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Prevalence of chronic hepatitis B among foreign‐born persons living in the United States by country of origin
Author(s) -
Kowdley Kris V.,
Wang Chia C.,
Welch Sue,
Roberts Henry,
Brosgart Carol L.
Publication year - 2012
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.24804
Subject(s) - medicine , demography , confidence interval , seroprevalence , population , foreign born , hepatitis b , environmental health , immunology , serology , sociology , antibody
Estimates of the prevalence of chronic hepatitis B (CHB) in the United States differ significantly, and the contribution of foreign‐born (FB) persons has not been adequately described. The aim of this study was to estimate the number of FB persons in the United States living with CHB by their country of origin. We performed a systematic review for reports of HBsAg seroprevalence rates in 102 countries (covering PubMed from 1980 to July 2010). Data from 1,373 articles meeting inclusion criteria were extracted into country‐specific databases. We identified 256 seroprevalence surveys in emigrants from 52 countries (including 689,078 persons) and 1,797 surveys in the general populations of 98 countries (including 17,861,035 persons). Surveys including individuals with lower or higher risk of CHB than the general population were excluded. Data were combined using meta‐analytic methods to determine country‐specific pooled CHB prevalence rates. Rates were multiplied by the number of FB living in the United States in 2009 by country of birth from the U.S. Census Bureau to yield the number of FB with CHB from each country. We estimate a total of 1.32 million (95% confidence interval: 1.04‐1.61) FB in the United States living with CHB in 2009; 58% migrated from Asia and 11% migrated from Africa, where hepatitis B is highly endemic. Approximately 7% migrated from Central America, a region with lower CHB rates, but many more emigrants to the United States. This analysis suggests that the number of FB persons living with CHB in the United States may be significantly greater than previously reported. Assuming 300,000‐600,000 U.S.‐born persons with CHB, the total prevalence of CHB in the United States may be as high as 2.2 million. (H epatology 2012)