2016 Hepatitis B and C Annual Surveillance Report Viral Hepatitis Surveillance and Prevention Unit Table of Contents Viral Hepatitis Data Summary ....................................................................................................................................3 Background and Technical Notes ................................................................................................................................7 Michigan Census and Demographics ......................................................................................................................... 12 Population by Age, Gender & Education .......................................................................................................................... 13 Population by Race & Ethnicity ......................................................................................................................................... 14 Poverty, Income & Health Insurance ................................................................................................................................ 15 Acute Hepatitis B ..................................................................................................................................................... 17 Acute Hepatitis B—Incidence and Gender ....................................................................................................................... 18 Acute Hepatitis B—Race and Ethnicity ............................................................................................................................. 19 Acute Hepatitis B—Risk Behaviors .................................................................................................................................... 20 Acute Hepatitis B Rate Maps by County, Local Health Jurisdiction, and Region .............................................................. 21 Chronic Hepatitis B .................................................................................................................................................. 22 Chronic Hepatitis B—Incidence and Gender .................................................................................................................... 23 Chronic Hepatitis B—Race and Ethnicity .......................................................................................................................... 24 Chronic Hepatitis B Rate Maps by County, Local Health Jurisdiction, and Region ........................................................... 26 Acute Hepatitis C ..................................................................................................................................................... 27 Acute Hepatitis C—Incidence and Gender........................................................................................................................ 28 Acute Hepatitis C—Race and Ethnicity ............................................................................................................................. 29 Acute Hepatitis C Rate Maps by County, Local Health Jurisdiction, and Region .............................................................. 31 Chronic Hepatitis C ................................................................................................................................................... 32 Chronic Hepatitis C—Incidence and Gender .................................................................................................................... 33 Chronic Hepatitis C—Race and Ethnicity .......................................................................................................................... 34 Chronic Hepatitis C—Risk Behaviors ................................................................................................................................. 35 Chronic Hepatitis C Rate Maps by County, Local Health Jurisdiction, and Region ........................................................... 36 Hepatitis C Testing & Treatment ............................................................................................................................... 37 Hepatitis C—Testing and Genotype Data ......................................................................................................................... 38 Hepatitis C Bureau of Labs (BOL) Testing .......................................................................................................................... 39 Viral Hepatitis Medicaid Data ........................................................................................................................................... 43 Hepatitis C—MI Behavioral Risk Factor Survey Data ........................................................................................................ 44 Special Populations .................................................................................................................................................. 48 Young Adults (18-29 years of age) .................................................................................................................................... 49 Young Adult (18-29 years old) HCV Case Rate Maps by County, Local Health Jurisdiction, and Region .......................... 52 Heroin Abuse and Treatment Data ................................................................................................................................... 53 Emergency Department Syndromic Surveillance Data ..................................................................................................... 54 Opioid Overdose Death Rate Maps by County, Local Health Jurisdiction, and Region .................................................... 56 Heroin Overdose Death Rate Maps by County, Local Health Jurisdiction, and Region .................................................... 57 Treatment Episode Data Sets (TEDS) Rate Maps by County, Local Health Jurisdiction, and Region ................................ 58 Hepatitis and HIV Co-infections ........................................................................................................................................ 59 Perinatal Hepatitis B ......................................................................................................................................................... 62 Viral Hepatitis Outcomes.......................................................................................................................................... 64 Viral Hepatitis Hospitalizations and Liver Transplants ...................................................................................................... 65 Viral Hepatitis-Related Cancer & Mortality ...................................................................................................................... 66 Appendices .............................................................................................................................................................. 69 Appendix A1: County Hepatitis Data ................................................................................................................................ 70 Appendix A2: Heroin Data by County ............................................................................................................................... 72 Appendix B1: Hepatitis Data by Local Health Jurisdiction ................................................................................................ 74 Appendix B2: Heroin Data by Local Health Jurisdiction .................................................................................................... 75 Appendix C1: Hepatitis Data by Region ............................................................................................................................ 76 Appendix C2: Heroin Data by Region ................................................................................................................................ 77 2 | P a g e Viral Hepatitis Data Summary Viral Hepatitis Data Summary 3 | P a g e Viral Hepatitis Data Summary Table 1. Summary of Demographic Information by Type of Hepatitis, Michigan, 2016 % % Acute % Acute Chronic Acute % Acute Chronic Chronic Chronic MI % MI Variable Hepatitis Hepatitis Hepatitis Hepatitis Hepatitis Hepatitis Hepatitis Hepatitis Population Population B B B C C C B C n 46 100% 1,284 100% 154 100% 11,883 100% 9,922,576 100% Sex Male 24 52% 745 58% 86 56% 6,946 58% 4,877,067 49% Female 22 48% 538 42% 68 44% 4,906 41% 5,045,509 51% Unknown 0 0% 1 0% 0 0% 31 0% 0 0% Race and Ethnicity Caucasian 33 72% 361 28% 126 82% 5,492 46% 7,801,483 79% Black or African 8 17% 312 24% 13 8% 2,119 18% 1,378,111 14% American Hispanic 1 2% 24 2% 1 1% 213 2% n/a* - Asian 1 2% 242 19% 1 1% 51 0% 293,157 3% American Indian or Alaskan 0 0% 2 0% 1 1% 69 1% 53,668 1% Native Other 0 0% 63 5% 3 2% 175 1% 392,400** 4% Unknown 3 7% 280 22% 9 6% 3,764 32% 3,757 0% Age Mean 47 - 46 - 37 - 49 - n/a* - Median 46 - 46 - 33 - 53 - 40 - Range 22-82 - 0-94 - 0-80 - 0-100 - n/a* - 0-19 years 0 0% 54 4% 4 3% 149 1% 2,480,644 25% 20-29 years 8 17% 150 12% 55 36% 1,848 16% 1,339,548 14% 30-39 years 8 17% 268 21% 43 28% 2,065 17% 1,170,864 12% 40-49 years 11 24% 250 19% 26 17% 1,292 11% 1,250,245 13% 50-59 years 9 20% 268 21% 13 8% 2,607 22% 1,458,619 15% 60+ years 10 22% 294 23% 13 8% 3,911 33% 2,222,657 22% Unknown 0 0% 0 0% 0 0% 11 0% 0 0% * Data not available in 2015 census estimates ** Includes 2015 census estimates of "some other race" and "two or more races" The summary table