Hepatitis B Infection among Korean Americans in Colorado: Evidence of the Need for Serologic Testing and Vaccination

Hepatitis B virus (HBV) infection is significantly higher in Asian American Pacific Islanders (AAPIs) than in the general U.S. population. People chronically infected with HBV not only have the potential for developing cirrhosis and primary hepatocellular carcinoma, but also are potential sources for infecting others. Therefore, early diagnosis of HBV infection can reduce the risk of further transmission of the virus through education and vaccination of high-risk groups. The aim of this study was to screen for current and past HBV infection in this high-risk group. A community-based participatory study was conducted between 2004 and 2007. A total of 609 Korean Americans (KA) completed HBV blood screening tests in seven Korean churches in Colorado. Current HBV infection (HBsAg), past HBV infection (anti-HBc positive), and HBV susceptibility were measured. Demographic information, including HBV vaccination history on these groups, was obtained. Korean Americans had an almost ten times higher incidence of current (4%) and past HBV infection (41%) than the general U.S population. Older individuals had a higher incidence of past HBV infection and lower immunization rate. The risk of lifetime HBV infection was less among participants younger than 30 (OR: 0.07; 95% CI: 0.02-0.21) and those who self-reported HBV vaccination (OR: 0.12; 95% CI: 0.05-0.29). Variables associated with immunity due to vaccination (anti-HBc negative but positive to anti-HBs) were, age under 30 (OR: 13.86; 95% CI: 4.68-41.05), and self-reported vaccination (OR: 8.06; 95% CI: 3.43-18.92). Our study findings confirm the high prevalence of HBV infection among AAPIs, specifically among AAPIs in regions where AAPIs constitute a small proportion of residents. Given the high incidence of HBV infection among these community-dwelling KA, and that the majority of HBV-infected participants were unaware of their condition, focused HBV screening should be conducted to uncover individuals with HBV