The clinical presentation of chronic hepatitis B virus infection in Asian Americans: a single center retrospective study.
BACKGROUND
The clinical course of chronic hepatitis B virus (HBV) infection varies with ethnicity. Little is known about the clinical presentation of chronic HBV infection in Asian Americans.


OBJECTIVE
To define the clinical presentation of chronic HBV infection in Asian Americans.


METHODS
This is a retrospective study that used systematic chart review and statistical analysis to investigate 213 Asian-American patients with chronic HBV infection who presented to a university medical center.


RESULTS
This cohort included 55.8% male patients, 97.9% were born outside the US, and 52.3% reported a family history of HBV infection. Of the 56 patients with liver biopsy, 34.0% had stage 3 to 4 fibrosis. In patients with available data, 21.5% were hepatitis B e antigen positive [HBeAg (+)] and 31.1% had HBV DNA levels >1 x 10(6) copies/mL. Patients with HBeAg (+) HBV infection were diagnosed at a younger age (P=0.002) and with higher alanine aminotransferase (P=0.001) and HBV DNA (P=0.001) levels. Although only 3.3% presented with obesity (ie, body mass index >or=30 kg/m2), 43.4% had evidence of hepatic steatosis. Presentation of hepatocellular carcinoma was associated with an older age at diagnosis (P<0.001), male sex (P<0.001), tobacco use (P<0.001), a greater degree of fibrosis on liver biopsy (P=0.01), and higher alanine aminotransferase, aspartate aminotransferase (P<0.001), and a fetoprotein (P<0.001) levels.


CONCLUSIONS
Chronic HBV infection in foreign-born Asian Americans was characterized by a low rate of HBeAg (+) and male predominance as well as high rates of family history of HBV infection, hepatic fibrosis, and hepatic steatosis.
Mellen
Jonathan S
JS
Department of Medicine parallel, Chao Comprehensive Digestive Disease Center, Irvine Medical Center, Orange, CA 92868, USA.
Xia
Victor W
VW
Hashemzadeh
Mehrtash
M
Imagawa
David
D
Jamal
Mazen
M
Hoefs
John
J
Hu
Ke-Qin
KQ
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D001213:Asian; D001219:Aspartate Aminotransferases / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D005234:Fatty Liver / Q000150:complications; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000509:alpha-Fetoproteins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase