Hepatitis B seroprevalence and disease characteristics in an urban Chinatown community.

Background & Aims: Chronic HBV infection is prevalent among Asian immigrants and is an important cause of cirrhosis and hepatocellular carcinoma. The aim of this study was to evaluate the HBsAg seroprevalence and to characterize hepatitis B in persons who presented to an urban Chinatown internal medicine practice.

Methods: Records were reviewed retrospectively from 4671 adult patients who had at least 1 office visit during a 2-year period. Demographic information and laboratory data were collected. An elevated ALT level was defined as >19 IU/mL for women and >30 IU/mL for men.

Results: All patients were ethnically Chinese, and 97% were born in Asia. HBsAg testing was available in 64% (3012/4671) of cases. The HBsAg seroprevalence rate was 11.1% (335/3012) overall and 14.9% in persons aged 30-39 years. HBeAg testing was available for 75% (250/335) of HBsAg+ cases. Seventy-five percent (188/250) were HBeAg-. Sixty percent (26/43) of HBeAg+ patients with available data had HBV DNA >10(5) copies/mL and an elevated ALT level. Sixteen percent (21/128) of HBeAg- patients with available data had HBV DNA >10(4) copies/mL and an elevated ALT level.

Conclusions: The HBsAg seroprevalence was high (11.1%) in Chinese immigrants presenting for general medical care. A majority (75%) of HBsAg+ patients were HBeAg-. Sixty percent of HBeAg+ cases and 16% of HBeAg- patients with available data had both HBV DNA and ALT levels that would prompt consideration of antiviral therapy. These findings highlight the importance of testing and medical management of hepatitis B in Chinese Americans.