Chronic hepatitis B at Charles B. Wang Community Health Center, New York City, 2013

Chronic Hepatitis B (CHB) infection is a significant health disparity for Asian Americans who compromise half of the estimated 1.4 million people with CHB in the US.  Estimated New York City (NYC) CHB prevalence (1.2%) is four times the US CHB prevalence ( 0.3%) and  93% of these are foreign-born, with half born in China. Charles B. Wang Community Health Center (CBWCHC) is a federally qualified health center serving low income Asian Americans in the Greater NYC area.

A retrospective study was performed on adult CHB patients seen at least once in 2013. Data was obtained from electronic medical records and the CBWCHC CHB Registry, used for case management as part of a collaborative care program.  Demographics and clinical characteristics were assessed using the most recent data entered after January 2005 (date of EMR adoption).

In 2013, of 24,628 unique CBWCHC patients, 3,219 patients had active CHB (13% prevalence).  Of active CHB patients, 93% were born in China, predominantly Fujian (68%) and Guangdong (20%) provinces.  Half have lived in the US greater than 15 years; however, almost all (98%) preferred receiving care in a language other than English, specifically Mandarin (55%), Cantonese (25%), and Fujianese (14%). Almost half (45%) are uninsured with a similar percentage (48%) below the federal poverty level. Three quarters (80%) are E antigen negative. Two thirds of males (63%) and slightly fewer females (57%) had normal ALT (<30 IU/L for males, <19 for females). A third (34%) had an undetectable viral load and a quarter (26%) received medications. 

CHB is extremely common among Chinese Americans receiving care at a community health center in NYC, particularly among those from southeast China.  Ongoing surveillance and care will be required to prevent the development of complications among these New Yorkers who also face linguistic and financial barriers to care.