Tse-Ling Fong1,2, Naranbaatar D Dashdorj3,4, Takeshi Saito5,6, Brian T Lee1, Mimi Chang2, Khishigsuren Nasanbayar3, Enkhjargal Tsogtoo4, Delgerbat Boldbaatar4, Esugen D Dashdorj4, Namuun E Clifford3, Arghun N Dashdorj4, Bo-Ram Bang1, Takeshi Chida1, Carolina Lim2, Masaya Sugiyama7, Masashi Mizokami7, Naranjargal J Dashdorj3,4, Ping Liu8, Jeffrey S Glenn8. 1. Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA. 2. Asian Pacific Liver Center, St. Vincent Medical Center, Los Angeles, CA, USA. 3. Onom Foundation, 3 Governance Academy Street, 15th Khoroo, Khan-Uul District, Ulaanbaatar, 17013-0017, Mongolia. 4. The Liver Center, 31 UNESCO Street, Dalai Tower 1st Khoroo, Sukhbaatar District, Ulaanbaatar, 14230, Mongolia. 5. Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA. saitotak@usc.edu. 6. USC Research Center for Liver Diseases, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, 2011 Zonal Avenue, HMR 801A, Los Angeles, CA, 90033-9141, USA. saitotak@usc.edu. 7. Genome Medical Sciences Project, National Center for Global Health and Medicine, Ichikawa, Chiba, Japan. 8. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Abstract
BACKGROUND: Mongolia is a highly endemic region for chronic hepatitis B (HBV), hepatitis delta (HDV), and hepatitis C (HCV) infections. Aim of this study was to comprehensively characterize chronic viral hepatitis among Mongols living in Southern California. METHODS: Three screening events were conducted between August and November 2018, with 528 adult Mongols tested for HBV and HCV. HBsAg (+) individuals (CHB) underwent additional testing for HDV RNA and anti-HDV. Liver tests, platelet count, and FibroScan™ were performed on CHB and chronic HCV (CHC) individuals. RESULTS: Fifty-one out of 534 were HBsAg reactive (9.7%), and all were foreign-born. Mean age of CHB individuals was 37.8 (range 18-69) years. Forty-six out of 51 were HBeAg (-). HBV genotypes were exclusively D2 or A1. Twenty-one out of 51 (41.2%) were anti-HDV (+) and 17/51 (33.3%) were HDV RNA (+). HDV RNA (+) individuals had significantly higher ALT, fibrosis-4 score, and liver stiffness compared to HDV RNA (-) individuals. Incidence of advanced fibrosis was higher in HDV RNA (+) individuals (57% vs. 13%, p = 0.013). Forty-eight (9.1%) individuals were anti-HCV (+) and 19 (3.6%) were HCV RNA (+). Mean age of CHC individuals was 40.2 (range 28-71) years. Prevalence of anti-HCV (+) was higher among those born between 1945 and 1965 versus those born after 1965 (18.8% vs. 7.9%, p = 0.025). Genotype 1b was predominant. Incidence of cirrhosis was 7% among all participants. CONCLUSIONS: Mongols living in the USA are at high risk for CHB and CHC infections. One-third of CHB individuals had CHD superinfection with advanced fibrosis. Universal screening for viral hepatitis in Mongols in the USA is mandatory.
BACKGROUND: Mongolia is a highly endemic region for chronic hepatitis B (HBV), hepatitis delta (HDV), and hepatitis C (HCV) infections. Aim of this study was to comprehensively characterize chronic viral hepatitis among Mongols living in Southern California. METHODS: Three screening events were conducted between August and November 2018, with 528 adult Mongols tested for HBV and HCV. HBsAg (+) individuals (CHB) underwent additional testing for HDV RNA and anti-HDV. Liver tests, platelet count, and FibroScan™ were performed on CHB and chronic HCV (CHC) individuals. RESULTS: Fifty-one out of 534 were HBsAg reactive (9.7%), and all were foreign-born. Mean age of CHB individuals was 37.8 (range 18-69) years. Forty-six out of 51 were HBeAg (-). HBV genotypes were exclusively D2 or A1. Twenty-one out of 51 (41.2%) were anti-HDV (+) and 17/51 (33.3%) were HDV RNA (+). HDV RNA (+) individuals had significantly higher ALT, fibrosis-4 score, and liver stiffness compared to HDV RNA (-) individuals. Incidence of advanced fibrosis was higher in HDV RNA (+) individuals (57% vs. 13%, p = 0.013). Forty-eight (9.1%) individuals were anti-HCV (+) and 19 (3.6%) were HCV RNA (+). Mean age of CHC individuals was 40.2 (range 28-71) years. Prevalence of anti-HCV (+) was higher among those born between 1945 and 1965 versus those born after 1965 (18.8% vs. 7.9%, p = 0.025). Genotype 1b was predominant. Incidence of cirrhosis was 7% among all participants. CONCLUSIONS: Mongols living in the USA are at high risk for CHB and CHC infections. One-third of CHB individuals had CHD superinfection with advanced fibrosis. Universal screening for viral hepatitis in Mongols in the USA is mandatory.
Authors: K M De Cock; J C Niland; H P Lu; A Rahimian; V Edwards; K Shriver; S Govindarajan; A G Redeker Journal: Am J Epidemiol Date: 1988-06 Impact factor: 4.897
Authors: A M Di Bisceglie; M Lombardero; J Teckman; L Roberts; H L A Janssen; S H Belle; J H Hoofnagle Journal: J Viral Hepat Date: 2016-12-05 Impact factor: 3.728