Publications by authors named "Kathleen N Ly"

Background And Aims: In the United States, hepatitis C virus (HCV) infection occurs primarily through injection drug use (IDU), but transmission also occurs through other ways. This study examined HCV prevalence and disparities among US residents aged 12-59 years with no IDU history.

Methods: We analysed 2013-March 2020 National Health and Nutrition Examination Survey data to calculate the HCV prevalence among people with no drug use history and only a non-IDU history, collectively referred to as no IDU history.

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Hepatitis A is a vaccine-preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person-to-person transmission have been widespread in the United States since 2016. We used public-use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A-listed deaths during non-outbreak (2011-2015) and outbreak (2017-2021) periods and assessed the median age at death among decedents with and without hepatitis A-listed deaths during the outbreak period.

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Article Synopsis
  • Injection drug use (IDU) significantly contributes to viral hepatitis, HIV, and drug overdose, but national data often lacks IDU information, hindering accurate assessment of its impact.
  • This study utilized 2019-2021 hepatitis C case data to compare different methods of imputing missing IDU information, including listwise deletion and multiple imputation models like logistic regression, predictive mean matching, and random forest.
  • Results showed that random forest methods, particularly the fast implementation, provided the most accurate and efficient estimates of IDU prevalence, suggesting they could improve surveillance and prevention strategies for IDU-related health issues.
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Background: Current US hepatitis B mortality rates remain three times higher than the national target. Mortality reduction will depend on addressing hepatitis B disparities influenced by social determinants of health.

Objectives: This study aims to describe characteristics of hepatitis B-listed decedents, which included US birthplace status and county social vulnerability attributes and quantify premature mortality.

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Objectives: Hepatitis C virus (HCV) infection is the most common bloodborne infection in the United States. We assessed trends in HCV testing, infection, and surveillance cases among US adults.

Methods: We used Quest Diagnostics data from 2013-2021 to assess trends in the numbers tested for HCV antibody and proportion of positivity for HCV antibody and HCV RNA.

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The application of a care continuum model (CCM) can identify gaps in diagnosis, care, and treatment of populations with a common condition, but challenges are inherent in developing a CCM for chronic hepatitis B. In contrast with treatment for HIV or hepatitis C, treatment is not indicated for all people with chronic hepatitis B, clinical endpoints are not clear for those receiving treatment, and those for whom treatment is not indicated remain at risk for complications. This topical review examines the data elements necessary to develop and apply chronic hepatitis B CCMs at the jurisdictional health department level.

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Background: Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complication that has disproportionately affected racial/ethnic minority children. We conducted a pilot study to investigate risk factors for MIS-C aiming to understand MIS-C disparities.

Methods: This case-control study included MIS-C cases and SARS-CoV-2-positive outpatient controls less than 18 years old frequency-matched 4:1 to cases by age group and site.

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Importance: US hepatitis B mortality has been described nationally, but examination subnationally may identify differences in mortality rates and decedent characteristics, including birthplace.

Objective: To examine characteristics of decedents with hepatitis B-listed deaths during 2010 to 2019 and compare age-adjusted hepatitis B-listed death rates during 2010 to 2019 vs 2000 to 2009.

Design, Setting, And Participants: This cross-sectional study used Multiple Cause of Death data from 50 US states and the District of Columbia (DC) from 2000 to 2019 to assess characteristics of US residents with hepatitis B listed as an underlying cause of death (UCOD) or contributing cause of death on death certificates.

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Persons with isolated antibody to hepatits B virus (HBV) core antigen (IAHBc) may have occult HBV infection (OBI), which is associated with reactivation and potential risk for hepatocellular carcinoma and HBV transmission. We used National Health and Nutrition Examination Survey data to estimate US IAHBc prevalence and published studies of IAHBc-associated OBI prevalence to estimate OBI burden. During 2001-2018, the prevalence of IAHBc was 0.

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Article Synopsis
  • HBV is a major health issue in the USA, leading to chronic liver disease and liver cancer, prompting a study to assess infection rates and immunity from 2013-2018.
  • Data from the National Health and Nutrition Examination Survey revealed that a significant portion of the population, especially non-US-born residents, is affected by chronic HBV infection, with many being susceptible to the virus.
  • Despite a growing number of vaccinated individuals, the prevalence of chronic hepatitis B has remained stable at 0.3% since 1999, indicating ongoing public health challenges.
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Background: After decades of decline, US acute hepatitis B incidence flattened since 2011. In persons aged ≥40 years and in jurisdictions affected by the opioid crisis, there is an increase in new cases. Data suggest new infections are occurring among US-born persons.

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Background: Despite national immunization efforts, including universal childhood hepatitis A (HepA) vaccination recommendations in 2006, hepatitis A virus (HAV)-associated outbreaks have increased in the United States. Unvaccinated or previously uninfected persons are susceptible to HAV infection, yet the susceptibility in the US population is not well known.

Methods: Using National Health and Nutrition Examination Survey 2007-2016 data, we estimated HAV susceptibility prevalence (total HAV antibody negative) among persons aged ≥2 years.

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Background: Mortality associated with hepatitis C virus (HCV) has been well-documented nationally, but an examination across regions and jurisdictions may inform health-care planning.

Methods: To document HCV-associated deaths sub-nationally, we calculated age-adjusted, HCV-associated death rates and compared death rate ratios (DRRs) for 10 US regions, 50 states, and Washington, D.C.

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Article Synopsis
  • Hepatitis B virus (HBV) prevalence is significantly higher among adults with a history of injection drug use (IDU), with nearly 20% showing signs of previous or ongoing infection compared to only 4.6% in the general population.
  • Analysis of data from the National Health and Nutrition Examination Survey (2001-2016) revealed key demographic factors, such as sex and ethnicity, linked to HBV infection rates among those with IDU history.
  • The findings underscore the need for targeted public health interventions, including safe injection practices and vaccination campaigns for hepatitis A and B, to help reduce the spread of viral hepatitis in this high-risk group.
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Background: According to death certificates, approximately 1800 persons die from hepatitis B annually in the United States; however, this figure may underestimate true mortality from chronic hepatitis B (CHB).

Methods: We analyzed data from CHB patients seen in the Chronic Hepatitis Cohort Study (CHeCS) between 1 January 2006 and 31 December 2013. We compared overall and cause-specific death rates and mean ages at death between CHeCS CHB decedents and U.

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Background: Mother-to-child transmission of hepatitis B can be prevented with vaccination and screening. Foreign-born women living in the United States may have lower vaccination coverage and greater lifetime exposure to hepatitis B virus than US-born women. This study compares self-reported hepatitis B vaccination and screening between US-born and foreign-born women of reproductive age and examines predictors.

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The prevalence of hepatitis C virus (HCV) infection in the Kenyan population has not been previously determined. We estimated the Kenyan HCV prevalence in HIV-negative persons aged 15-64 years. This is a retrospective cross-sectional study using data from the 2007 Kenya AIDS Indicator Survey-a nationally representative sample of 15,853 persons aged 15-64 years who completed a health interview and provided a blood specimen.

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Background: In the United States, hepatitis C virus (HCV) infection has increased among young persons who inject drugs, but the extent of this epidemic among reproductive-aged women and their children is unknown.

Objective: To estimate numbers and describe characteristics of reproductive-aged women with HCV infection and of their offspring.

Design: Analysis of the National Notifiable Diseases Surveillance System (NNDSS) from 2006 to 2014 and the Quest Diagnostics Health Trends national database from 2011 to 2014.

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Article Synopsis
  • Current estimates indicate that hepatitis B virus (HBV) infection prevalence in Kenya is between 5-8%, but a specific study found that about 31.5% of HIV-negative adults and adolescents have been exposed to HBV.
  • The data was gathered from the 2007 Kenya AIDS Indicator Survey, showing approximately 6.1 million people in the country have had past or present HBV infection, with around 398,000 estimated to have chronic HBV infection (CHBI).
  • Understanding the prevalence of HBV infection is crucial for effective public health planning, decision making, and evaluating the success of hepatitis prevention programs in Kenya.
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Background: Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers.

Methods: Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC's National Center for Health Statistics (NCHS).

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In the United States, hepatitis C virus (HCV)-associated mortality is increasing. From 2003-2013, the number of deaths associated with HCV has now surpassed 60 other nationally notifiable infectious conditions combined. The increasing HCV-associated mortality trend underscores the urgency in finding, evaluating, and treating HCV-infected persons.

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Article Synopsis
  • The prevalence of chronic hepatitis B virus (HBV) infection in the U.S. is influenced by both reduced susceptibility in young people due to vaccination and an influx of HBV-infected immigrants from endemic regions.
  • Serological data from the National Health and Nutrition Examination Survey (NHANES) show a stable chronic HBV infection rate of 0.3% since 1999, with higher rates among non-Hispanic blacks and non-Hispanic Asians.
  • There has been a significant increase in vaccine-induced immunity, rising from 57.8 million to 68.5 million vaccinated individuals from 1999 to 2012, reflecting a growing protection against HBV, particularly in the younger population.
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Background & Aims: Persons chronically infected with the hepatitis C virus (HCV) may be at higher risk for developing and dying from non-liver cancers than the general population.

Methods: 12,126 chronic HCV-infected persons in the Chronic Hepatitis Cohort Study (CHeCS) contributed 39,984 person-years of follow-up from 2006 to 2010 and were compared to 133,795,010 records from 13 Surveillance, Epidemiology and End Results Program (SEER) cancer registries, and approximately 12 million U.S.

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