Joseph A.
Dubin, Perry H.
Suryaprasad, Anil
Moorman, Anne C.
Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title_full Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title_fullStr Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title_full_unstemmed Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title_short Underreporting of Hepatitis B and C virus infections — Pennsylvania, 2001–2015
title_sort underreporting of hepatitis b and c virus infections — pennsylvania, 2001–2015
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553716/
https://www.ncbi.nlm.nih.gov/pubmed/31170165
http://dx.doi.org/10.1371/journal.pone.0217455
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