High Prevalence of Chronic Viral Hepatitis and Liver Fibrosis Among Mongols in Southern California.

Abstract

BACKGROUND:

Mongolia is a highly endemic region for chronic hepatitis B (HBV), hepatitis delta (HDV), and hepatitis C (HCV) infections. Aim of this study was to comprehensively characterize chronic viral hepatitis among Mongols living in Southern California.

METHODS:

Three screening events were conducted between August and November 2018, with 528 adult Mongols tested for HBV and HCV. HBsAg (+) individuals (CHB) underwent additional testing for HDV RNA and anti-HDV. Liver tests, platelet count, and FibroScan™ were performed on CHB and chronic HCV (CHC) individuals.

RESULTS:

Fifty-one out of 534 were HBsAg reactive (9.7%), and all were foreign-born. Mean age of CHB individuals was 37.8 (range 18-69) years. Forty-six out of 51 were HBeAg (-). HBV genotypes were exclusively D2 or A1. Twenty-one out of 51 (41.2%) were anti-HDV (+) and 17/51 (33.3%) were HDV RNA (+). HDV RNA (+) individuals had significantly higher ALT, fibrosis-4 score, and liver stiffness compared to HDV RNA (-) individuals. Incidence of advanced fibrosis was higher in HDV RNA (+) individuals (57% vs. 13%, p = 0.013). Forty-eight (9.1%) individuals were anti-HCV (+) and 19 (3.6%) were HCV RNA (+). Mean age of CHC individuals was 40.2 (range 28-71) years. Prevalence of anti-HCV (+) was higher among those born between 1945 and 1965 versus those born after 1965 (18.8% vs. 7.9%, p = 0.025). Genotype 1b was predominant. Incidence of cirrhosis was 7% among all participants.

CONCLUSIONS:

Mongols living in the USA are at high risk for CHB and CHC infections. One-third of CHB individuals had CHD superinfection with advanced fibrosis. Universal screening for viral hepatitis in Mongols in the USA is mandatory.

• Authors: Tse-Ling Fong, Brian T Lee, Mimi Chang, Khishigsuren Nasanbayar, Enkhjargal Tsogtoo, Delgerbat Boldbaatar, Esugen D Dashdorj, Namuun E Clifford, Arghun N Dashdorj, Bo-Ram Bang, Takeshi Chida, Carolina Lim, Masaya Sugiyama, Masashi Mizokami, Naranjargal J Dashdorj, Ping Liu, Jeffrey S Glenn, Naranbaatar D Dashdorj, Takeshi Saito
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 66 Issue 8 Pg. 2833-2839 (08 2021) ISSN: 1573-2568 [Electronic] United States
• PMID: 32770488 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2020. Springer Science+Business Media, LLC, part of Springer Nature.

Chemical References

• Antibodies, Viral
• RNA, Viral

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Viral (blood)
• Asian People
• Cross-Sectional Studies
• Female
• Genotype
• Hepatitis B virus (genetics)
• Hepatitis B, Chronic (complications, epidemiology)
• Hepatitis C, Chronic (complications, epidemiology)
• Hepatitis D, Chronic (complications, epidemiology)
• Humans
• Liver Cirrhosis (epidemiology, etiology)
• Male
• Middle Aged
• Mongolia
• RNA, Viral (blood)
• Young Adult