Hepatitis B Exceeds Two Million in U.S.

A new study published in Hepatology finds that the prevalence of chronic hepatitis B virus (HBV) infection in the U.S. may be as high as 2.2 million cases. According to the study, the higher prevalence of chronic HBV can be attributed to foreign-born persons who were infected in their country of origin prior to arrival in the U.S. Emigrants from Asia and Africa, where infection with hepatitis B is highly endemic, represent close to 70 percent of the 1.32 million foreign-born persons living with chronic HBV in the U.S. in 2009.

In the study, researchers systematically reviewed the world’s medical literature for HBV seroprevalence rates from 1980 to 2010. They identified 256 disease prevalence surveys for emigrants from 52 countries and 1,797 surveys for the general populations of 98 countries for use in the meta-analysis. Individuals with lower or higher risk of chronic HBV than the general population and groups not likely to emigrate were excluded. Analysis determined that between 1.04 million and 1.61 million (1.32 million estimate) foreign-born persons were living with chronic hepatitis B in the U.S. in 2009.

Chronic HBV is a major health burden that experts say affects up to 400 million individuals worldwide, with up to 25 percent at risk of premature mortality due to primary liver cancer and end-stage liver disease if the infection is left untreated. In the U.S., the Centers for Disease Control and Prevention estimates that in 2006 there were 800,000 to 1.4 million persons living with chronic HBV. However, previous reports may underestimate the true burden of chronic HBV because individuals in the U.S. who are institutionalized, homeless and foreign-born “at risk” populations are underrepresented on national health surveys. “There is a wide discrepancy in the current estimates of the chronic HBV burden in the U.S.,” explains lead author Dr. Kris Kowdley, director of the Liver Center of Excellence at Virginia Mason Medical Center in Seattle, Wash. “Understanding the ethnic and cultural populations affected by chronic hepatitis B will provide more accurate estimates and help to develop programs for prevention, earlier diagnosis and access to care for those at greatest risk.”