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HCV Prevalence in Asian Americans in California

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Abstract

The World Health Organization estimates that 170 million persons are infected with HCV worldwide, but only 22 million are from the Americas and Europe, compared to 94 million from Asia. HCV prevalence in the general US population is 1.6 %, but data for Asian Americans are limited. Our goal was to examine HCV prevalence in Asian Americans in a large ethnically diverse patient cohort seeking primary care at a free clinic in Northern California. A total of 1347 consecutive patients were seen from September 2009 to October 2012 and were studied via individual chart review using case report forms. HCV infection was defined as positive HCV antibody (anti-HCV) or HCV RNA by PCR. 699 out of 1347 patients were screened for HCV. Asian Americans comprised 57.2 % of these patients and 29 (4.1 %) patients tested positive for HCV. Of these 29 HCV-positive patients, 22 (75.9 %) were Asian, yielding a prevalence of 5.5 % for Asians and 2.3 % for non-Asians (P = 0.038). The highest HCV prevalence was seen in Vietnamese patients at 7.9 %, and 6.0 % in Chinese patients. Of the HCV-positive Asians, none had a history of intravenous drug use (IVDU), tattoos, or sexual exposure. On multivariate analysis, significant independent predictors for positive HCV infection were male gender (OR 2.53, P = 0.02) and presence of known risk factors (OR 21.1, P < 0.001). However, older age and Asian ethnicity were found to be significant predictors of HCV infection (OR 1.03, P = 0.05 and 2.31, P = 0.066, respectively). In our study, HCV prevalence in patients seeking routine primary care was 5.5 % in Asian Americans, which was over double the prevalence for non-Asians at 2.3 %. Known risk factors were also notably absent in Asian patients with HCV infection. The high prevalence of HCV in Asian-Americans is likely reflective of the higher prevalence of HCV in their countries of origin in Asia. Asian-Americans immigrants from endemic countries are at higher risk of HCV infection and should be screened for HCV, regardless of their exposure risk profile.

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Abbreviations

HCV:

Hepatitis C virus

HBV:

Hepatitis B virus

ALT:

Alanine transaminase

AST:

Aspartate transaminase

NHANES:

National Health and Nutrition Examination Survey

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA

    Oliver N. Lin, Christine Chang, Ailinh Do & Mindie H. Nguyen

  2. Stanford University School of Medicine, Stanford, CA, USA

    Joyce Lee

  3. Division of General Medical Discipline, Stanford University Medical Center, Palo Alto, CA, USA

    Marina Martin

  4. Pacific Free Clinic, San Jose, CA, USA

    Marina Martin & Andy Martin

  5. Stanford Center for Clinical Informatics, Palo Alto, CA, USA

    Andy Martin

Authors
  1. Oliver N. Lin
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  2. Christine Chang
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  4. Ailinh Do
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  5. Marina Martin
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  6. Andy Martin
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  7. Mindie H. Nguyen
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Correspondence to Mindie H. Nguyen.

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Conflict of interest

Oliver N. Lin, Christine Chang, Ailinh Do, Joyce Lee, Marina Martin, and Andy Martin have no financial relationship with a commercial interest. Mindie H. Nguyen has served as a consultant for and has received research funding from Bristol-Myers Squibb, Janssen Pharmaceuticals and Gilead Sciences Inc.

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Lin, O.N., Chang, C., Lee, J. et al. HCV Prevalence in Asian Americans in California. J Immigrant Minority Health 19, 91–97 (2017). https://doi.org/10.1007/s10903-016-0342-1

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  • DOI: https://doi.org/10.1007/s10903-016-0342-1

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