Harris Aaron M, Schoenbachler Ben T, Ramirez Gilberto, Vellozzi Claudia, Beckett Geoff A
Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, GA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN.
Public Health Rep. 2016 May-Jun;131 Suppl 2(Suppl 2):20-8. doi: 10.1177/00333549161310S204.
Hepatitis B virus (HBV) infection continues to be a public health threat in the United States. As many as 2.2 million people are infected, approximately 70% of whom are foreign-born, and fewer than one-third are aware of their infection. We launched an HBV testing and linkage-to-care initiative among foreign-born people.
As part of the Hepatitis Testing and Linkage to Care (HepTLC) initiative, which promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites, nine U.S. programs in seven states conducted HBV screening from October 2012 to September 2014. The nine programs partnered with health-care centers and community-based organizations to recruit foreign-born people recommended for HBV testing. We assessed patient characteristics, region of origin, risk factors, hepatitis B surface antigen (HBsAg) status, and referral to medical care.
Of 23,144 participants tested for HBV, 1,317 (5.7%) were HBsAg positive. Of these, the median age was 47 years, 1,205 (91%) had at least one risk factor for HBV infection, 1,117 (85%) received posttest counseling, 1,098 (83%) were referred to care, and 606 (46%) attended a first medical appointment. The proportion of HBsAg-positive participants by region of origin included Africa (10%, 206/2,129), Western Pacific (6%, 616/9,673), Eastern Mediterranean (5%, 174/3,337), Southeast Asia (5%, 191/3,891), South America (2%, 6/252), Eastern Europe (2%, 6/262), and North America (1%, 17/1,936).
Community-based HBV testing initiatives can identify substantial numbers of people with chronic HBV infection, inform them of their infection status, and provide posttest counseling and linkage to care. However, strategies are needed to improve linkage to HBV-directed medical care for foreign-born individuals living with chronic HBV infection.
乙肝病毒（HBV）感染在美国仍然是一个公共卫生威胁。多达220万人受到感染，其中约70%出生于国外，且知晓自己感染情况的不到三分之一。我们在出生于国外的人群中发起了一项HBV检测及与医疗服务衔接的倡议。
作为促进乙肝和丙肝筛查、检测后咨询以及在美国34个地点与医疗服务衔接的“肝炎检测及与医疗服务衔接”（HepTLC）倡议的一部分，美国七个州的九个项目在2012年10月至2014年9月期间开展了HBV筛查。这九个项目与医疗保健中心和社区组织合作，招募被推荐进行HBV检测的出生于国外的人群。我们评估了患者特征、原籍地区、风险因素、乙肝表面抗原（HBsAg）状态以及转介至医疗服务的情况。
在23144名接受HBV检测的参与者中，1317人（5.7%）HBsAg呈阳性。其中，年龄中位数为47岁，1205人（91%）至少有一项HBV感染风险因素，1117人（85%）接受了检测后咨询，1098人（83%）被转介至医疗服务，606人（46%）参加了首次医疗预约。按原籍地区划分的HBsAg阳性参与者比例包括非洲（10%，206/2129）、西太平洋（6%，616/9673）、东地中海（5%，174/3337）、东南亚（5%，191/3891）、南美洲（2%，6/252）、东欧（2%，6/262）和北美洲（1%，17/1936）。
基于社区的HBV检测倡议能够识别出大量慢性HBV感染患者，告知他们的感染状况，并提供检测后咨询以及与医疗服务的衔接。然而，需要采取策略来改善为慢性HBV感染的出生于国外的个体与针对HBV的医疗服务的衔接。
