title: HCV Prevalence in Asian Americans in California.
abstract: The World Health Organization estimates that 170 million persons are infected with HCV worldwide, but only 22 million are from the Americas and Europe, compared to 94 million from Asia. HCV prevalence in the general US population is 1.6 %, but data for Asian Americans are limited. Our goal was to examine HCV prevalence in Asian Americans in a large ethnically diverse patient cohort seeking primary care at a free clinic in Northern California. A total of 1347 consecutive patients were seen from September 2009 to October 2012 and were studied via individual chart review using case report forms. HCV infection was defined as positive HCV antibody (anti-HCV) or HCV RNA by PCR. 699 out of 1347 patients were screened for HCV. Asian Americans comprised 57.2 % of these patients and 29 (4.1 %) patients tested positive for HCV. Of these 29 HCV-positive patients, 22 (75.9 %) were Asian, yielding a prevalence of 5.5 % for Asians and 2.3 % for non-Asians (P = 0.038). The highest HCV prevalence was seen in Vietnamese patients at 7.9 %, and 6.0 % in Chinese patients. Of the HCV-positive Asians, none had a history of intravenous drug use (IVDU), tattoos, or sexual exposure. On multivariate analysis, significant independent predictors for positive HCV infection were male gender (OR 2.53, P = 0.02) and presence of known risk factors (OR 21.1, P < 0.001). However, older age and Asian ethnicity were found to be significant predictors of HCV infection (OR 1.03, P = 0.05 and 2.31, P = 0.066, respectively). In our study, HCV prevalence in patients seeking routine primary care was 5.5 % in Asian Americans, which was over double the prevalence for non-Asians at 2.3 %. Known risk factors were also notably absent in Asian patients with HCV infection. The high prevalence of HCV in Asian-Americans is likely reflective of the higher prevalence of HCV in their countries of origin in Asia. Asian-Americans immigrants from endemic countries are at higher risk of HCV infection and should be screened for HCV, regardless of their exposure risk profile.
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA.
authors.forename: Oliver N
authors.initials: ON
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Chang
authors.affiliation: Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA.
authors.forename: Ailinh
authors.initials: A
authors.lastname: Do
authors.affiliation: Division of General Medical Discipline, Stanford University Medical Center, Palo Alto, CA, USA.|Pacific Free Clinic, San Jose, CA, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Martin
authors.affiliation: Pacific Free Clinic, San Jose, CA, USA.|Stanford Center for Clinical Informatics, Palo Alto, CA, USA.
authors.forename: Andy
authors.initials: A
authors.lastname: Martin
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.
authors.forename: Mindie H
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005838:Genotype; D006526:Hepatitis C / Q000208:ethnology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D015819:Substance Abuse, Intravenous
chemical_list: D018937:Hepatitis C Antibodies
keywords: Clinic-based; Epidemiology; Hepatitis C; Risk factors; Screening