Prevalence of Hepatitis B Virus (HBV) Infection Among Hmong Immigrants in the San Joaquin Valley

Abstract

Chronic hepatitis B infection (HBV) is the major cause of primary liver cancer worldwide and Asians are disproportionately affected. The prevalence of HBV among most Asian American groups has been well documented, except in Hmong immigrants in the United States. The aim of this study was to determine the prevalence of HBV among Hmong immigrants in the San Joaquin Valley of California. A convenient sample of 534 Hmong age ≥18 years was recruited at various locations throughout Fresno County. Blood samples from study participants were collected and tested for hepatitis B surface antigen (HBsAg) by enzyme-immunoassay. Two hundred and eighty-nine females and 245 males of Hmong descent (mean age, 43.93) were screened. Eighty-nine (41 males and 48 females) were positive for HBsAg, which accounts for a prevalence of 16.7% (95% C.I. 13.5–19.9). The majorities of HBsAg positive patients were ≥40 years (64.2%), married (66.7%), born in Laos (87.3%), and had lived in the United States ≥20 years (62.5%). Only 37.5% of the participants reported having a primary care physician. Our study revealed that approximately one out of every six Hmong immigrants screened was infected with HBV. Based on our findings, more than one-third of these infected patients have no primary care physician to provide further treatment, surveillance for liver cancer, or vaccination of their families. This supports the Institute of Medicine’s recent recommendations to the Center for Disease Control to engage in a national Hepatitis B surveillance system.

Chronic Hepatitis B and Liver Cancer Risks among Asian Immigrants in New York City: Results from a Large, Community-Based Screening, Evaluation, and Treatment Program

“…The prevalence in Chinese immigrants grouped by province/region of birth is similar to that found in China with the exception of the Fujian province (7, 8, 10). The prevalence of chronic HBV in Fujianese immigrants in our study was more than twice the rate (17.1%) reported for the Fujian province in the China National Survey, the province with the highest HBV infection prevalence in China (7, 11, 25, 26). Higher infection rates among the Fujianese in our sample may be due to specific migration-related factors that overlap with HBV risk factors.…”

“…While less than 0.5% of the US population tests positive for HBsAg, the prevalence of chronic HBV infection among Asian Americans is estimated to be between 9 and 15%, and may be as high as 25% in select subgroups of recent immigrants (20-26). Asian Americans, the fastest growing racial/ethnic group in the US, are largely foreign-born (27) and account for 60% of persons in the US with chronic HBV (28).…”

Hepatitis B Virus and Hepatitis C Virus Infections in United States-Bound Refugees from Asia and Africa

“…Similarly, a study among Hmong living in the San Joaquin Valley found almost 17% prevalence of CHB, and high-risk behavior including multiple sex partners, tattooing, and injecting drugs are common within the community. 30 These refugee groups could benefit from early screening for HBV infections, identification, and treatment upon their arrival, which can prevent further progression of disease to end-stage liver disease and HCC, and diminish the risk of transmitting HBV to their contacts.…”

Seroprevalence of Hepatitis B and C Infections among Healthy Volunteer Blood Donors in the Central California Valley

“…The Central Valley has a diverse ethnic population composition, about 30% to 68% Hispanics and 3% to 14% Asians across various counties. Our recent prospective study revealed that approximately one out of every six Hmong immigrants in the Central California Valley is infected with HBV 22. Therefore; the disparities in prevalence of viral hepatitis are expected in the valley as compared to general US population.…”