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Background: Hepatitis B virus (HBV) infection is a global health problem. Immigrants to the United States have a high prevalence of HBV infection. Understanding the HBV infection trends and its distribution can improve prevention and control strategies. This study was to determine the infection trends, distribution, and factors associated with HBV infection in Delaware. Methods: We performed a retrospective study on persons suspected of having HBV infection reported to Delaware Division of Public Health’s Surveillance System during January 1, 2005-December 31, 2015. The charts of 4, 981 persons were reviewed and included in the analysis. Results: Of these 4, 981 persons, 2, 119 (42.5%) had HBV infection. During 2005-2015, acute and chronic HBV infection declined 80.9% and 60%, respectively for an overall reduction of 62.2%. Males had a higher yearly infection rate. Rates declined 63.5% among males and 60.1% among females. There was an increase of 13.4% in the HBV infection in females during 2010-2015. HBV infection declined in all racial groups. Asians had a higher yearly infection rate and it increased 40.0% during 2010-2015. HBV infection declined in all age groups. However, an increase of 12.2% was seen among those 15-39 years during 2010-2015. Sixty-six percent of infected patients were in five cities: Wilmington, Newark, New Castle, Dover, and Bear. In a multivariable logistic model, significant predictors for HBV infection included being male [adjusted odds ratio (aOR): 1.6, 95% CI: 1.4-1.8], age 15-39 years and 40-59 years (aOR: 3.7, 95% CI: 2.3-5.9 and 2.4, 95%CI: 1.5-3.8). Asian, black, and other race had a greater risk compared with white, with aOR of 5.8 (95% CI: 4.8-7.0), 1.7 (95% CI: 1.4-1.9), and 1.4 (95% CI: 1.1-1.9), respectively. Conclusions: HBV infection is significant in Delaware and concentrated mainly in a few cities. Despite an overall decline, increases were seen among females, in the 15-39 age group, and in the Asian population during 2010-2015. Further studies should be conducted to identify factors contributing to these increases

Infection Trend, Distribution, and Factors Associated with Hepatitis B Virus Infection in Delaware, 2005-2015