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.
Asian Pacific Liver Center, St. Vincent Medical Center, Los Angeles, CA, USA.
Dig Dis Sci. 2021 Aug;66(8):2833-2839. doi: 10.1007/s10620-020-06499-6. Epub 2020 Aug 8.
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.
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.
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.
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.
蒙古是乙型肝炎病毒（HBV）、丁型肝炎病毒（HDV）和丙型肝炎病毒（HCV）慢性感染的高度流行地区。本研究旨在全面描述生活在南加州的蒙古人慢性病毒性肝炎的特征。
2018 年 8 月至 11 月期间进行了三次筛查，共有 528 名成年蒙古人接受了 HBV 和 HCV 检测。HBsAg（+）个体（CHB）进一步检测 HDV RNA 和抗-HDV。对 CHB 和慢性 HCV（CHC）个体进行肝功能检查、血小板计数和 FibroScan™检查。
534 名个体中，51 名 HBsAg 阳性（9.7%），均为外国出生。CHB 个体的平均年龄为 37.8 岁（18-69 岁）。46 名个体 HBeAg（-）。HBV 基因型均为 D2 或 A1。51 名个体中有 21 名（41.2%）抗-HDV（+），17 名（33.3%）HDV RNA（+）。HDV RNA（+）个体的 ALT、纤维化-4 评分和肝硬度显著高于 HDV RNA（-）个体。HDV RNA（+）个体的晚期纤维化发生率更高（57% vs. 13%，p=0.013）。48 名个体（9.1%）抗-HCV（+），19 名（3.6%）HCV RNA（+）。CHC 个体的平均年龄为 40.2 岁（28-71 岁）。1945 年至 1965 年出生的个体抗-HCV（+）的患病率高于 1965 年以后出生的个体（18.8% vs. 7.9%，p=0.025）。基因型 1b 为主导型。所有参与者的肝硬化发生率为 7%。
生活在美国的蒙古人感染乙型肝炎和丙型肝炎的风险很高。三分之一的 CHB 个体存在乙型肝炎和丁型肝炎重叠感染，且伴有晚期纤维化。在美国对蒙古人进行病毒性肝炎的普遍筛查是必要的。
