Hepatitis B virus infection in 6,130 unvaccinated Korean-Americans surveyed between 1988 and 1990.
OBJECTIVE
During the past decades, the influx of immigrants from hepatitis B virus (HBV) endemic regions has brought significant changes in the prevalence of HBV-associated liver diseases and hepatocellular carcinoma (HCC) in the United States. Our program, which was intended to identify those in need of hepatitis B vaccination, helped us to learn of the natural history of HBV infection in Korean Americans.


METHODS
Between November of 1988 and May 1990, we screened 6,130 Korean Americans in the eastern United States for HBV infection.


RESULTS
The overall hepatitis B surface antigen (HBsAg) (+) rate was 6.1%, with 8.0% for males and 4.4% for females. The carrier rate peaked in subjects between the ages of 21 and 40 yr. The HBsAg (+) rate for 452 U.S.-born children was lower (2.7%) than that of 623 Korean-born (5.5%). None received hepatitis B immune-globulin or HBV vaccination. The vertical transmission rate was 30.3% in children born to HBsAg (+) mothers and 100% in those born to hepatitis B e antigen (HBeAg) positive mothers. In contrast, the paternal transmission rate was low; 10.3% in children with HBsAg (+) fathers and 19.2% in those with HBeAg (+) fathers. Another significant observation was the unexpected finding of ongoing liver diseases in incidentally identified carriers. Evaluation of 139 asymptomatic adult carriers revealed that 42% had elevated liver enzymes and 11% had already developed liver cirrhosis.


CONCLUSIONS
These findings strongly suggest the need for active HBV screening of immigrants from endemic regions and, most importantly, the need for careful monitoring of the carriers.
Hann
Hie-Won L
HW
Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Hann
Richard S
RS
Maddrey
Willis C
WC
D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002353:Carrier State; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007723:Korea / Q000208:ethnology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D017325:Hepatitis B Vaccines