Racial/ethnic- and County-specific Prevalence of Chronic Hepatitis B and Its Burden in California

Overview

Journal Hepatol Med Policy

Publisher Biomed Central

Specialty Public Health

Date 2018 Oct 6

PMID 30288329

Citations 3

Authors

Mehlika Toy

Bin Wei

Tejpal S Virdi

An Le

Huy Trinh

Jiayi Li

Jian Zhang

Ann W Hsing

Samuel K So

Mindie H Nguyen

Affiliations

Soon will be listed here.

Abstract

Background: In the United States, the highest burden of chronic hepatitis B (CHB) and CHB-related liver cancer is in the state of California, primarily in the San Francisco (SF) Bay and Los Angeles (LA) areas. The aim of this study was to estimate county-specific hepatitis B surface antigen (HBsAg) prevalence and quantify CHB cases by age, race/ethnicity, nativity, and disease activity status.

Methods: Twelve counties in SF Bay Area and three large counties in LA area were included for this analysis. Race/ethnicity-specific prevalence of HBsAg for each county and the state of California as a whole, was estimated by including prevalence data from the National Health and Nutrition Examination Survey and various studies that estimated HBsAg prevalence in US and foreign-born Asian Pacific Islanders, Hispanic, and Black populations. In addition, clinical data of 2000 consecutive CHB patients (collected between 2009 and 2014) from a large clinical consortium in the SF Bay area were used to calculate the age-specific disease burden.

Results: Of the 15 counties analyzed, SF had the highest HBsAg prevalence (1.78%), followed by Santa Clara (1.63%) and Alameda (1.45%). The majority of CHB cases were estimated to be in LA County (83,770), followed by Santa Clara (31,273), and Alameda (23,764). Among the CHB cases, 12.7% is active HBeAg positive, 24.2% is active HBeAg negative, and 10.6% has cirrhosis.

Conclusion: This study confirms and quantifies the current burden of CHB in high endemic counties in the state of California using population-level estimates combined with clinical data including those from the community.

Citing Articles

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.

Conners E, Panagiotakopoulos L, Hofmeister M, Spradling P, Hagan L, Harris A MMWR Recomm Rep. 2023; 72(1):1-25.

PMID: 36893044 PMC: 9997714. DOI: 10.15585/mmwr.rr7201a1.

Prevalence and Susceptibility to Hepatitis B virus and the Need for Community Health Education in Milwaukee's Hmong Community.

Kosasih M, Sendaydiego X, Bednarke K, Wong S, Chow Y, Fox A J Racial Ethn Health Disparities. 2021; 9(5):1873-1881.

PMID: 34342867 DOI: 10.1007/s40615-021-01124-2.

Diagnosis Rates of Chronic Hepatitis B in Privately Insured Patients in the United States.

Ogawa E, Yeo Y, Dang N, Le M, Jeong D, Tran S JAMA Netw Open. 2020; 3(4):e201844.

PMID: 32271388 PMC: 7146097. DOI: 10.1001/jamanetworkopen.2020.1844.

References

Setiawan V, Wei P, Hernandez B, Lu S, Monroe K, Le Marchand L . Disparity in liver cancer incidence and chronic liver disease mortality by nativity in Hispanics: The Multiethnic Cohort. Cancer. 2016; 122(9):1444-52. PMC: 4840042. DOI: 10.1002/cncr.29922. View

Ghany M, Perrillo R, Li R, Belle S, Janssen H, Terrault N . Characteristics of adults in the hepatitis B research network in North America reflect their country of origin and hepatitis B virus genotype. Clin Gastroenterol Hepatol. 2014; 13(1):183-92. PMC: 4268271. DOI: 10.1016/j.cgh.2014.06.028. View

Roberts H, Kruszon-Moran D, Ly K, Hughes E, Iqbal K, Jiles R . Prevalence of chronic hepatitis B virus (HBV) infection in U.S. households: National Health and Nutrition Examination Survey (NHANES), 1988-2012. Hepatology. 2015; 63(2):388-97. DOI: 10.1002/hep.28109. View

Stanaway J, Flaxman A, Naghavi M, Fitzmaurice C, Vos T, Abubakar I . The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. 2016; 388(10049):1081-1088. PMC: 5100695. DOI: 10.1016/S0140-6736(16)30579-7. View

. Characteristics of persons with chronic hepatitis B--San Francisco, California, 2006. MMWR Morb Mortal Wkly Rep. 2007; 56(18):446-8. View

McMahon B . Editorial Commentary: Sliding Down the Cascade of Care for Chronic Hepatitis B Virus Infection. Clin Infect Dis. 2016; 63(9):1209-1211. DOI: 10.1093/cid/ciw517. View

Lin D, Yang H, Nguyen N, Hoang J, Kim Y, Vu V . Reduction of chronic hepatitis B-related hepatocellular carcinoma with anti-viral therapy, including low risk patients. Aliment Pharmacol Ther. 2016; 44(8):846-55. DOI: 10.1111/apt.13774. View

Hyun C, Kim S, Kang S, Jung S, Lee S . Chronic hepatitis B in Korean Americans: decreased prevalence and poor linkage to care. BMC Infect Dis. 2016; 16(1):415. PMC: 4986342. DOI: 10.1186/s12879-016-1732-7. View

Levy V, Yuan J, Ruiz J, Morrow S, Reardon J, Facer M . Hepatitis B sero-prevalence and risk behaviors among immigrant men in a population-based household survey in low-income neighborhoods of northern California. J Immigr Minor Health. 2009; 12(6):828-33. PMC: 2964463. DOI: 10.1007/s10903-009-9239-6. View

10.

Terrault N, Bzowej N, Chang K, Hwang J, Jonas M, Murad M . AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2015; 63(1):261-83. PMC: 5987259. DOI: 10.1002/hep.28156. View

11.

Gish R, Cooper S . Hepatitis B in the Greater San Francisco Bay Area: an integrated programme to respond to a diverse local epidemic. J Viral Hepat. 2010; 18(4):e40-51. PMC: 3084996. DOI: 10.1111/j.1365-2893.2010.01382.x. View

12.

Din E, Wasley A, Jacques-Carroll L, Sirotkin B, Wang S . Estimating the number of births to hepatitis B virus-infected women in 22 states, 2006. Pediatr Infect Dis J. 2011; 30(7):575-9. DOI: 10.1097/INF.0b013e31820cd65c. View

13.

Tanaka J, Koyama T, Mizui M, Uchida S, Katayama K, Matsuo J . Total numbers of undiagnosed carriers of hepatitis C and B viruses in Japan estimated by age- and area-specific prevalence on the national scale. Intervirology. 2011; 54(4):185-95. DOI: 10.1159/000324525. View

14.

Kim L, Nguyen V, Trinh H, Li J, Zhang J, Nguyen M . Low treatment rates in patients meeting guideline criteria in diverse practice settings. Dig Dis Sci. 2014; 59(9):2091-9. DOI: 10.1007/s10620-014-3283-3. View

15.

Liaw Y, Sung J, Chow W, Farrell G, Lee C, Yuen H . Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004; 351(15):1521-31. DOI: 10.1056/NEJMoa033364. View

16.

Hu D, Xing J, Tohme R, Liao Y, Pollack H, Ward J . Hepatitis B testing and access to care among racial and ethnic minorities in selected communities across the United States, 2009-2010. Hepatology. 2013; 58(3):856-62. DOI: 10.1002/hep.26286. View

17.

Spradling P, Xing J, Rupp L, Moorman A, Gordon S, Teshale E . Infrequent Clinical Assessment of Chronic Hepatitis B Patients in United States General Healthcare Settings. Clin Infect Dis. 2016; 63(9):1205-1208. PMC: 6743315. DOI: 10.1093/cid/ciw516. View

18.

Tohme R, Andre-Alboth J, Tejada-Strop A, Shi R, Boncy J, Francois J . Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey. J Clin Virol. 2016; 76:66-71. PMC: 5802338. DOI: 10.1016/j.jcv.2016.01.012. View

19.

Jung M, Kuniholm M, Ho G, Cotler S, Strickler H, Thyagarajan B . The distribution of hepatitis B virus exposure and infection in a population-based sample of U.S. Hispanic adults. Hepatology. 2015; 63(2):445-52. PMC: 4718892. DOI: 10.1002/hep.28328. View

20.

Lin S, Chang E, So S . Why we should routinely screen Asian American adults for hepatitis B: a cross-sectional study of Asians in California. Hepatology. 2007; 46(4):1034-40. DOI: 10.1002/hep.21784. View