Hepatitis B Virus ¨C Reduce Deaths Among Non-Hispanic A/PI Persons

Age-adjusted rate* of hepatitis B-related deaths^† among non-Hispanic Asian/Pacific Islander persons^‡ and annual targets for the United States by year

Source: National Vital Statistics System (NVSS) data in this report are from the 2018–Present Provisional Multiple Cause of Death Data files in the CDC WONDER online database as of November 16, 2024.1
* Rates are per 100,000 population and age-adjusted to the 2000 US Standard Population.
† Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Diseases, 10^th Revision (ICD-10) codes B16, B17.0, B18.0, or B18.1.2
‡ Excludes those reporting Hispanic or Latino origin.

Summary of findings

Compared to the overall population, non-Hispanic Asian/Pacific Islander (A/PI) persons had a much higher age-adjusted hepatitis B-related death rate in 2023 (0.44 vs. 2.20 deaths per 100,000 population, respectively). The death rate among non-Hispanic A/PI persons decreased in 2023 but remained above the annual target rate of 1.84 deaths per 100,000 population. Minimal progress has been made in reducing hepatitis B-related deaths among non-Hispanic A/PI persons over the past decade, and rates among this population continue to remain substantially higher compared to all other racial and ethnic groups. Targeted efforts are needed to increase awareness, hepatitis B screening, diagnosis, and access to care and treatment to further reduce hepatitis B-related deaths among non-Hispanic A/PI persons.

This reduction can best be achieved by:

• Building and harnessing partnerships that amplify the use of effective prevention, testing, and treatment strategies in persons and settings with higher rates of hepatitis B virus (HBV) transmission.
• Developing trainings, technical assistance, and clinical decision support tools for primary care and other health care providers to support and increase implementation of hepatitis B vaccination, screening, testing, and care.
• Developing public health campaigns that raise awareness about hepatitis B and encourage non-Hispanic A/PI persons to be screened and vaccinated.
• Expanding access to hepatitis B vaccination, screening, and testing for all non-Hispanic A/PI persons.
• Increasing access to care and appropriate treatment for persons with chronic HBV infection.
• Promoting and implementing hepatitis B birth dose and childhood and adolescent immunization schedules.
• Promoting and implementing universal adult hepatitis B vaccination recommendations.
• Promoting and implementing universal hepatitis B screening for all adults at least once in their life and for every pregnant woman during each pregnancy.
• Supporting continuing medical education and developing partnerships with service providers to improve confidence and comfort when working with people with HBV infection.
• Supporting research and development for new and more effective antiviral therapies with the goal of a functional cure for hepatitis B.
• Using digital technology and telemedicine models to expand access to specialty health care providers.

Technical notes

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

Numerator: Number of death records among non-Hispanic A/PI persons with a report of hepatitis B listed as the underlying or one of the multiple causes of death

Denominator: Total United States Census population of non-Hispanic A/PI persons

Indicator notes: Death certificates are completed for all deaths registered in the US.1 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, 10^th Revision (ICD-10).2 National Multiple Cause of Death 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 (contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis B among non-Hispanic A/PI persons who were US residents in the 50 states and the District of Columbia divided by the total US Census population of non-Hispanic A/PI persons in these jurisdictions using the postcensal estimates of the July 1 resident population. Rates were standardized to the age distribution of the 2000 US Standard Population.3

Goal setting: The 2025 goal of 1.84 hepatitis B-related deaths per 100,000 population among non-Hispanic A/PI persons is consistent with CDC’s Division of Viral Hepatitis 2025 Strategic Plan and the . Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).

Limitations: Death data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial and/or ethnic populations in US Census data, and underreporting of viral hepatitis as a cause of death on death certificates.4