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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Increase the proportion of people who know they have chronic hepatitis B — IID‑13 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Health and Nutrition Examination Survey (NHANES), CDC/NCHS

Baseline: 32.4 percent of persons with chronic hepatitis B were aware they have chronic hepatitis B in 2013-16

Target: 90.0 percent

Numerator
Number of persons aged 6 years and over with chronic hepatitis B (i.e., blood sample tested positive for hepatitis B core antibody (anti-HBc) and hepatitis B surface antigen (HBsAg)) and who report ever having been told that they had hepatitis B.
Denominator
Number of persons aged 6 years and over who were interviewed (self, parent or caregiver) and provided a blood sample which tested positive for hepatitis B core antibody and surface antigen indicating current, likely chronic, infection at the time of the NHANES examination.
Target-setting method
Maintain consistency with national programs, regulations, policies, or laws
Target-setting method justification
The target was selected to align with the 2030 target presented in the Viral Hepatitis National Strategic Plan (VH-NSP) for the indicator "Increase proportion of people with hepatitis B infection aware of their infection to 50% by 2025 and 90% by 2030." The Indicators subcommittee of the VH-NSP, in consultation with HHS leadership, set quantitative targets to eliminate viral hepatitis as a public health threat by 2030, in alignment with WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 and the US National Academies of Sciences, Engineering, and Medicine A National Strategy for the Elimination of Hepatitis B and C.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2015-2016 National Health and Nutrition Examination Survey:

Numerator and Denominator:
Has a doctor or other health professional ever told {you/SP} that {you have/s/he/SP has} Hepatitis B? (Hepatitis is a form of liver disease. Hepatitis B is an infection of the liver from the Hepatitis B virus (HBV).)
  1. Yes
  2. No
  3. Refused
  4. Don't know

Methodology notes

Beginning in 2013 and continuing through 2016, all NHANES participants aged 6 years and older (or their parents or caregivers) were asked at the home interview survey, before the NHANES blood test for hepatitis B, if they had ever been told that they had hepatitis B. Following the home interview, blood was drawn during the examination component of the survey and subsequently tested for anti-HBc and HBsAg at the CDC's Division of Viral Hepatitis laboratory. Due to small sample sizes and instability of estimates for hepatitis B, multiple NHANES samples must be aggregated. Aggregate estimates for 2013-2016 are weighted using the NHANES survey weights. Rolling estimates will be used (e.g., second data point will be for 2015-2018 NHANES surveys) for future data points. The estimates are considered representative of the US civilian non-institutional household population. NHANES estimates have been critiqued for use in estimating prevalence of viral hepatitis in the United States because the sampling frame omits by design, or may under-represent, certain populations expected to have higher prevalence of hepatitis C, such as persons living in correctional facilities or experiencing homelessness (Holmberg 2013, Edlin 2015). Similar concerns may be a consideration for NHANES estimates of hepatitis B. However, beginning in 2011, NHANES began oversampling the Asian population in the United States, a population in which prevalence of hepatitis B may be higher for persons who migrated to the United States as adults or whose parents did, from countries with higher prevalence of hepatitis B (Roberts 2015).

History

Comparable HP2020 objective
Related, which includes objectives that have the same or a similar intent to either a measurable or developmental/archived objective in Healthy People 2020.
Revision History
Revised. 

In 2021, to align with the Viral Hepatitis National Strategic Plan (VH-NSP), the target-setting method was changed from "minimal statistical significance" to "maintain consistency with national programs, regulations, policies or laws." The target was revised from 56.0 percent to 90.0 percent.