Managing Chronic Hepatitis B Infection in Immigrants to Promote Healthy Community

The number of chronic Hepatitis B Virus (HBV) carriers in the United States (U.S.) is increasing as a result of immigration from regions where hepatitis B is endemic. Of the 2 million chronic HBV cases in the U.S., about 47% to 70% of them were born in foreign countries. Migration of population has changed HBV infection prevalence in the U.S., particularly in Hawaii, a state with a large population of Asian and Pacific Islanders and immigrants from countries where HBV is endemic, including China, Taiwan, the Philippines, Vietnam, and the Pacific Islands. In an effort to lessen health disparity caused by HBV, the Centers for Disease Control and Prevention has recommended to screen and identify all foreign born persons from endemic countries for hepatitis B infection, with the purpose of further management. This study was conducted to test the relationship between prevalence of infection and susceptibility to HBV, as well as vaccination compliance rates among screened participants, and country of birth. A purposeful sample of 1,501 participants were from the Hawaii 3ForLife program, a community-based public health program that offers free hepatitis B screening and vaccination. Chi-squared analysis was used to test the study hypotheses related to the relationships between birth status (foreign born versus United States born) and HBV infected, immune, and susceptible status as well as with vaccination compliance. Significant associations were found between birth status and HBV infection, HBV susceptibility, and compliance in completing vaccination. The overall prevalence of HBV infection in the sample was 5.8%; for HBV susceptibility, it was 52%. Approximately 40% of those who were HBV susceptible completed the hepatitis B vaccinations. Public health intervention program such as Hawaii 3ForLife supports effort to reduce health disparity among immigrants and to promote healthy community.