Epidemiology

High hepatitis B rate found in underserved Asians in NYC

Last Updated: 2005-11-10 15:00:17 -0400 (Reuters Health)

By Larry Schuster

SAN FRANCISCO (Reuters Health) - A community hepatitis B screening program targeting mainly underserved foreign-born Asian residents of New York City found a higher prevalence of infection than previously reported among Asian populations in the United States.

The physicians reported an overall prevalence of 23.8% among the 1,836 people screened as of June 30. Previous hepatitis screening programs in the United States have reported prevalence rates of 10% to 15%.

The results represent 1 year of screening, which attracted mostly China and Korea-born immigrants, said Dr. Alex Sherman, clinical associate professor of medicine at New York University School of Medicine. He will present the results of the screening program this week here at the annual meeting of the American Association for the Study of Liver Diseases.

In an interview with Reuters Health, Dr. Sherman said many of the participants haven't had ready access to medical care either because of language, economics or other reasons. And some of the participants may not have been aware of their risk of hepatitis B infection or the medical implications of an untreated infection or that effective well-tolerated, oral treatments have become available in the last 2 or 3 years that can reduce the risk of cirrhosis and liver cancer.

He speculated that the higher prevalence found in this screening program might reflect the success of the community outreach effort to find underserved, foreign-born Asian immigrants. He noted that this was not a randomized study. People participated in response to the media campaign and outreach efforts, particularly in the areas of Chinatown in Manhattan for Chinese immigrants, and Flushing in Queens for Korean immigrants.

In the program, 99% of the participants were foreign born, 60% from China, about 30% were from Korea, and 7% were from Malaysia.

Of those born in China, 32.9% were infected. Of those born in Korea or other Asian countries, 11.3% were infected.

"Being born in China was one of the risk factors," Dr. Sherman said.

A positive family history was the strongest risk factor. A "yes" answer to that question was associated with a 42.5% prevalence, compared with 18.1% among those who said no one else in their family was infected.

Also, male participants had a higher prevalence than females - at 30.9% and 15.4%, respectively, and those between 19 and 40 years old, who had a 33.8% prevalence compared with 17.2% for older or younger participants.

If the participants said they had been previously screened, then they also had an increased risk of being infected. Many of those people may have been aware that they were infected and were coming to receive further medical evaluation and treatment.

Overall, 23.8 % were HBsAg+, and were referred for further evaluation and treatment; 27.6% carried no immunity and were referred for vaccination, and 48.6% appeared to have been previously vaccinated.

"We figure that half of the population we screened were eligible for intervention," Dr. Sherman said.

The study was sponsored by a New York City Council grant to the Asian American Hepatitis B Program (AAHBP), a non-profit, public/private coalition working with the New York University Center for the Study of Asian American Health. The AAHBP aims to screen 5000 Asian Americans to determine the prevalence of chronic hepatitis B and organize a treatment model.