Hepatitis B Serologic Testing Among Koreans in Western Washington

BACKGROUND: Chronic hepatitis B viral (HBV) infection and its sequelae disproportionately affect Asian immigrants. Identification of chronic carriers can potentially reduce liver cancer and cirrhosis. This study identified factors associated with HBV serology testing among Korean Americans. METHODS: We conducted a population-based survey about HBV among randomly selected Korean adults age 18-64. Our primary outcome was self-report of HBV serology testing. We used bivariate comparisons to identify factors associated with HBV testing. RESULTS: The survey was completed by 466 Korean Americans. Although most had heard of HBV (93%), less than half reported past serology testing (48%) or vaccinations (46%). Sociodemographic factors associated with past HBV testing included: current or previous marriage; and fewer number of years spent in the U.S. Health care access factors associated with testing included: having a chronic health condition; and having received past obstetric care in Korea. Participants who received recommendations for testing from physicians or family members were more likely to have had serologic testing. Participants who correctly understood that HBV causes cirrhosis or liver cancer were more likely to have had testing (p<0.05 for all associations presented). CONCLUSIONS: Despite high incidence of cirrhosis and liver cancer, more than half of Korean Americans reported no history of HBV serology testing. As part of a strategy to reduce the disproportionate burden of chronic HBV, clinicians should consider routine serologic testing for Korean patients and their families, and offer vaccination for those without immunity. Clinicians should emphasize the long-term consequences of chronic infection with their Korean patients.