Literature DB >> 27190318

A Novel Collaborative Community-Based Hepatitis B Screening and Linkage to Care Program for African Immigrants.

Hari Shankar1, Demetri Blanas1, Kian Bichoupan1, Daouda Ndiaye2, Ellie Carmody3, Valerie Martel-Laferriere1, Joan Culpepper-Morgan4, Dougles T Dieterich1, Andrea D Branch1, Mulusew Bekele2, Kim Nichols2, Ponni V Perumalswami1.   

Abstract

BACKGROUND: 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.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Entities:  

Keywords:  African; hepatitis B; linkage to care; liver cancer; screening

Mesh:

Substances:

Year:  2016        PMID: 27190318      PMCID: PMC4889899          DOI: 10.1093/cid/ciw090

Source DB:  PubMed          Journal:  Clin Infect Dis        ISSN: 1058-4838            Impact factor:   9.079


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