Asian Americans are disproportionately affected by chronic hepatitis B (CHB), with incidence and mortality rates well above those experienced by non-Hispanic white populations. The goal of this study was to examine the association between depression and modifiable lifestyle behaviors among Asian Americans with CHB, with a comparison between those on hepatitis medication and those not on medication. In total, 313 Asian Americans with CHB were recruited through outpatient clinics and community-based organizations to participate in an in-person baseline assessment. We collected data on participants’ sociodemographic characteristics, health-related behaviors, depression symptoms, and modifiable lifestyle behaviors. Bivariate analyses (two sample t-test and chi-square test of independence) and multivariable logistic regression were conducted. We found a high prevalence of depression among individuals living with CHB (41.81% among those not on antiviral medication and 39.71% among those on medication). Multivariate logistic regression results showed that Chinese ethnicity (vs. Vietnamese) and lack of physical activity were significantly associated with a higher risk of mild/severe depression, regardless of medication status. However, the protective effect of physical activity was strong for those on antiviral medication. Furthermore, being employed was significantly associated with a lower risk for depression among Asian Americans on medication, while younger age and being currently married were significantly associated with lower risk of depression among those not on medication. Our findings highlight the significance of physical activity among Asian Americans with CHB, especially for those on antiviral medication. Future prospective research efforts are needed to better identify the potential behavioral mechanisms of depression and provide insights for the psychopharmacological management in this vulnerable population.

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Background: Although Asian Americans only make up about 6% of the total U.S. population, they comprise almost 60% of individuals living with chronic hepatitis B (CHB). Asian Americans are disproportionately affected by CHB; and are more likely to develop Hepatitis B Virus (HBV)-related cirrhosis and hepatocellular carcinoma (HCC). Mental health may impact patient adherence to long-term management and treatment of chronic conditions such as CHB. Increased likelihood to report depressive symptoms and lower health-related quality of life (HRQOL) has been established among patients with CHB compared to the general population. Physical inactivity and smoking have also been associated with lower HRQOL among U.S. adults with depression. This study aims to examine the association between modifiable lifestyle behaviors (physical activity, smoking, alcohol use) and depression among Asian Americans with CHB by medication status. Methods: Chinese- and Vietnamese-Americans with CHB were recruited through outpatient clinics and community-based organizations to participate in an in-person assessment at baseline, as part of an ongoing intervention trial aimed at improving long-term adherence to monitoring/treatment. Participants were asked to report on their socio-demographic characteristics, health-related behaviors, depression symptoms, and modifiable lifestyle behaviors, among others. Bivariate analyses (two sample t- test, chi square test of independence) and multivariable logistic regression were conducted to examine association between exposures to modifiable lifestyle behaviors and outcomes of depression. Results: The study analysis sample consists of 289 participants (219 Chinese- and 70 Vietnamese-Americans). Bivariate analyses showed that there is no statistically significant difference in mean depression scores among those on CHB medication vs. those not (4.73 vs. 4.78, p 0.94), with 38.71% and 39.39% reporting mild to severe depression, respectively. In terms of lifestyle behaviors, when controlling for socio-demographic factors, multivariable logistic regression showed that while none of the three lifestyle behaviors (physical activity, smoking, alcohol use) were significantly associated with depression (p > 0.05) among participants not on medication, being physically inactive was significantly associated with a higher risk of depression (OR = 5.10, 95% CI = 1.72-15.10, p < 0.01) among participants currently on CHB medications, with other covariates held constant. Conclusion: Our study found a significant association between physical inactivity and depression among Asian Americans currently on CHB medication. Our findings suggest a need to incorporate physical activity, as part of a mental health intervention for patients with CHB, particularly for those on medication. Larger studies are needed to determine the association between depression and smoking and/or alcohol use among Asian Americans with CHB. Citation Format: Winterlyn Gamoso, Lin Zhu, Timmy R. Lin, Yin Tan, Grace X. Ma. The association between modifiable lifestyle behaviors and depression among Asian Americans with chronic hepatitis B by medication status [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-137.