Endemic hepatitis B virus infection and chronic liver disease mortality in the Republic of Palau, 1990—2002

Type Journal Article - Transactions of the Royal Society of Tropical Medicine and Hygiene
Title Endemic hepatitis B virus infection and chronic liver disease mortality in the Republic of Palau, 1990—2002
Author(s)
Volume 100
Issue 12
Publication (Day/Month/Year) 2006
Page numbers 1130-1134
Publisher Royal Society of Tropical Medicine and Hygiene
URL https://academic.oup.com/trstmh/article-abstract/100/12/1130/1894992
Abstract
In the Republic of Palau, a Pacific island nation, approximately 20% of the population is chronically infected with hepatitis B virus (HBV) and is at risk of developing chronic liver disease (CLD), including cirrhosis and hepatocellular carcinoma (HCC). To examine the consequences of HBV infection, we sought to quantify HBV-related CLD mortality in this population. The cause of death was abstracted from death certificates of all persons who died in Palau during 1990–2002. CLD deaths were categorised as cirrhosis or HCC. HBV serological status was determined by review of a hospital database. The cause of death was determined for 1366 (85%) of 1608 deaths. CLD was the fifth most common cause of death, accounting for 102 (7%) deaths with a known cause. Of deaths due to CLD, 55 (54%) were from cirrhosis and 47 (46%) were from HCC. Sixty-five percent of CLD decedents and 19% of non-CLD decedents were chronically infected with HBV (P < 0.01). The attributable fraction of HBV-related CLD was 54% (58% for cirrhosis and 53% for HCC). CLD mortality rates were approximately twice the worldwide CLD rate. HBV-related CLD is a common cause of death in the Republic of Palau, highlighting the importance of routine infant hepatitis B vaccination, especially in countries with high endemicity.