Chronic hepatitis B prevalence among foreign-born and US-born adults in the United States, 1999-2016.

Abstract

Hepatitis B virus (HBV) infection remains a major global health problem, exacerbated by poor linkage to care. We aimed to determine the prevalence of HBV infection, exposure, self-reported vaccination, vaccine-induced immunity, disease awareness, and treatment in the United States (U.S.) by birthplace and race/ethnicity during 1999-2016. 47,628 adult participants in the National Health and Nutrition Examination Survey completed HBV core antibody (anti-HBc) and surface antigen (HBsAg) tests and 47,618 adults completed HBV surface antibody (anti-HBs) and anti-HBc tests and were included in the analysis. HBV infection was defined by positive HBsAg and past exposure by positive anti-HBc. Vaccine-mediated immunity was defined by positive anti-HBs and negative anti-HBc. No significant change in the prevalence of HBV infection was observed between 1999-2016 (P=0.442), affecting 0.35% (95% CI: 0.28-0.45) or 0.84 million adults. In contrast, a significant decrease in HBV exposure and increase in vaccine-mediated immunity was observed. U.S. born had significantly lower prevalence of HBV infection and exposure as well as higher prevalence of vaccine-mediated immunity and self-reported vaccination than foreign born. Prevalence of HBV infection was highest in non-Hispanic Asians in both foreign- (3.85%, 95% CI: 2.97-4.97) and U.S.-born (0.79%, 95% CI: 0.17-3.59) persons during 2011-2016. Among infected persons, liver disease awareness was only 15.19%, and treatment rate was only 4.60%. CONCLUSION: This study revealed disparities of HBV infection among ethnic/racial groups and between U.S.-born and foreign-born persons. Awareness of liver disease and treatment rate among infected persons was dismal. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/hep.30831

View details for PubMedID 31228279