Hospitalizations and Mortality Due to Hepatitis B in Older Adults: A Comparative Analysis of Brazil, Rio De Janeiro, and Rio Grande Do Sul (2014–2024)

Hepatitis B is a viral infection that is considered a public health problem in Brazil, especially among older adults, who may progress more rapidly and have a higher risk of complications and mortality. The Brazilian states with the largest older-adult populations are Rio Grande do Sul (RS) and Rio de Janeiro (RJ), which serve as a comparative and analytical basis for evaluating hospitalizations, mortality, and average length of hospital stay in this age group from 2014 to 2024. This is an observational, descriptive, retrospective study based on secondary data obtained from the Notifiable Diseases Information System (SINAN) from 2014 to 2024 for Brazil and the states of RS and RJ. Age group, hospitalizations, in-hospital deaths, and average length of stay were analyzed. In Brazil, 3,792 hepatitis B hospitalizations in older adults were analyzed, with predominance in the 60–69 age group (60%), and 17% in-hospital deaths, distributed as follows: 60–69 years = 51%, 70–79 years = 32%, and ≥80 years = 17%. Length of stay was 9.1 days (60–69 years), 9.2 days (70–79 years), and 11.5 days (≥80 years). In Rio de Janeiro, there were 47 hospitalizations, most frequently among those aged 60–69 years (53%), with 23% in-hospital deaths (60–69 years = 54%, 70–79 years = 23%, and ≥80 years = 23%) and a mean length of stay (days) of 10.6 for ages 60–69, 9.4 for 70–79, and 11.7 for ≥80. Rio Grande do Sul had a total of 26 hospitalizations, with predominance among ages 60–69 (50%), 11.5% in-hospital deaths (60–69 years = 50%, 70–79 years = 38.4%, and ≥80 years = 11.6%), and a mean length of stay of 8.6 days for ages 60–69, 7.4 days for 70–79, and 7.3 days for ≥80. Regional differences in hepatitis B hospitalizations among older adults were observed. In Brazil and in RJ, hospitalizations and deaths predominated in the 60–69 age group; however, in RJ the proportion of deaths in ages 70–79 was equal to that in ≥80 years. In RS, although hospitalizations and deaths followed the same general pattern, in-hospital case fatality was lower, whereas RJ exceeded the national average. Regarding average length of hospital stay, an increase with advancing age was observed in Brazil and RJ. In contrast, in RS length of stay decreased with age, possibly due to faster diagnosis and treatment or lower-case severity. Therefore, regional strategies are needed for early diagnosis, effective management, and prevention of hepatitis B in older adults.