Objective: Compare the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) among African, Asian, and Hispanic immigrants and US-born persons.

Methods: We performed a cross-sectional analysis of 6769 adults recruited from screening events from 2016-2018 in the Baltimore-Washington, D.C. metropolitan area. Participants were US-born (N=403), African(N=1267), Asian(N=4,681) and Hispanic(N=418) immigrants were screened for HBV antigen/antibody, and HCV antibody/confirmatory RNA. Using multivariable logistic regression, we compared the prevalence of HBV among the groups.

Results: The mean(±SD) age was 52.2±15.9 years; 61% female. US-born persons(87%) were more likely to be insured than African(33%), Asian(35%), and Hispanic(23%) immigrants.US-born persons(76%) were more likely to have primary care than African(36%), Asian (34%), and Hispanic immigrants(27%). African(4.3%) and Asian immigrants(4.8%) were more likely to have chronic HBV than US-born persons (0.3%). After controlling for age, sex, insurance, and primary care, African [Odds ratio(OR): 16.9, 95% CI: 2.3-123.9] and Asian immigrants(OR: 19.3, 95% CI: 2.7-138.8) were more likely to have chronic HBV than US-born persons. Only 7% , 3%, 1%, and 6% of US-born persons, African, Asian, and Hispanic immigrants respectively self-reported HBV vaccination. Only 23%, 20%, 7% and 14% of US-born persons, African, Asian, and Hispanic immigrants respectively reported previous HBV or HCV screening. Among those with HCV antibody, African immigrants (67%) were more likely to have detectable(≥15 IU/L) RNA than US-born persons(33%), Asian(52%) immigrants

Conclusion: Asian and African immigrants had the highest prevalence of HBV and HCV but had poor healthcare access. Targeted screening, health education and linkage to care are urgently needed in immigrants.