title: Lower than expected hepatitis B virus infection prevalence among first generation Koreans in the U.S.: results of HBV screening in the Southern California Inland Empire.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection is prevalent in Asian immigrants in the USA. California's Inland Empire region has a population of approximately four million, including an estimated 19,000 first generation Koreans. Our aim was to screen these adult individuals to establish HBV serological diagnoses, educate, and establish linkage to care.
  
  
  METHODS
  A community-based program was conducted in Korean churches from 11/2009 to 2/2010. Subjects were asked to complete a HBV background related questionnaire, provided with HBV education, and tested for serum HBsAg, HBsAb and HBcAb. HBsAg positive subjects were tested for HBV quantitative DNA, HBeAg and HBeAb, counseled and directed to healthcare providers. Subjects unexposed to HBV were invited to attend a HBV vaccination clinic.
  
  
  RESULTS
  A total of 973 first generation Koreans were screened, aged 52.3y (18-93y), M/F: 384/589. Most (75%) had a higher than high school education and were from Seoul (62.2%). By questionnaire, 24.7% stated they had been vaccinated against HBV. The serological diagnoses were: HBV infected (3.0%), immune due to natural infection (35.7%), susceptible (20.1%), immune due to vaccination (40.3%), and other (0.9%). Men had a higher infection prevalence (4.9% vs. 1.7%, p = 0.004) and a lower vaccination rate (34.6% vs. 44.0%, p = 0.004) compared to women. Self-reports of immunization status were incorrect for 35.1% of subjects.
  
  
  CONCLUSIONS
  This large screening study in first generation Koreans in Southern California demonstrates: 1) a lower than expected HBV prevalence (3%), 2) a continued need for vaccination, and 3) a need for screening despite a reported history of vaccination.
authors.forename: Natali
authors.initials: N
authors.lastname: Navarro
authors.forename: Nelson
authors.initials: N
authors.lastname: Lim
authors.forename: Jiah
authors.initials: J
authors.lastname: Kim
authors.forename: Elliot
authors.initials: E
authors.lastname: Joo
authors.forename: Kendrick
authors.initials: K
authors.lastname: Che
authors.forename: Bruce Allen
authors.initials: BA
authors.lastname: Runyon
authors.affiliation: Division of GI and Liver Diseases, Loma Linda University Medical Center, 11234 Anderson St,, Loma Linda, CA 92354, USA. mmendler@ucsd.edu.
authors.forename: Michel Henry
authors.initials: MH
authors.lastname: Mendler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D066106:Seoul / Q000208:ethnology; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens