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Prevalence and Presentation of Hepatitis B and C Virus (HBV and HCV) Infection in Vietnamese Americans via Serial Community Serologic Testing

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Abstract

The prevalence of hepatitis B virus (HBV) infection is reportedly high in Vietnamese Americans (VAs), but most previous studies did not assess full HBV serology, and not the prevalence of HBV and hepatitis C virus (HCV) infection simultaneously. The aim of the study is to assess the prevalence of different HBV serologies and HCV infection in VAs. This study was based on the data collected by testing for Hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (HBcAb IgG), anti-HBs antibody (HBsAb), and anti-HCV antibody (anti-HCV) in a series of community screening in VAs in Orange County, California. In 1,405 VA participants, the mean age was 51 (17–87) years, 45.1 % were males; 68.2 %, married; 97.2 %, born in Vietnam. Most of the participants were non-US born with their primary language being non-English and with limited access to health care. Of the 1,405 cases, 124 (8.8 %) were confirmed HBV infection by HBsAg+; 81 (5.8 %), HCV infection by anti-HCV+; including four (0.3 %) with HBV/HCV coinfection. Twelve percent of the participants with confirmed HBV infection thought they were previously tested negative, while 29.7 % of the participants with confirmed HCV infection thought they were previously tested negative. In this cohort, 15.4 % were HBsAg−/HBsAb−/HBcAb IgG−, i.e. being susceptible to HBV infection. In HCV infected participants, 65.4 % were born between 1945 and 1965. This large serial survey and screening in the Vietnamese American community confirmed the rates of HBV and HCV infection to be as high as 8.8 % and 5.8 %, respectively. We have also identified factors related to HBV and HCV infection in this high-risk population.

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Abbreviations

AASLD:

American association for the study of liver diseases

CDC:

Centers for disease control and prevention

HBcAb IgG:

Anti-hepatitis B core antibody

HBsAb:

Anti-hepatitis B surface antibody

HBsAg:

Hepatitis B surface antigen

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

Anti-HCV:

Anti-HCV antibody

VA:

Vietnamese American

VACF:

Vietnamese American cancer foundation

References

  1. World Health Organization. Fact sheet: hepatitis B. 2008.

  2. Custer B, Sullivan SD, Hazlet TK, et al. Global epidemiology of hepatitis B virus. J Clin Gastroenterol. 2004;38:S158–68.

    Article  PubMed  Google Scholar 

  3. Weiss RA, McMichael AJ. Social and environmental risk factors in the emergence of infectious diseases. Nat Med. 2004;10:S70–6.

    Article  CAS  PubMed  Google Scholar 

  4. Institute of Medicine. Hepatitis and liver cancer: a national strategy for prevention and control of hepatitis B and C. Washington, DC: The National Academies Press; 2010.

    Google Scholar 

  5. Chang MH, Chen CJ, Lai MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan childhood hepatoma study group. N Engl J Med. 1997;336:1855–9.

    Article  CAS  PubMed  Google Scholar 

  6. CDC website. http://www.cdc.gov/hepatitis/B/bFAQ.htm#statistics. Accessed 29 Sept 2012.

  7. Kowdley KV, Wang CC, Welch S, et al. Prevalence of chronic hepatitis B among foreign- born persons living in the United States by country of origin. Hepatology. 2012;56:422–33.

    Article  PubMed  Google Scholar 

  8. Bosch FX, Ribes J, Cleries R, et al. Epidemiology of hepatocellular carcinoma. Clin Liver Dis. 2005;9:191–211.

    Article  PubMed  Google Scholar 

  9. Beasley RP, Hwang LY, Lin CC, et al. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22,707 men in Taiwan. Lancet. 1981;2:1129–33.

    Article  CAS  PubMed  Google Scholar 

  10. McMahon BJ, Alward WL, Hall DB, et al. Acute hepatitis B viral infection: relation of age to the clinical expression of disease and subsequent development of carrier state. J Infec Dis. 1985;151:599–603.

    Article  CAS  Google Scholar 

  11. Beasley RP, Trepo C, Stevens CE, et al. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol. 1977;105:94–8.

    CAS  PubMed  Google Scholar 

  12. London WT, McGlynn KA. Liver cancer. In: Scottenfield D, Fraumeni JF, editors. Cancer epidemiology and prevention. New York: Oxford University Press; 1996. p. 772–93.

    Google Scholar 

  13. Johnson PJ. The epidemiology of hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 1996;8:845–9.

    CAS  PubMed  Google Scholar 

  14. Lok ASF, McMahon BJ. AASLD practice guideline: corrections to AASLD guidelines on chronic hepatitis B. Hepatology. 2007;45:1347.

    Article  Google Scholar 

  15. Lok ASF, McMahon BJ. AASLD practice guidelines: hepatitis B. Hepatology. 2007;45:507–39.

    Article  CAS  PubMed  Google Scholar 

  16. Lok ASF, McMahon BJ. Chronic hepatitis B. Hepatology. 2001;34:1225–41.

    Article  CAS  PubMed  Google Scholar 

  17. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50:661–2.

    Article  PubMed  Google Scholar 

  18. National Institutes of Health Consensus Development Conference Statement. Management of hepatitis C: 2002. Hepatology. 2002;36:S3–20.

    Google Scholar 

  19. Yu ML, Chuang WL. Treatment of chronic hepatitis C in Asia: when East meets West. J Gastroenterol Hepatol. 2009;24:336–45.

    Article  CAS  PubMed  Google Scholar 

  20. Statement Consensus. J Viral Hepat. 2004;11:2–4.

    Google Scholar 

  21. Pan CQ, Hu K-Q, Ding C, Cheung E. Prevalence of HCV and Risk of HCV acquisition in hepatitis C screening programs in Asian community in New York City. Am J Gastroenterology. 2008;103:S138.

    Article  Google Scholar 

  22. Reeves TJ, Bennett CE. The Asian and pacific islander population in the United States. Washington DC: Census Bureau. Current Population Reports; 2003. p. 20–540.

    Google Scholar 

  23. U.S. Census Bureau. The American community-Asians: 2004, the American community survey reports. Washington, DC: Department of Commerce; 2007.

  24. McPhee SJ, Stewart S, Brock KC, et al. Factors associated with breast and cervical cancer screening practices among Vietnamese American women. Cancer Detect Prev. 1997;21:510–21.

    CAS  PubMed  Google Scholar 

  25. Lin SY, Chang ET, So SK. Why we should routinely screen Asian American adults for hepatitis B: a cross-sectional study of Asians in California. Hepatology. 2007;46:1034–40.

    Article  PubMed  Google Scholar 

  26. Goodman RA, Sikes RK. Hepatitis B markers in Southeast Asian refugees. JAMA. 1984;251:2086.

    Article  CAS  PubMed  Google Scholar 

  27. Klontz KC. A program to provide hepatitis B immunoprophylaxis to infants born to HBsAg-positive Asian and Pacific Island women. West J Med. 1987;146:195–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  28. Centers of Disease Control and Prevention. Screening for hepatitis B virus infection among refugees arriving in the United States, 1979–1991. MMWR Morb Mortal Wkly Rep. 1991;40:784–6.

    Google Scholar 

  29. Hwang SJ, Tong MJ, Lai PP, et al. Evaluation of hepatitis B and C viral markers: clinical significance in Asian and Caucasian patients with hepatocellular carcinoma in the Unites States of America. J Gastroenterol Hepatol. 1996;11:949–54.

    CAS  PubMed  Google Scholar 

  30. Choe J, Taylor V, Yasui Y, et al. Health care access and sociodemographic factors associated with hepatitis B testing in Vietnamese American men. J Immigr Minor Health. 2006;8:193–201.

    Article  PubMed  Google Scholar 

  31. Johnson PJ. The epidemiology of hepatocellular carcinoma. Eur J Ganstroenterol Hepatol. 1996;8:845–9.

    CAS  Google Scholar 

  32. Kallman JB, Tran S, Arsalla A, et al. Vietnamese community screening for hepatitis B virus and hepatitis C virus. J Viral Hepat. 2011;18:70–6.

    Article  CAS  PubMed  Google Scholar 

  33. Census Bureau Reports. http://www.Census.gov. Accessed 5 Jan 2011.

  34. Lee J, Lok A, Chen J. Hepatitis B prevalence among Asian Americans: an assessment to guide future education and intervention strategies. J Community Health. 2010;35:534–42.

    Article  PubMed  Google Scholar 

  35. Philbin M, Erby L, Lee S, et al. Hepatitis B and liver cancer among three Asian American subgroups: A focus group inquiry. J Immigtant Minority Health 2011 (online published).

  36. Lee H, Hontz I, Warner A, et al. Hepatitis B infection among Asian American pacific islanders in the rocky mountain area. Appl Nurs Res. 2005;18:2–6.

    Article  PubMed  Google Scholar 

  37. Kato Y, Nakao K, Hamasaki K, et al. Spontaneous loss of hepatitis B surface antigen in chronic carriers, based on a long-term follow-up study in Goto Islands. Japan. J Gastroenterol. 2000;35:201–5.

    Article  CAS  Google Scholar 

  38. Tsang TK, Blei AT, O’Reilly DJ, et al. Clinical significance of concurrent hepatitis B surface antigen and antibody positivity. Dig Dis Sci. 1986;31:620–4.

    Article  CAS  PubMed  Google Scholar 

  39. Shiels MT, Taswell HF, Czaja AJ, et al. Frequency and significance of concurrent hepatitis B surface antigen and antibody in acute and chronic hepatitis B. Gastroenterology. 1987;93:675–80.

    CAS  PubMed  Google Scholar 

  40. Hayashi J, Noguchi A, Nakashima K, et al. Frequency of concurrence of hepatitis B surface antigen and antibody in a large number of carriers in Okinawa Japan. Gastroenterol Jpn. 1990;25:593–7.

    CAS  PubMed  Google Scholar 

  41. Alter MJ, Kruszon-Moran D, Nainan OV, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341:556–62.

    Article  CAS  PubMed  Google Scholar 

  42. Nguyen MH, Keeffe EB. Chronic hepatitis B and hepatitis C in Asian Americans (review). Rev Gastroenterol Disord. 2003;3:125–34.

    PubMed  Google Scholar 

  43. Nguyen MH, Whittemore AS, Garcia RT, et al. Role of ethnicity in risk for hepatocellularcarcinoma in patients with chronic hepatitis C and cirrhosis. Clin Gastroenterol Hepatol. 2004;2:820–4.

    Article  PubMed  Google Scholar 

  44. Shepard CW, Simard EP, Finelli L, et al. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev. 2006;28:112–25.

    Article  PubMed  Google Scholar 

  45. Chu CJ, Lee SD. Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features viral interactions, and treatment. J Gastroenterol Hepatol. 2008;23:512–20.

    Article  PubMed  Google Scholar 

  46. Jamma S, Hussain G, Lau DT. Current concepts of HBV/HCV coinfection: coexistence, but not necessarily in harmony. Curr Hepat Rep. 2010;9:260–9.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Liaw YF, Tsai SL, Chang JJ, et al. Displacement of hepatitis B virus by hepatitis C virus as the cause of continuing chronic hepatitis. Gastroenterology. 1994;106:1048–53.

    CAS  PubMed  Google Scholar 

  48. Zarski JP, Bohn B, Bastie A, et al. Characteristics of patients with dual infection by hepatitis B and C viruses. J Hepatol. 1998;28:27–33.

    Article  CAS  PubMed  Google Scholar 

  49. 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:S118–24.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR. 2012;61:1–18.

    Google Scholar 

  51. Smith BD, Patel N, Beckett GA, et al. Hepatitis C virus antibody prevalence, correlates and predictors among persons born from 1945 through 1965, United States, 1999–2008 (Abstract). American Association for the Study of Liver Disease, November 6, 2011. San Francisco, CA 2011.

  52. Shehab TM, Sonnad SS, Lok AS. Management of hepatitis C patients by primary care physicians in the USA: results of a national survey. J Viral Hepat. 2001;8:377–83.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Part of the study was presented at AASLD in San Francisco in 2011.

Author information

Authors and Affiliations

  1. Department of Medicine, University of California, Irvine Medical Center, Orange, CA, USA

    Kelvin Nguyen & Ke-Qin Hu

  2. Vietnamese American Cancer Foundation, Orange, CA, USA

    Thai Van Nguyen, Diep Tran & Khanh Banh

  3. Division of Gastroenterology/Hepatology, University of California, Irvine Medical Center, 101 The City Drive, Building 56, Rt. 81, Rm. 237, Orange, CA, 92868, USA

    Duke Shen, Victor Ruan & Ke-Qin Hu

  4. Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Victor Xia

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  1. Kelvin Nguyen
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Correspondence to Ke-Qin Hu.

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Nguyen, K., Van Nguyen, T., Shen, D. et al. Prevalence and Presentation of Hepatitis B and C Virus (HBV and HCV) Infection in Vietnamese Americans via Serial Community Serologic Testing. J Immigrant Minority Health 17, 13–20 (2015). https://doi.org/10.1007/s10903-013-9975-5

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  • DOI: https://doi.org/10.1007/s10903-013-9975-5

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