Evaluation of the Prevalence and Knowledge of Hepatitis B, Hepatitis C, and Hepatocellular Carcinoma Among African Immigrants Living in Minnesota

Lewis R. Roberts, M.B., Ch.B., Ph.D.

Consultant, Gastroenterology and Hepatology
Rochester campus of Mayo Clinic

Abstract

In the United States, the overall prevalence of hepatitis B (HBV) surface antigen (HBsAg) carriers is 0.2%, and the prevalence of chronic hepatitis C (HCV) infection is 1.6%. However, substantial racial disparity in the prevalence of chronic liver diseases due to HBV and HCV infection exists among African Americans, Asians and Hispanics. Cross-sectional data from the National Health and Nutrition Examination Survey between 1999-2006 (NHANES) showed the prevalence of anti-HBc was 4times higher among non-Hispanic blacks (12.2%) than it was among non-Hispanic whites (2.8%) and it was higher among foreign-born persons (12.2%). In the 2012 Cancer Report produced by the Minnesota Department of Health, the incidences of liver cancer in Black men (14.9) and in Black women (4.4) were higher than in non-Hispanic White men (8.9) and non-Hispanic White women (2.9) respectively. In addition, the mortality rates in black men (11.9) and black women (4.0) are higher than in non-Hispanic white men (7.0) and non-Hispanic white women (2.9). Since we know that African immigration to Minnesota is the third highest in the United States, we assume that this unique population might be a contributing factor to the increased burden of hepatitis and liver cancer complications in the state of Minnesota. Unfortunately, very little research has been conducted in the United States on the burden of hepatitis and liver cancer in African Immigrants from areas of high endemicity of hepatitis B and hepatitis C. We propose to conduct a pilot study to determine the prevalences of HBV, HCV and HCC among African immigrants in Minnesota from Ethiopia, Liberia and Kenya; and identify the knowledge, attitudes and practices of the respective communities related to hepatitis, liver disease and liver cancer.