—Christine. M. Kukka, Project Manager, HBV Advocate
Because it is difficult to screen
Asian-Americans for hepatitis B—due to
language barriers, insurance, or cultural barriers—the Asian
Center held 63 free screening across Los Angeles County, home
to more than 2
The screenings, staffed by Korean- and
providers, tested 6,959 adults and found that 387 (5.2%) had
B. The infection rate was 3.9% among Korean-Americans and 8.6%
34% had been infected with HBV and recovered. Of those under age
30, 61% had been immunized.
- About 27% of those screened required
- Among the 4,909 (66%) participants who
claimed they had not been tested for or vaccinated against HBV,
the prevalence of chronic infection was 4.1%.
Among 1,630 participants (22%) who reported
- 71% were immune either due to
immunization or resolved infection
- 29% were still susceptible to
- And 3% had chronic hepatitis B.
Of 555 participants who said they were unsure
of their prior
HBV testing results, 9% (50) had chronic hepatitis B. Curiously,
only 47% of
197 participants who reported having been diagnosed with hepatitis
were positive for infection.
HBV infection was highest among those age 50–59
among young adults under age 30 and seniors over age 70.
Among those with chronic hepatitis B, the
average age was
51, most were male, 99% were foreign-born and 22% did not speak
74% of those infected had no medical insurance.
The healthcare providers sent out test results
participants and instructed those infected to get medical care.
77% (297) of people with HBV could be reached six months after
notified of their diagnosis. Among them, 57% reported that they
follow-up medical care.
Among 128 patients (43%) who had not sought
treatment, 81 (63%) cited lack of money and health insurance as
the reasons for
not seeking care. Even when care and lab tests are heavily
costs are still prohibitive, researchers noted.
"In Los Angeles, indigent patients may seek
care at one of the government (Los Angeles County) clinics, but
with only 27%
individuals with chronic hepatitis B being able to read English,
most ... are
unable to navigate through this medical system," they wrote. Even
care is sough, wait times can reach four months, they added.
"To maximize the benefit of limited funding and
the greatest number of individuals with chronic hepatitis B to
priority for allocation of resources should be directed towards
patients within primary care physician and gastroenterology
Abstract: Demographic and serological
of Asian Americans with hepatitis
infection diagnosed at community
Asian Pacific Liver Center, Saint
Center, Los Angeles, CA, USA.
information regarding follow-up and hepatitis B
status of Asian Americans diagnosed
chronic hepatitis B (CHB) through community
The aims of this study were to evaluate the
characterize CHB among Asians living in Los Angeles, assess
individuals with CHB diagnosed at screening and
patients with CHB followed by community
Between October 2007 and May 2010, 7387 Asians were tested for
positive individuals (CHB) underwent additional testing for ALT,
and HBV DNA. Patients with CHB were contacted 6 months later to
they received follow-up care. We compared serological
these individuals with CHB to patients with CHB who were seen
for the first
time (treatment naïve) by community
gastroenterologists during the
study period. Prevalence of CHB was 5.2%. About 99% patients
with CHB were
foreign-born, and only 27% could read/write English. 297 (77%)
CHB could be reached 6 months after diagnosis; 43% did not
follow-up care, mostly because of lack of medical insurance.
Patients with CHB
followed by gastroenterologists were more likely to have
insurance (69% vs 26%,
P < 0.0001). 90% patients with CHB at screening were HBeAg
negative/anti-HBe positive with 62% having inactive disease
compared to only
30% of patients seen by gastroenterologists (P < 0.0001).
CHB participants, 13% met criteria for treatment compared to 51%
with CHB (P < 0.0001).
Only a small number of CHB screening
participants require antiviral therapy. Lack of medical
insurance is the main
reason for most patients with CHB not seeking follow-up care
J Viral Hepat.
doi: 10.1111/jvh.12073. Epub 2013 Mar 25.
Labels: access, demographics, epidemiology, literacy, patient education, screening