Background and Aims
The Centers for Disease Control and Prevention recommend screening for hepatitis C virus (HCV) in patients with injection drug use, blood transfusion before 1992, stigmata of liver disease, or born between 1945 and 1965. The purpose of this study was to examine risk factors for HCV acquisition in Asian Americans.
This was a case–controlled study, with 471 consecutive patients testing positive for anti-HCV between January 2001 and December 2008. Controls included 471 patients with negative HCV matched at a one-to-one ratio for sex, age (±5 years), and ethnicity.
For Asian patients, the most common risk factors were blood transfusion and acupuncture or exposure to dirty needles (27 and 20 %, respectively). On multiple logistic regression, potential predictors for a positive anti-HCV test in Asians were acupuncture or exposure to dirty needles (OR = 12.9, P < 0.0001), body tattoo (OR = 12.0, P = 0.001), and history of blood transfusion (OR = 5.7, P < 0.0001).
Acupuncture and exposure to dirty needles are independent risk factors of HCV infection. Asians coming from endemic areas should be screened for HCV even when commonly-known risk factors for Western patients are not present.
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Global Burden Of Hepatitis C Working Group. Global burden of disease (GBD) for hepatitis C. J Clin Pharmacol. 2004;44:20–29.
Hepatitis C. Fact sheet no. 164. World Health Organization. Available at: www.who.int/mediacentre/factsheets/fs164/. Accessed 28 June 2013.
McQuillan GM, Kruszon-Moran D, Denniston MM, et al. Viral hepatitis. Hyattsville, MD: National Center for Health Statistics; 2010.
Armstrong GL, Wasley A, Simard EP, et al. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–714.
Perz JF, Armstrong GL, Farrington LA, et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;45:529–538.
Di Bisceglie AM, Lyra AC, Schwartz M, et al. Hepatitis C-related hepatocellular carcinoma in the United States: influence of ethnic status. Am J Gastroenterol. 2003;98:2060–2063.
El-Serag HB. Hepatocellular carcinoma and hepatitis C in the United States. Hepatology. 2002;36:S74–S83.
Lin H, Ha NB, Ladzekpo D, et al. Association of hepatocellular carcinoma with hepatitis B virus (HBV) versus hepatitis C virus (HCV) infection among different Asian subgroups. Gastroenterology. 2011;140:S924–S925.
Nguyen MH, Whittemore AS, Garcia RT, et al. Role of ethnicity in risk for hepatocellular carcinoma in patients with chronic hepatitis C and cirrhosis. Clin Gastroenterol Hepatol. 2004;2:820–824.
WHO. Global surveillance and control of hepatitis C. Report of a WHO consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat. 1999;6:35–47.
Te HS, Jensen DM. Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis. 2010;14:1–21, vii.
Bornschlegel K, Berger M, Garg RK, et al. Prevalence of hepatitis C infection in New York City, 2004. J Urban Health. 2009;86:909–917.
Hwang JP, Mohseni M, Gor BJ, et al. Hepatitis B and hepatitis C prevalence and treatment referral among Asian Americans undergoing community-based hepatitis screening. Am J Public Health. 2010;100:S118–S124.
Kallman JB, Tran S, Arsalla A, et al. Vietnamese community screening for hepatitis B virus and hepatitis C virus. J Viral Hepat. 2011;18:70–76.
Kin KC, Lin B, Ha NB, et al. High proportion of hepatitis C virus in community Asian American patients with non-liver related complaints. J Clin Gastroenterol. 2013;47:367–371.
CDC. Hepatitis C information for health professionals. Centers for Disease Control and Prevention. Available at: www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Accessed 28 June 2013.
Ho EY, Ha NB, Ahmed A, et al. Prospective study of risk factors for hepatitis C virus acquisition by Caucasian, Hispanic, and Asian American patients. J Viral Hepat. 2012;19:e105–e111.
Nguyen NH, Vutien P, Trinh HN, et al. Risk factors, genotype 6 prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans. Hepatol Int. 2010;4:523–529.
Nguyen LH, Nguyen MH. Systematic review: Asian patients with chronic hepatitis C infection. Aliment Pharmacol Ther. 2013;37:921–936.
Cheng JT, Hsien C, Sun HE, et al. The emerging importance of chronic hepatitis C infection in Asian Americans. Am J Gastroenterol. 2006;101:2737–2743.
Kao JH, Chen DS. Transmission of hepatitis C virus in Asia: past and present perspectives. J Gastroenterol Hepatol. 2000;15:E91–E96.
Celona AF, Yu MC, Prakash M, et al. Hepatitis C in a Los Angeles public hepatitis clinic: demographic and biochemical differences associated with race-ethnicity. Clin Gastroenterol Hepatol. 2004;2:459–462.
Sun DX, Zhang FG, Geng YQ, et al. Hepatitis C transmission by cosmetic tattooing in women. Lancet. 1996;347:541.
McCaughan GW, Omata M, Amarapurkar D, et al. Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection. J Gastroenterol Hepatol. 2007;22:615–633.
Rein DB, Smith BD, Wittenborn JS, et al. The cost-effectiveness of birth-cohort screening for hepatitis C antibody in U.S. primary care settings. Ann Intern Med. 2012;156:263–270.
U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: final recommendation statement. AHRQ publication no. 12-05174-EF-2. Available at: http://www.uspreventiveservicestaskforce.org/uspstf12/hepc/hepcfinalrs.htm. Accessed 28 June 2013.
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Kin, K.C., Lin, B., Chaung, K.T. et al. Less-Established Risk Factors Are Common in Asian Americans with Hepatitis C Virus: A Case–Controlled Study. Dig Dis Sci 58, 3342–3347 (2013). https://doi.org/10.1007/s10620-013-2884-6