Email updates

Keep up to date with the latest news and content from BMC Infectious Diseases and BioMed Central.

Open Access Highly Accessed Research article

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

Natali Navarro1, Nelson Lim2, Jiah Kim2, Elliot Joo2, Kendrick Che2, Bruce Allen Runyon2 and Michel Henry Mendler2*

Author Affiliations

1 Division of GI and Liver Disease, University of California at San Diego Health System, 200 W Arbor Drive #8413, San Diego, CA 92103-8413, USA

2 Division of GI and Liver Diseases, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354, USA

For all author emails, please log on.

BMC Infectious Diseases 2014, 14:269  doi:10.1186/1471-2334-14-269

Published: 17 May 2014

Abstract

Background

Hepatitis B virus (HBV) infection is prevalent in Asian immigrants in the USA. California’s Inland Empire region has a population of approximately four million, including an estimated 19,000 first generation Koreans. Our aim was to screen these adult individuals to establish HBV serological diagnoses, educate, and establish linkage to care.

Methods

A community-based program was conducted in Korean churches from 11/2009 to 2/2010. Subjects were asked to complete a HBV background related questionnaire, provided with HBV education, and tested for serum HBsAg, HBsAb and HBcAb. HBsAg positive subjects were tested for HBV quantitative DNA, HBeAg and HBeAb, counseled and directed to healthcare providers. Subjects unexposed to HBV were invited to attend a HBV vaccination clinic.

Results

A total of 973 first generation Koreans were screened, aged 52.3y (18-93y), M/F: 384/589. Most (75%) had a higher than high school education and were from Seoul (62.2%). By questionnaire, 24.7% stated they had been vaccinated against HBV. The serological diagnoses were: HBV infected (3.0%), immune due to natural infection (35.7%), susceptible (20.1%), immune due to vaccination (40.3%), and other (0.9%). Men had a higher infection prevalence (4.9% vs. 1.7%, p = 0.004) and a lower vaccination rate (34.6% vs. 44.0%, p = 0.004) compared to women. Self-reports of immunization status were incorrect for 35.1% of subjects.

Conclusions

This large screening study in first generation Koreans in Southern California demonstrates: 1) a lower than expected HBV prevalence (3%), 2) a continued need for vaccination, and 3) a need for screening despite a reported history of vaccination.

Keywords:
Hepatitis B; Population screening; Korean immigrants; Hepatitis B carrier; Hepatitis B vaccination