Changing epidemiology of hepatitis B in a U.S. community.
Despite a reduction in newly acquired hepatitis B virus (HBV) infections since the mid-1980s, HBV remains an important cause of liver disease in the U.S. We report the prevalence of chronic HBV infection in a U.S. community and describe demographic and clinical characteristics. The Rochester Epidemiology Project records healthcare encounters of residents of Olmsted County, Minnesota. For all cases with a potential diagnosis of hepatitis B in this database, complete medical records were reviewed to identify subjects who met the inclusion criteria, i.e., a clinician diagnosis of chronic HBV infection and a laboratory record of positive hepatitis B surface antigen (HBsAg). There were 191 residents with chronic HBV infection in the community, consisting of 53% Asian, 29% African, 13% Caucasian, and 5% other or unknown race. The overall age- and sex-adjusted prevalence of HBV in this community was 0.15% in 2000. The race-specific prevalence was highest among Asians (2.1%), followed by African Americans (1.9%). The prevalence among Caucasians was 0.02%. Overall, 86% were born outside the U.S., 98% of whom were non-Caucasian. A total of 131 residents were tested for HBV replicative status, of whom 27% had viral replication. Of those tested for aminotransferases (n = 184), 28% had an abnormal value at least once. In a multivariable regression analysis, replicative status was the most influential (odds ratio [OR] = 5.98, P <.01) factor associated with abnormal aminotransferase values, followed by male gender (OR = 3.69) and age greater than 40 years (OR = 2.32 per decade). In conclusion, in this Midwestern community, chronic HBV infection was predominantly seen in immigrants from endemic parts of the world.
Division of Gastroenterology and Hepatology (Mayo 16E), Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA. kim.woona@mayo.edu
W Ray
WR
Kim
Joanne T
JT
Benson
Terry M
TM
Therneau
Heidi A
HA
Torgerson
Barbara P
BP
Yawn
L Joseph
LJ
Melton
D000328:Adult; D000349:Africa / Q000208:ethnology; D017677:Age Distribution; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D006515:Hepatitis B virus; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D000637:Transaminases / Q000097:blood; D014779:Virus Replication; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
D000637:Transaminases