Disparities in HBV rates present between ethnic groups, U.S. and foreign-born patients

Recent study data showed disparities in hepatitis B virus infection rates between ethnic groups as well as among between U.S.-born and foreign-born patients.

“There are wide variations in prevalence of HBV infection and exposure by age, race and ethnicity and birthplace,” Michael H. Le, MA, from Stanford University Medical Center’s division of gastroenterology and hepatology, and colleagues wrote. “To achieve the goal of the HHS to increase the diagnosis rate from one-third to two-thirds of persons with chronic HBV by 2020 and the elimination of HBV by 2030, more effort is needed to improve screening and disease awareness among providers and high-risk groups for HBV infection so as to provide vaccination to those who remain unvaccinated and treatment to those who require treatment.”

Researchers examined HBV infection, self-reported vaccination, exposure, vaccine-induced immunity, treatment and disease awareness in the U.S. by race and ethnicity and by birthplace in 47,618 adults via the National Health and Nutrition Examination Survey from 1999-2016. HBV infection was defined as a positive HBV surface antigen test and past exposure by positive HBV core antibody test, with vaccine-mediated immunity defined as positive HBV surface antibody test and negative HBV core antibody test.

Investigators did not observe a significant change in HBV prevalence during the study period, with 0.35% (95% CI, 0.28-0.45) adults infected. Overall, 0.49% of patients tested positive for HBV, 37.9% of whom were born in U.S. and 62.1% of whom were foreign born. HBV prevalence was highest in both foreign-born (3.85%; 95% CI, 2.97-4.97) and U.S. born (0.79; 95% CI, 0.17-3.59) non-Hispanic Asians from 2011-2016.

HBV exposure decreased from 5.8% (95% CI, 4.51-7.42) during 1999-2000 to 4.69% (95% CI, 3.89-5.65) during 2015-2016 (P = .014). However, the decrease was only observed in U.S.-born patients — with a decrease from 4.22% (95% CI, 3.31-5.36) in 1999-2000 to 2.66% (95% CI, 2.13-3.3) in 2015-2016 (P = .001), with no change in exposure in the foreign-born patients.

“We would suggest that both providers and at-risk populations need education and that the use of alerts in electronic health records or a clinical check list with place of birth should be used to improve HBV screening, diagnosis and treatment,” the researchers wrote. “More

efforts are needed to screen these high-risk persons for HBV, to enter them into a hepatocellular carcinoma surveillance program using culturally appropriate approaches and to consider them for treatment to prevent long term complications such as HCC.” – by Eamon Dreisbach

Disclosures : Le reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosure.

Recent study data showed disparities in hepatitis B virus infection rates between ethnic groups as well as among between U.S.-born and foreign-born patients.

“There are wide variations in prevalence of HBV infection and exposure by age, race and ethnicity and birthplace,” Michael H. Le, MA, from Stanford University Medical Center’s division of gastroenterology and hepatology, and colleagues wrote. “To achieve the goal of the HHS to increase the diagnosis rate from one-third to two-thirds of persons with chronic HBV by 2020 and the elimination of HBV by 2030, more effort is needed to improve screening and disease awareness among providers and high-risk groups for HBV infection so as to provide vaccination to those who remain unvaccinated and treatment to those who require treatment.”

Researchers examined HBV infection, self-reported vaccination, exposure, vaccine-induced immunity, treatment and disease awareness in the U.S. by race and ethnicity and by birthplace in 47,618 adults via the National Health and Nutrition Examination Survey from 1999-2016. HBV infection was defined as a positive HBV surface antigen test and past exposure by positive HBV core antibody test, with vaccine-mediated immunity defined as positive HBV surface antibody test and negative HBV core antibody test.

Investigators did not observe a significant change in HBV prevalence during the study period, with 0.35% (95% CI, 0.28-0.45) adults infected. Overall, 0.49% of patients tested positive for HBV, 37.9% of whom were born in U.S. and 62.1% of whom were foreign born. HBV prevalence was highest in both foreign-born (3.85%; 95% CI, 2.97-4.97) and U.S. born (0.79; 95% CI, 0.17-3.59) non-Hispanic Asians from 2011-2016.

HBV exposure decreased from 5.8% (95% CI, 4.51-7.42) during 1999-2000 to 4.69% (95% CI, 3.89-5.65) during 2015-2016 (P = .014). However, the decrease was only observed in U.S.-born patients — with a decrease from 4.22% (95% CI, 3.31-5.36) in 1999-2000 to 2.66% (95% CI, 2.13-3.3) in 2015-2016 (P = .001), with no change in exposure in the foreign-born patients.

“We would suggest that both providers and at-risk populations need education and that the use of alerts in electronic health records or a clinical check list with place of birth should be used to improve HBV screening, diagnosis and treatment,” the researchers wrote. “More

efforts are needed to screen these high-risk persons for HBV, to enter them into a hepatocellular carcinoma surveillance program using culturally appropriate approaches and to consider them for treatment to prevent long term complications such as HCC.” – by Eamon Dreisbach

Disclosures : Le reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosure.