Economic and clinical burden of viral hepatitis in California: A population-based study with longitudinal analysis

Haesuk Park, Donghak Jeong, Pauline Nguyen, Linda Henry, Joseph Hoang, Yoona Kim, Edward Sheen, Mindie H. Nguyen

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9 Scopus citations


Background Economic burden of HBV and HCV infection are trending upwards. Aims Compare hepatitis B virus (HBV) and hepatitis C virus (HCV) related hospital admission rates, charges, mortality rates, causes of death in a US population-based study. Methods Retrospective cohort analysis of HBV and HCV patients from the California Office of Statewide Health Planning and Development (2006–2013) database. Results A total of 23,891 HBV and 148,229 HCV patients were identified. Across the 8-year period, the mean increase for all-cause ($1,863 vs $1,388) and liver-related hospitalization charges ($1,175 vs $675) were significantly higher for the HBV cohort compared to the HCV cohort. HBV patients had significantly higher liver-related hospital charges per person per year than HCV patients after controlling for covariates ($123,239 vs $111,837; p = 0.002). Compared to HCV patients, adjusted mortality hazard ratio was slightly lower in HBV patients (relative risk = 0.96; 95% CI 0.94–0.99). The major causes and places of death were different. The three major causes of death for HBV were: other malignant neoplasms (35%), cardiovascular disease/other circulatory disorders (17%), and liver-related disease (15%) whereas for HCV patients were: liver-related disease (22%), other malignant neoplasms (20%), and cardiovascular disease (16%). Regarding the place of death, 53% of HBV patients and 44% of HCV patients died in hospital inpatient, respectively. Conclusions HBV patients incurred higher liver-related hospital charges and higher mean increase for all-cause and liver-related hospitalization charges over the 8-year period compared to HCV patients. HBV patients had slightly lower mortality rate and their major causes and places of death were noticeably different from HCV patients.

Original languageEnglish
Article numbere0196452
JournalPloS one
Issue number4
StatePublished - Apr 2018


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