Shankar Hari, Blanas Demetri, Bichoupan Kian, Ndiaye Daouda, Carmody Ellie, Martel-Laferriere Valerie, Culpepper-Morgan Joan, Dieterich Dougles T, Branch Andrea D, Bekele Mulusew, Nichols Kim, Perumalswami Ponni V
Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine.
African Services Committee.
Clin Infect Dis. 2016 Jun 1;62 Suppl 4(Suppl 4):S289-97. doi: 10.1093/cid/ciw090.
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.
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).
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.
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.
撒哈拉以南非洲国家是全球慢性乙型肝炎病毒（HBV）感染率最高的地区之一，但对于在美国出生的非洲人HBV感染情况却知之甚少。
2011年10月至2013年7月，针对纽约市来自非洲的人群开展了基于社区的HBV筛查。将人群确定为当前HBV感染（HBsAg阳性）或暴露（HBcAb阳性）。
总体而言，955人接受了HBV筛查；年龄中位数为45岁（四分位间距为35 - 54岁），75.5%为男性。其中，919人无肝病病史，这些人中9.6%（n = 88）为当前HBV感染，73.9%（n = 679）曾有暴露。在逻辑回归分析中，年龄较大（比值比[OR]，0.97；95%置信区间[CI]，0.94 - 0.99；P < 0.01）和女性（OR，0.35；95% CI，0.14 - 0.75；P < 0.01）与HBV感染的相关性较低，而母亲患有肝炎与感染相关（OR，18.8；95% CI，2.72 - 164.65；P < 0.01）。HBV暴露与年龄较大相关（OR，1.03；95% CI，1.01 - 1.04；P < 0.01），而女性（OR，0.46；95% CI，0.33 - 0.66；P < 0.01）和输血史（OR，0.43；95% CI，0.22 - 0.83；P = 0.01）呈负相关。一名患者导航员将97%的感染者与医疗服务联系起来。11人被建议接受治疗，其中9人（82%）开始治疗。在首次筛查超声检查时，有3人被诊断为肝细胞癌。
美国非洲移民中HBV感染负担沉重，这凸显了对这一高危人群持续进行筛查并与医疗服务建立联系的必要性。
