Incidence and characterization of hepatitis B infection in Chinese-Americans in the San Francisco Bay Area
The Asian Liver Center at Stanford University, Stanford, CA, United States
AIM: The greatest disparity in cancer rates between Asian and Pacific Islander (API) and Caucasian Americans is hepatocellular carcinoma (HCC), 80% of which is caused by chronic hepatitis B (HBV) infection. To address this disparity, the Asian Liver Center developed the Jade Ribbon Campaign as a health intervention model to prevent hepatitis B and liver cancer. As a public service to the API community, the Asian Liver Center held a free hepatitis B screening over the period of one day (5 hours) in Palo Alto, CA. METHODS: During the screening, 486 adult ethnic Chinese Americans (mean age=46.5) were screened for chronic hepatitis B (presence of HBsAg), out of which 205 elected to receive comprehensive blood panels that additionally tested for prior infection with HBV (total anti-HBc) and HBV immunity (anti-HBs). Participants were also asked to report information about their family HBV history and asked to complete a follow-up survey one year following their screening. RESULTS: Among the 486 adults tested, 12.1% (n=59) were HBV carriers (HBsAg positive). Analysis of the serologic data in the 205 people who received a comprehensive blood panel, only 6.5% (n=15) showed immunity to HBV due to prior vaccination. 60% (n=123) showed serologic evidence of prior HBV infection (anti-HBc positive) in which 17.1% (n=35) had chronic HBV infection (HBsAg positive) and 31.2% (n=64) developed natural immunity due to prior infection (anti-HBs positive). Among participants who had children, only 38% reported vaccinating their children. Data from pre-screening questionnaires and post-screening follow-up surveys were also obtained on participants’ health seeking behaviors. Results revealed that despite high levels of education and high insurance coverage, knowledge about and preventative action for hepatitis B and liver cancer remained low in the high-risk Chinese community without community intervention. Of those surveyed (n=307), 45% would not have been tested for hepatitis B without the screening event, and 71% had never talked to their physicians about hepatitis B prior to the event. CONCLUSION: Data gathered from this event both demonstrated the need for and helped in the design of culturally specific health intervention in the API community.
Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in oral session 791 (Viral Infections).