a2bf56c534853a673bdf83de0e5b845a 309292.pdf 1882933576ade54ee467c2741c7e4175a848d3b9 309292.pdf 41a5475be050495f4095236d9d8409d0f31a5cab64ce6c0696ec1484915c8193 309292.pdf Title: Hepatitis B Virus-Related Cirrhosis and Hepatocellular Carcinoma Hospital Discharge Rates from 2005 to 2021 in Spain: Impact of Universal Vaccination Subject: Background: The main consequences of chronic hepatitis B virus (HBV) infections are cirrhosis and hepatocellular carcinoma (HCC), both associated with frequent hospitalization. The aim of this study was to analyze the impact of universal HBV vaccination in Spain on chronic HBV-related hospital discharges from 2005 to 2021. Methods: Using data from the Minimum Basic Data Set of the Spanish National Health System, we calculated the hospital discharge rate ratio (HDRR) and 95% confidence interval (CI) values for chronic HBV-related discharges between 2005 and 2021. For comparative purposes, we calculated the HDRR and 95% confidence interval (CI) values for the early (2005–2013) and later (2014–2021) periods and the vaccinated compared with unvaccinated cohorts for the 20–39 age group. Results: The hospital discharge rate per 1,000,000 people was 3.08 in 2005 and 4.50 in 2021 for HCC, and 4.81 in 2005 and 1.92 in 2021 for cirrhosis. Comparing the early and later periods, values were higher for HCC (HDRR 1.13; 95% CI: 1.06–1.20) and lower for cirrhosis (HDRR 0.56; 95% CI: 0.51–0.60). The rate for the 20–39 age group was lower for the vaccinated compared with the unvaccinated cohorts overall (HDRR 0.53; 95% CI: 0.45–0.62), for HCC (HDRR 0.66; 95% CI: 0.53–0.82), and for cirrhosis (HDRR 0.41; 95% CI: 0.33–0.53). Conclusions: This study describes the important impact, after 25 years, of universal HBV vaccination in Spain: cirrhosis hospital discharge rate was reduced, and the vaccinated cohorts, compared with the unvaccinated cohorts in the 20–39 age group, had a lower hospital discharge rate of both HCC and cirrhosis. Keywords: hepatitis B; hepatocellular carcinoma; cirrhosis; impact evaluation; vaccination Author: Angela Domínguez, Ana Avellón, Victoria Hernando, Núria Soldevila, Eva Borràs, Ana Martínez, Conchita Izquierdo, Núria Torner, Carles Pericas, Cristina Rius and Pere Godoy Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Nov 5 05:13:04 2024 CET ModDate: Tue Nov 5 05:16:57 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1437824 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UURBZW+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 ZVJKNK+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 TERHTU+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 VKGAIS+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 GGUWXY+VnURWPalladioL Type 1 Custom yes yes yes 32 0 HFKHDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 77 0 HFKHFA+PalatinoLinotype TrueType WinAnsi yes yes no 80 0 HFKHFC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 83 0 HFKHKB+PalatinoLinotype TrueType MacRoman yes yes no 86 0 HFKHDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 100 0 HFKHFA+PalatinoLinotype TrueType WinAnsi yes yes no 103 0 HFKHFC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 106 0 HFKHKB+PalatinoLinotype TrueType MacRoman yes yes no 109 0 HFKHDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 121 0 HFKHFA+PalatinoLinotype TrueType WinAnsi yes yes no 124 0 HFKHFC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 127 0 HFKHKB+PalatinoLinotype TrueType MacRoman yes yes no 130 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 139 0 HFKHDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 154 0 HFKHFA+PalatinoLinotype TrueType WinAnsi yes yes no 157 0 HFKHFC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 160 0 HFKHKB+PalatinoLinotype TrueType MacRoman yes yes no 163 0 HFKHDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 176 0 HFKHFA+PalatinoLinotype TrueType WinAnsi yes yes no 179 0 HFKHFC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 182 0 HFKHKB+PalatinoLinotype TrueType MacRoman yes yes no 185 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-03-21 02:42:54 CET RepresentationInformation: 309292.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-03-20 10:01:22 CET Size: 1437824 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 421 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Hepatitis B Virus-Related Cirrhosis and Hepatocellular Carcinoma Hospital Discharge Rates from 2005 to 2021 in Spain: Impact of Universal Vaccination Author: Angela Domínguez, Ana Avellón, Victoria Hernando, Núria Soldevila, Eva Borràs, Ana Martínez, Conchita Izquierdo, Núria Torner, Carles Pericas, Cristina Rius and Pere Godoy Subject: Background: The main consequences of chronic hepatitis B virus (HBV) infections are cirrhosis and hepatocellular carcinoma (HCC), both associated with frequent hospitalization. The aim of this study was to analyze the impact of universal HBV vaccination in Spain on chronic HBV-related hospital discharges from 2005 to 2021. Methods: Using data from the Minimum Basic Data Set of the Spanish National Health System, we calculated the hospital discharge rate ratio (HDRR) and 95% confidence interval (CI) values for chronic HBV-related discharges between 2005 and 2021. For comparative purposes, we calculated the HDRR and 95% confidence interval (CI) values for the early (2005 2013) and later (2014 2021) periods and the vaccinated compared with unvaccinated cohorts for the 20 39 age group. Results: The hospital discharge rate per 1,000,000 people was 3.08 in 2005 and 4.50 in 2021 for HCC, and 4.81 in 2005 and 1.92 in 2021 for cirrhosis. Comparing the early and later periods, values were higher for HCC (HDRR 1.13; 95% CI: 1.06 1.20) and lower for cirrhosis (HDRR 0.56; 95% CI: 0.51 0.60). The rate for the 20 39 age group was lower for the vaccinated compared with the unvaccinated cohorts overall (HDRR 0.53; 95% CI: 0.45 0.62), for HCC (HDRR 0.66; 95% CI: 0.53 0.82), and for cirrhosis (HDRR 0.41; 95% CI: 0.33 0.53). Conclusions: This study describes the important impact, after 25 years, of universal HBV vaccination in Spain: cirrhosis hospital discharge rate was reduced, and the vaccinated cohorts, compared with the unvaccinated cohorts in the 20 39 age group, had a lower hospital discharge rate of both HCC and cirrhosis. 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