Acute hepatitis B in Japan: Incidence, clinical practices and health policy

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http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2010.00745.x/abstract

Acute hepatitis B in Japan: Incidence, clinical practices and health policy

Akahito Sako1, Hideo Yasunaga2,*, Hiromasa Horiguchi2, Hideki Hashimoto3,

Naohiko Masaki1, Shinya Matsuda4Article first published online: 25 NOV 2010

DOI: 10.1111/j.1872-034X.2010.00745.x

© 2010 The Japan Society of Hepatology

Issue

Hepatology Research

Early View (Articles online in advance of print)

Aim:  The epidemiology of acute hepatitis B is unknown in many countries, and

the clinical features of this disease remain unclear. In this study, we used the

Diagnosis Procedure Combination (DPC) database to estimate the incidence of

acute hepatitis B and investigate the clinical practices for acute hepatitis B

in Japan.

Methods:  The DPC database is a nationwide discharge abstract and

administrative claims database, covering 40% of all inpatient admissions to

acute care hospitals between 1 July and 31 December each year in Japan. We

identified cases with a diagnosis of acute hepatitis B between 2007 and 2008.

Patient characteristics, length of stay, in-hospital mortality and total charges

were determined. Clinical practice patterns were examined, including drugs used

and procedures performed during hospitalization.

Results:  We identified 890 cases with acute hepatitis B among 5.85 million

inpatients in the database. The mean age was 40.0 years old and 76% were male.

The incidence of acute hepatitis B was estimated to be approximately

2100–2400/year (17–19/1 million people per year). Of 890 cases, 53 (6.0%)

developed fulminant hepatitis and 36 (4.0%) died. Nucleos(t)ide analogs were

prescribed for 226 cases (25.4%). Only 194 cases (21.8%) were tested for HIV

status.

Conclusion:  It is essential to monitor the trends of this communicable and

preventable disease. The establishment and distribution of appropriate clinical

evidence and guidelines are vital to improve the clinical practices for acute

hepatitis B.