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Data highlight need for support of HBV immunization programs overseas

Active and past hepatitis B virus infection was identified among refugee groups from Bhutan, Burma, Iraq and other countries — the rates varied significantly by race and both active and past infection rates were highest among men, according to data published in a recent Morbidity and Mortality Weekly Report.

“Hepatitis B can cause acute or chronic disease and is a significant public health concern both globally and in the United States,” Kevin C. Scott, MD, of Thomas Jefferson University, Philadelphia, and colleagues wrote. “CDC guidelines recommend hepatitis B screening in U.S.-bound refugees from countries with a prevalence of chronic hepatitis B infection [greater than or equal to] 2%. However, many U.S. refugee health programs screen refugees universally for hepatitis B.”

While almost all refugees are routinely screened for hepatitis B, the prevalence of HBV infection among those recently resettled in the U.S. is unknown. For this reason, Scott and colleagues conducted a multisite, retrospective study to assess “the prevalence of past HBV infection, current infection, and immunity among refugees resettled in the U.S.; to better characterize the burden of hepatitis B in this population and to inform screening recommendations.”

The researchers pooled data on 6,175 refugees who received hepatitis B screening at the Minnesota Department of Health, the State University of New York-Upstate Medical University, Thomas Jefferson University or Yale-New Haven Hospital.

The largest single refugee group was Burmese (39%), followed by Iraqis (13%) and Bhutanese (10%).

According to study results, compared with the prevalence for any past HBV infection and chronic or acute infection among Bhutanese (5.7%, past; 0.9%, chronic or acute) and Iraqi refugees (3.8%, past; 0.4%, chronic or acute), the prevalence was significantly higher among Burmese (36%, past; 9.4%, chronic or acute) and other refugees (15%, past; 5%, chronic or acute).

In addition, past HBV infection rates were higher among males (23.8%) when compared with females (19.5%; P < .001). Adults had the highest rates for any past HBV or chronic infection when compared with children (28.6% vs. 9.5%; P<.001). The overall rates for immunity among refugees without confirmed past infection were significantly higher among children vs. adults (51.8% and 20.9%; P < .001).

“Public health officials and health care providers can use these results to further support overseas immunization programs and to target outreach efforts to populations found to be at increased risk for HBV infection,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.