Clinical Characteristics of Chronic Hepatitis B Virus Infection in Immigrants from Sub-Saharan Africa

Abstract

Chronic hepatitis B virus (HBV) infection is a significant, worldwide burden due to it's high prevalence, and risk of complications, including cirrhosis and hepatocellular carcinoma (HCC). Current literature suggests that African patients with chronic hepatitis B are at higher risk for hepatocellular carcinoma. The exact mechanism for the explanation for this observation is contentious and may be due to higher rates of chronicity, and/or exposure to hepatotoxins including aflatoxin. We sought to report the clinical characteristics of African born immigrants with chronic hepatitis B referred to a liver clinic in New York City. A total of 111 patients were enrolled. 19 patients (17%) had cirrhosis, and 14 patients (13%) had HCC at initial presentation. During the course of follow up, 13 patients (12%) died of complications of HBV, all of them related to HCC. Our case series revealed that a significant proportion of these patients manifested advanced complications of HBV such as cirrhosis or HCC.

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“…However, there is a growing body of evidence that African immigrants have lower uptake of preventative health services than U.S.-born people, including for vaccinations [ 10 , 11 ], cancer screening [ 10 , 12 , 13 , 14 ], and HIV testing [ 15 ]. Consequently, African immigrant communities are disproportionately impacted by late diagnoses across a broad range of health conditions, including some cancers [ 16 ], HIV [ 17 , 18 ], and hepatitis B [ 16 ].…”