Disparities in Hepatitis B Virus Infection and Immunity Among New York City Asian American Patients, 1997 to 2017

Abstract

Objectives. To measure disparities in hepatitis B virus (HBV) infection and immunity among a high-risk patient population at a community health center in New York City. Methods. We performed a retrospective chart review of 25 565 adults with HBV surface antigen, surface antibody, and total core antibody tests from 1997 to 2017. We categorized HBV test results by infection and immunity status and analyzed by demographic characteristics with χ2 and logistic regression analysis. Results. Of 25 565 adults, 13.4% were currently infected, 52.1% were ever infected, 33.4% were immune from vaccination, and 14.5% were susceptible. Significant factors associated with ever infection were age, male sex, being China-born, limited English proficiency, having Medicaid or no insurance, and family history of HBV (P < .01). Conclusions. Our study demonstrated a high burden of HBV infection among foreign-born Asian Americans seeking care at a community health center. Public Health Implications. It is important to test patients at high risk for HBV infection with all 3 tests to identify those with current infection, risk for reactivation, or need for vaccination, and to assess the effectiveness of public health interventions.

Hep B Moms: A cross‐sectional study of mother‐to‐child transmission risk among pregnant Asian American women with chronic hepatitis B in New York City, 2007‐2017

“…This may be explained by the large wave of Chinese migrant workers from this Fujian province to New York City between the late 1980s and early 2000s . The high burden of HBV infection among Fujian‐born immigrants has been reported in two HBV screening studies conducted in New York City, showing 23.5%‐33.1% HBsAg‐positivity among persons born in Fujian province . At the time of pregnancy, most of the HBsAg‐positive pregnant women were of low socioeconomic status with limited English proficiency, Medicaid insurance, an education level of high school or lower and unemployment.…”

“…The Health Center provides comprehensive primary care including internal medicine, paediatrics, and obstetrics and gynaecology services to a primarily low income Asian population with a high burden of chronic HBV. Approximately 13% of adult patients seen at the Health Center have chronic HBV and receive monitoring and treatment for HBV in the primary care setting . The Obstetrics and Gynaecology department sees approximately 1300 pregnant women each year.…”

Hepatitis B Virus Elimination in the U.S.: Time to Dismantle Barriers and Implement Solutions

“…Community health centers have developed innovative strategies for delivering primary care-based HBV care to marginalized populations. Charles B. Wang Community Health Center (NYC) and North East Medical Services (San Francisco Bay Area) have implemented universal HBV screening of adults [59] and HBV patient registries to support primary care-based chronic HBV management and liver cancer surveillance in their primarily Asian immigrant populations. North East Medical Services' in-house radiology department has adopted the Ultrasound Liver Imaging Reporting and Data System (US LI-RADS) [60] for HCC surveillance of chronic HBV patients with EHR prompts for ordering ultrasounds and serum AFP for men over age 40 and women over age 50.…”

Factors Associated with Hepatitis B Medication Adherence and Persistence among Underserved Chinese and Vietnamese Americans

“…HBV is the leading risk factor for developing HCC, which has been known to create a >100-fold increased risk for developing HCC [5]. More specifically, Vietnamese and Chinese Americans suffer from disproportionate rates of HBV infection, as they represent countries with endemic HBV infection at the highest rates in Asia [6][7][8]. Community-based studies within the United States have illustrated infection rates in these populations as high as 52% [8].…”