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Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
The clinical presentation of chronic hepatitis B virus infection in Asian Americans: a single center retrospective
Jonathan S Mellen1, Victor W Xia, Mehrtash Hashemzadeh
1Department of Medicine parallel, Chao Comprehensive Digestive Disease Center, Irvine Medical Center, Orange, CA 92868, USA.
Insights
Chronic hepatitis B virus (HBV) infection in Asian Americans often presents with a family history of HBV, hepatic fibrosis, and hepatic steatosis. This study highlights key clinical characteristics in this population.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- The clinical course of chronic hepatitis B virus (HBV) infection varies significantly by ethnicity.
- Limited data exists on the specific clinical presentation of chronic HBV infection among Asian Americans.
Purpose of the Study:
- To characterize the clinical presentation of chronic HBV infection in Asian Americans.
- To identify demographic and clinical factors associated with chronic HBV infection in this population.
Main Methods:
- Retrospective chart review of 213 Asian-American patients with chronic HBV infection.
- Statistical analysis to evaluate clinical and demographic data.
- Inclusion of liver biopsy and laboratory results where available.
Main Results:
- The cohort was predominantly foreign-born (97.9%) with a high family history of HBV (52.3%).
- Significant rates of advanced hepatic fibrosis (34.0% stage 3-4) and hepatic steatosis (43.4%) were observed.
- Hepatocellular carcinoma presentation was linked to older age, male sex, tobacco use, and advanced fibrosis.
Conclusions:
- Chronic HBV in foreign-born Asian Americans is marked by low rates of hepatitis B e antigen positivity (HBeAg) and male predominance.
- High prevalence of family history of HBV, hepatic fibrosis, and hepatic steatosis are key features.
- These findings underscore the need for targeted screening and management strategies in Asian American populations.
Background:
The clinical course of chronic hepatitis B virus (HBV) infection varies with ethnicity. Little is known about the clinical presentation of chronic HBV infection in Asian Americans.
Objectives:
To define the clinical presentation of chronic HBV infection in Asian Americans.
Methods:
This is a retrospective study that used systematic chart review and statistical analysis to investigate 213 Asian-American patients with chronic HBV infection who presented to a university medical center.
Results:
This cohort included 55.8% male patients, 97.9% were born outside the US, and 52.3% reported a family history of HBV infection. Of the 56 patients with liver biopsy, 34.0% had stage 3 to 4 fibrosis. In patients with available data, 21.5% were hepatitis B e antigen positive [HBeAg (+)] and 31.1% had HBV DNA levels >1 x 10(6) copies/mL. Patients with HBeAg (+) HBV infection were diagnosed at a younger age (P=0.002) and with higher alanine aminotransferase (P=0.001) and HBV DNA (P=0.001) levels. Although only 3.3% presented with obesity (ie, body mass index >or=30 kg/m2), 43.4% had evidence of hepatic steatosis. Presentation of hepatocellular carcinoma was associated with an older age at diagnosis (P<0.001), male sex (P<0.001), tobacco use (P<0.001), a greater degree of fibrosis on liver biopsy (P=0.01), and higher alanine aminotransferase, aspartate aminotransferase (P<0.001), and a fetoprotein (P<0.001) levels.
Conclusions:
Chronic HBV infection in foreign-born Asian Americans was characterized by a low rate of HBeAg (+) and male predominance as well as high rates of family history of HBV infection, hepatic fibrosis, and hepatic steatosis.
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