title: A Novel Collaborative Community-Based Hepatitis B Screening and Linkage to Care Program for African Immigrants.
abstract: Sub-Saharan African nations have among the highest rates of chronic hepatitis B virus (HBV) infection worldwide, but little is known about HBV infection in African-born persons in the United States.
  
  
  
  From October 2011 to July 2013, community-based HBV screenings were conducted targeting persons originating from Africa in New York City. Persons were identified as currently HBV infected (HBsAg positive) or exposed (HBcAb positive).
  
  
  
  Overall, 955 persons were screened for HBV; the median age was 45 years (interquartile range, 35-54 years) and 75.5% were men. Of these, 919 persons had no history of liver disease, of whom 9.6% (n = 88) had current HBV infection and 73.9% (n = 679) had exposure. In logistic regression, older age (odds ratio [OR], 0.97; 95% confidence interval [CI], .94-.99; P < .01) and female sex (OR, 0.35; 95% CI, .14-.75; P < .01) were less likely to be associated with HBV infection, whereas having a mother with hepatitis was associated with infection (OR, 18.8; 95% CI, 2.72-164.65; P < .01). HBV exposure was associated with older age (OR, 1.03; 95% CI, 1.01-1.04; P < .01), whereas female sex (OR, 0.46; 95% CI, .33-.66; P < .01) and history of blood transfusion (OR, 0.43; 95% CI, .22-.83; P = .01) were negatively associated. A patient navigator linked 97% of infected persons to care. Eleven persons were recommended for treatment, of whom 9 (82%) started therapy. Three persons were diagnosed with hepatocellular carcinoma on the first screening ultrasound.
  
  
  
  The high burden of HBV infection among African immigrants in the United States underscores a need for continued screening and linkage to care in this at-risk population.
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Hari
authors.initials: H
authors.lastname: Shankar
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Demetri
authors.initials: D
authors.lastname: Blanas
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Kian
authors.initials: K
authors.lastname: Bichoupan
authors.affiliation: African Services Committee.
authors.forename: Daouda
authors.initials: D
authors.lastname: Ndiaye
authors.affiliation: Division of Infectious Diseases and Immunology, Department of Medicine, New York University School of Medicine.
authors.forename: Ellie
authors.initials: E
authors.lastname: Carmody
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Valerie
authors.initials: V
authors.lastname: Martel-Laferriere
authors.affiliation: Division of Gastroenterology, Department of Medicine, Harlem Hospital Center, New York, New York.
authors.forename: Joan
authors.initials: J
authors.lastname: Culpepper-Morgan
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Dougles T
authors.initials: DT
authors.lastname: Dieterich
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Branch
authors.affiliation: African Services Committee.
authors.forename: Mulusew
authors.initials: M
authors.lastname: Bekele
authors.affiliation: African Services Committee.
authors.forename: Kim
authors.initials: K
authors.lastname: Nichols
authors.affiliation: Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
authors.forename: Ponni V
authors.initials: PV
authors.lastname: Perumalswami
mesh_terms: D000328:Adult; D044383:Black People / Q000208:ethnology / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular; D003153:Community Health Services; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines; D006801:Humans; D008113:Liver Neoplasms; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009519:New York City; D012307:Risk Factors; D001741:Black or African American
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
keywords: African; hepatitis B; linkage to care; liver cancer; screening