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Latino Adults Have Hepatitis B Rates Similar to the General U.S. Population

Hispanic and Latino adults living in the U.S. are about as likely as the general population to have active hepatitis B virus (HBV) infection, though rates varied across subgroups based on country of origin, according to research published in the February edition of Hepatology.

Molly Jung from Albert Einstein College of Medicine and colleaguesassessed the prevalence of HBV exposure, active HBV infection, and vaccine-induced HBV immunity among U.S. Hispanics and Latinos -- the first large-scale population-based study of HBV infection among U.S. Hispanic/Latino adults by place of birth.

Accurate information about hepatitis B rates in different subgroups is important for tailoring education and prevention efforts. Asians in the U.S. have a high rate of HBV infection, often attributable to mother-to-child transmission in countries where the virus is endemic, but rates among Latinos -- another population with a high proportion of immigrants -- is unknown.

The analysis included 11,999 participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based household survey in 4 urban communities: the Bronx, Chicago, Miami, and San Diego.

The study population consisted of adults age 18-74 who self-identified as Hispanic or Latino. About 60% of participants were women and the mean age was 46 years. Being a household survey, it excluded homeless and institutionalized individuals such as prisoners and people in long-term care facilities.

The analysis determined hepatitis B status according to serum markers. HBV exposure is indicated by presence of serum hepatitis B core antibodies (anti-HBc), vaccine-induced immunity is based on hepatitis B surface antibodies (anti-HBs), and current active HBV infection is indicated by hepatitis B surface antigen (HBsAg). Some unvaccinated people become infected and clear HBV naturally, leaving them with anti-HBc and anti-HBs antibodies but without HBsAg. Vaccine-induced immunity was defined as presence of anti-HBs but not anti-HBc.

Results

• The prevalence of serum HBsAg or active infection was 0.29% overall, but it varied by country of birth.
• Men were more likely than women to be HBsAg positive (0.43% vs 0.16%, respectively).
• Antibody prevalence rates were 22% for anti-HBs and 7.7% for anti-HBc.
• Again, men were more likely than women to have anti-HBc antibodies indicating exposure (10% vs 6.4%).
• People born in the Dominican Republic had the highest rates of both HBV exposure (20% among women and 30% among men) and active infection (0.95%).
• Vaccine-induced immunity against hepatitis B was greatest among people age 18-29 years (60% among women and 54% among men).

Vaccine-induced immunity declined with increasing age, regardless of country of birth. This reflects the fact that the U.S. and many other countries now include the hepatitis B vaccine as a routine infant immunization; universal childhood vaccination started in the U.S. in the early 1990s.

"The overall age-standardized prevalence of active HBV infection in Hispanic/Latino adults (0.29%) was no different from the general U.S. population estimate (0.27%) and did not exceed 2%, regardless of country of birth," the study authors concluded. "These data do not support targeting HBV screening to U.S. Hispanic/Latino adults based upon background."

The Albert Einstein research team previously reported that hepatitis C virus (HCV) infection among U.S. Hispanics and Latinos also varies by region of origin, with Puerto Ricans having the highest rate.

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Reference

M Jung, MH Kuniholm, GY Ho, et al. The distribution of hepatitis B exposure and infection in a population-based sample of U.S. Hispanic adults. Hepatology 63(2):445-452. February 2016.