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Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

Chronic hepatitis B in Korean Americans: decreased prevalence and poor linkage to care

Authors: Chul S. Hyun, Sue Kim, Seung Y. Kang, Seo Jung, Seulgi Lee

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Chronic hepatitis B virus(HBV) infection is a major cause of liver related morbidity and mortality. HBV infection remains largely underdiagnosed in Asian American population, and it is also poorly linked to clinical care. We, therefore, assessed the HBV prevalence and evaluated linkage to care among Korean Americans in order to develop strategic plans to reduce the impact of HBV in a high risk community.

Methods

Serologic screening and survey were provided to 7157 Korean American adults (age 21–100) in New Jersey between December 2009 and June 2015. All participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core IgG antibody (anti-HBc). Additional survey was conducted on the subjects chronically infected with HBV on their history of infection. Self-administered questionnaires were employed to evaluate demographic and epidemiologic characteristics.

Results

Of those 7157screened, 171 (2.4 %) were HBV infected, 2736(38.2 %) were susceptible to HBV, and 4250(59.4 %) were immune. The prevalence of chronic HBV varied between the age groups: 1.18 % (age21-30); 2.53 % (age 31–40); 2.76 % (age 41–50); 2.90 % (age 51–60); 2.06 % (age 61–70); and 1.37 % (age 71–100). The rate of HBsAg was significantly higher in males (3.04 %) as compared to females (1.93 %). At least 75 % of these HBV infected subjects had been previously diagnosed, but were not engaged in care.

Conclusion

This screening study suggests that the HBV prevalence in Korean Americans is significantly lower than currently understood. On the other hand, many of the individuals chronically infected with HBV cannot access care, suggesting a poor linkage-to-care (LTC). Further, a large percentage of the population is still susceptible to HBV. Study findings will be used to develop strategies to tailor community-based HBV screenings and LTC to the high risk populations.
Literature
1.
go back to reference Hollinger FB, Liang TJ. Hepatitis B Virus. In: Knipe DM et al., editors. Fields Virology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 2971–3036. Hollinger FB, Liang TJ. Hepatitis B Virus. In: Knipe DM et al., editors. Fields Virology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 2971–3036.
2.
go back to reference Block TM, Mehta AS, Fimmel CJ, Jordan R. Molecular viral oncology of hepatocellular carcinoma. Oncogene. 2003;22(33):5093–107.CrossRefPubMed Block TM, Mehta AS, Fimmel CJ, Jordan R. Molecular viral oncology of hepatocellular carcinoma. Oncogene. 2003;22(33):5093–107.CrossRefPubMed
3.
go back to reference Lok AS, McMahon BJ. Chronic hepatitis B: AASLD practice guidelines. Hepatology. 2001;34(6):1225–41.CrossRefPubMed Lok AS, McMahon BJ. Chronic hepatitis B: AASLD practice guidelines. Hepatology. 2001;34(6):1225–41.CrossRefPubMed
5.
go back to reference Chang ET, So SK. Ten largest racial and ethnic health disparities in the United States based on healthy people 2010 objectives. Am J Epidemiol. 2007;166:1105–6.CrossRefPubMed Chang ET, So SK. Ten largest racial and ethnic health disparities in the United States based on healthy people 2010 objectives. Am J Epidemiol. 2007;166:1105–6.CrossRefPubMed
6.
go back to reference Cohen C, Evans AA, London WT, Block J, Conti M, Block T. Underestimation of chronic hepatitis B virus infection in the United States of America. J Viral Hepat. 2008;15(1):12–3.PubMedPubMedCentral Cohen C, Evans AA, London WT, Block J, Conti M, Block T. Underestimation of chronic hepatitis B virus infection in the United States of America. J Viral Hepat. 2008;15(1):12–3.PubMedPubMedCentral
7.
go back to reference Cohen C, Holmberg SD, McMahon BJ, Brosgart CL, Gish RF, London WT, Block TM. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18(6):377–83.CrossRefPubMed Cohen C, Holmberg SD, McMahon BJ, Brosgart CL, Gish RF, London WT, Block TM. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18(6):377–83.CrossRefPubMed
8.
go back to reference Hu KQ, Pan CQ, Goodwin D. Barriers to screening for hepatitis B virus infection in asian americans. Dig Dis Sci. 2011;56:3163–71.CrossRefPubMed Hu KQ, Pan CQ, Goodwin D. Barriers to screening for hepatitis B virus infection in asian americans. Dig Dis Sci. 2011;56:3163–71.CrossRefPubMed
9.
go back to reference Cohen C, Caballero J, Martin M, Weerasinghe I, Ninde M, Block J. Eradication of hepatitis B: A nationwide community coalition approach to improving vaccination, screening, and linkage to care. J Community Health. 2013;38(5):799–804.CrossRefPubMed Cohen C, Caballero J, Martin M, Weerasinghe I, Ninde M, Block J. Eradication of hepatitis B: A nationwide community coalition approach to improving vaccination, screening, and linkage to care. J Community Health. 2013;38(5):799–804.CrossRefPubMed
10.
go back to reference Nishimura A, Shiono P, Stier D. et al. Enhanced Surveillance for Chronic Hepatitis B-San Francisco, 2008 [abstr OP-57]. Washington, DC: Presented at the 13th International Symposium on Viral Hepatitis and Liver Disease. ISVHLD Abstracts. 2009. Nishimura A, Shiono P, Stier D. et al. Enhanced Surveillance for Chronic Hepatitis B-San Francisco, 2008 [abstr OP-57]. Washington, DC: Presented at the 13th International Symposium on Viral Hepatitis and Liver Disease. ISVHLD Abstracts. 2009.
11.
go back to reference Pollack H, Wan K, Miyoshi T, et al. Management of chronic hepatitis B virus (HBV) infection by primary care physicians in urban hospitals and clinics in New York City. [abstract 984]. Hepatology. 2007;46(Suppl):676A. Pollack H, Wan K, Miyoshi T, et al. Management of chronic hepatitis B virus (HBV) infection by primary care physicians in urban hospitals and clinics in New York City. [abstract 984]. Hepatology. 2007;46(Suppl):676A.
12.
go back to reference Philbin MM, Erby LA, Lee S, Juon HS. Hepatitis B and liver cancer among three asian american sub-groups: a focus group inquiry. J Immigr Minor Health. 2012;14(5):858–68.CrossRefPubMedPubMedCentral Philbin MM, Erby LA, Lee S, Juon HS. Hepatitis B and liver cancer among three asian american sub-groups: a focus group inquiry. J Immigr Minor Health. 2012;14(5):858–68.CrossRefPubMedPubMedCentral
13.
go back to reference Ward JW, Byrd KK. Hepatitis B in the United States: A major health disparity affecting many foreign-born populations. Hepatology. 2012;52(2):419–21.CrossRef Ward JW, Byrd KK. Hepatitis B in the United States: A major health disparity affecting many foreign-born populations. Hepatology. 2012;52(2):419–21.CrossRef
14.
go back to reference Upadhyaya N, Chang R, Davis C, Conti MC, Salinas Garcia D, Tang H. Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians. Postgrad Med. 2010;122(5):165–75.CrossRefPubMed Upadhyaya N, Chang R, Davis C, Conti MC, Salinas Garcia D, Tang H. Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians. Postgrad Med. 2010;122(5):165–75.CrossRefPubMed
15.
go back to reference Ferrante JM, Winston DG, Chen PH, de la Torre AN. Family physicians' knowledge and screening of chronic hepatitis and liver cancer. Fam Med. 2008;40(5):345–51.PubMed Ferrante JM, Winston DG, Chen PH, de la Torre AN. Family physicians' knowledge and screening of chronic hepatitis and liver cancer. Fam Med. 2008;40(5):345–51.PubMed
18.
go back to reference Hann HW, Hann RS, Maddrey WC. Hepatitis B virus infection in 6130 unvaccinated korean americans surveyed between 1988 and 1990. Am J Gastro. 2007;102:767–72.CrossRef Hann HW, Hann RS, Maddrey WC. Hepatitis B virus infection in 6130 unvaccinated korean americans surveyed between 1988 and 1990. Am J Gastro. 2007;102:767–72.CrossRef
19.
go back to reference Lee HO, Levin M, Kim F, Warner A, Park WJ. Hepatitis B infection among korean americans in Colorado: evidence of the need for serologic testing and vaccination. Hepat Mon. 2008;8(2):91–6. Lee HO, Levin M, Kim F, Warner A, Park WJ. Hepatitis B infection among korean americans in Colorado: evidence of the need for serologic testing and vaccination. Hepat Mon. 2008;8(2):91–6.
20.
go back to reference Navarro N, Lim N, Kim J, Joo E, Che K, Runyon BA, Mendler MH. Lower than expected hepatitis B virus infection prevalence among first generation Koreans in the U.S.: results of HBV screening in the Southern California Inland Empire. BMC Infect Dis. 2014;14:269–75.CrossRefPubMedPubMedCentral Navarro N, Lim N, Kim J, Joo E, Che K, Runyon BA, Mendler MH. Lower than expected hepatitis B virus infection prevalence among first generation Koreans in the U.S.: results of HBV screening in the Southern California Inland Empire. BMC Infect Dis. 2014;14:269–75.CrossRefPubMedPubMedCentral
21.
go back to reference Kim H, Shin AR, Chung HH, Kim MK, Lee JS, Shim JJ, Kim BH. Recent trends in hepatitis B virus infection in the general Korean population. Korean J Int Med. 2013;28:413–9.CrossRef Kim H, Shin AR, Chung HH, Kim MK, Lee JS, Shim JJ, Kim BH. Recent trends in hepatitis B virus infection in the general Korean population. Korean J Int Med. 2013;28:413–9.CrossRef
23.
go back to reference Park NH, Chung YH, Lee HS. Impacts of Vaccination on hepatitis B viral infections in Korea over a 25 year period. Intervirology. 2010;53:20–8.CrossRefPubMed Park NH, Chung YH, Lee HS. Impacts of Vaccination on hepatitis B viral infections in Korea over a 25 year period. Intervirology. 2010;53:20–8.CrossRefPubMed
24.
go back to reference Mast EE, Margolis HS, Fire AE. A comprehensive Immunization Strategy to eliminate transmission of hepatitis B infection in the United States: recommendations of the Advisory Committee on Immunization Practices part 1: Immunization of infants, children, and adolescents. MMWR Recom Rep. 2005 Dec. 23;54(RR16):1–31. Mast EE, Margolis HS, Fire AE. A comprehensive Immunization Strategy to eliminate transmission of hepatitis B infection in the United States: recommendations of the Advisory Committee on Immunization Practices part 1: Immunization of infants, children, and adolescents. MMWR Recom Rep. 2005 Dec. 23;54(RR16):1–31.
25.
go back to reference Lin HH, Wang LY, Hu CT. Decline of hepatitis B carrier rate in vaccinated and unvaccinated subjects: sixteen years after newborn vaccination program in Taiwan. J Med Virol. 2003;69:471–4.CrossRefPubMed Lin HH, Wang LY, Hu CT. Decline of hepatitis B carrier rate in vaccinated and unvaccinated subjects: sixteen years after newborn vaccination program in Taiwan. J Med Virol. 2003;69:471–4.CrossRefPubMed
26.
go back to reference Ma GX, Shive SE, Toubbeh JI, Tan Y, Wu D. Kowledge, attitudes, and behaviours of chinese hepatitis B screening and vaccination. Am J Health Behaviour. 2008;32:1788–187.CrossRef Ma GX, Shive SE, Toubbeh JI, Tan Y, Wu D. Kowledge, attitudes, and behaviours of chinese hepatitis B screening and vaccination. Am J Health Behaviour. 2008;32:1788–187.CrossRef
27.
go back to reference Stuver SO, Boschi-Pinto C, Trichopoulos D. Infection with hepatitis B and C viruses, social class and cancer. In: Kogevinas M, Pearce N, Susser M, Boffetta P, editors. Social Inequalities and Cancer. 1997. p. 319–24. Stuver SO, Boschi-Pinto C, Trichopoulos D. Infection with hepatitis B and C viruses, social class and cancer. In: Kogevinas M, Pearce N, Susser M, Boffetta P, editors. Social Inequalities and Cancer. 1997. p. 319–24.
28.
go back to reference Coates T, Wilson R, Patrick G, André F, Watson V. Hepatitis B vaccines: assessment of the seroprotective efficacy of two recombinant DNA vaccines. Clin Ther. 2001;23:392–403.CrossRefPubMed Coates T, Wilson R, Patrick G, André F, Watson V. Hepatitis B vaccines: assessment of the seroprotective efficacy of two recombinant DNA vaccines. Clin Ther. 2001;23:392–403.CrossRefPubMed
30.
go back to reference Rein DR, Lesesne SB, Smith BD, Weinbaum CM. MOdels of community-based hepatitis B surface screening programs in the U.S. and their estimated outcomes and costs. Public Health Rep. 2011;126(4):560–7.PubMedPubMedCentral Rein DR, Lesesne SB, Smith BD, Weinbaum CM. MOdels of community-based hepatitis B surface screening programs in the U.S. and their estimated outcomes and costs. Public Health Rep. 2011;126(4):560–7.PubMedPubMedCentral
Metadata
Title
Chronic hepatitis B in Korean Americans: decreased prevalence and poor linkage to care
Authors
Chul S. Hyun
Sue Kim
Seung Y. Kang
Seo Jung
Seulgi Lee
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1732-7

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