Original Contribution
The American Journal of Gastroenterology (2007) 102, 767–772; doi:10.1111/j.1572-0241.2007.01060.x
Hepatitis B Virus Infection in 6,130 Unvaccinated Korean-Americans Surveyed Between 1988 and 1990
Hie-Won L Hann MD, Richard S Hann MD and Willis C Maddrey MD*
Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
Correspondence: Hie-Won L Hann, MD, Jefferson Medical College, 1025 Walnut Street, Rm 904, Philadelphia, PA, 19107.
*Current address: Department of Medicine, University of Texas Southwestern Medical Center in Dallas, Dallas, Texas
Received 1 March 2006; Accepted 20 October 2006.
Abstract
OBJECTIVES:
During the past decades, the influx of immigrants from hepatitis B virus (HBV) endemic regions has brought significant changes in the prevalence of HBV-associated liver diseases and hepatocellular carcinoma (HCC) in the United States. Our program, which was intended to identify those in need of hepatitis B vaccination, helped us to learn of the natural history of HBV infection in Korean Americans.
METHODS:
Between November of 1988 and May 1990, we screened 6,130 Korean Americans in the eastern United States for HBV infection.
RESULTS:
The overall hepatitis B surface antigen (HBsAg) (+) rate was 6.1%, with 8.0% for males and 4.4% for females. The carrier rate peaked in subjects between the ages of 21 and 40 yr. The HBsAg (+) rate for 452 U.S.-born children was lower (2.7%) than that of 623 Korean-born (5.5%). None received hepatitis B immune-globulin or HBV vaccination. The vertical transmission rate was 30.3% in children born to HBsAg (+) mothers and 100% in those born to hepatitis B e antigen (HBeAg) positive mothers. In contrast, the paternal transmission rate was low; 10.3% in children with HBsAg (+) fathers and 19.2% in those with HBeAg (+) fathers.
Another significant observation was the unexpected finding of ongoing liver diseases in incidentally identified carriers. Evaluation of 139 asymptomatic adult carriers revealed that 42% had elevated liver enzymes and 11% had already developed liver cirrhosis.
CONCLUSION:
These findings strongly suggest the need for active HBV screening of immigrants from endemic regions and, most importantly, the need for careful monitoring of the carriers.
