title: Hepatitis B virus infection testing and prevalence among Asian and Pacific Islanders.
abstract: OBJECTIVE
  Asian and Pacific Islanders (APIs) constitute less than 6% of the US population, but account for more than half of Americans with chronic hepatitis B virus (HBV) infection. We sought to examine the effect of country of origin on HBV testing and chronic HBV infection prevalence among APIs.
  
  
  METHODS
  We analyzed demographic and clinical data collected for adults from Kaiser Permanente Hawaii with 1 or more healthcare encounters during 2006 to 2008, 12 months or more of follow-up before 2009, and no HBV-related diagnosis within 6 months of enrollment. Persons who received a test and a positive test result for HBV surface antigen or HBV DNA were classified "tested" and with "chronic HBV infection," respectively.
  
  
  RESULTS
  Of 92,687 eligible APIs, 53,573 (58%) had country-of-origin data available. Among those, 41,263 were US born; 28.3% were tested; and 1.8% of those tested had chronic HBV infection. Of 12,310 foreign-born APIs, 30.5% were tested and 7.4% of those tested had chronic HBV infection. Foreignborn APIs had higher odds of being tested (odds ratio [OR] = 1.15) and testing positive (OR = 4.18) compared with US-born APIs. Persons with 2 or more abnormal tests for alanine aminotransferase (ALT) levels had higher odds of getting tested (OR = 6.12) and of testing positive (OR = 1.86) compared with persons with other ALT levels.
  
  
  CONCLUSIONS
  Less than one-third of this managed care API population (29% of 53,573) was tested, yet the prevalence of chronic HBV infection (3.2%) was 12 times higher than that of the general US population. These findings underscore the importance of adherence to HBV testing guidelines to identify persons with infection so they may be linked to care.
authors.affiliation: Kaiser Permanente Center for Health Research Hawaii, 501 Alakawa St, Ste 201, Honolulu, HI 96817. E-mail: vinutha.x.vijayadeva@kp.org.
authors.forename: Vinutha
authors.initials: V
authors.lastname: Vijayadeva
authors.forename: Phillip R
authors.initials: PR
authors.lastname: Spradling
authors.forename: Anne C
authors.initials: AC
authors.lastname: Moorman
authors.forename: Loralee B
authors.initials: LB
authors.lastname: Rupp
authors.forename: Mei
authors.initials: M
authors.lastname: Lu
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Gordon
authors.forename: Emily
authors.initials: E
authors.lastname: Henkle
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Boscarino
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.forename: Cynthia
authors.initials: C
authors.lastname: Nakasato
mesh_terms: D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D003140:Communicable Disease Control / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens