Underestimation of chronic hepatitis B virus infection in the United States of America.

摘要

In the December 2006 issue of Journal of Viral Hepatitis, Drs. Gish and Gadano made the important point that the current prevalence estimate of 1.25 million individuals in the USA with chronic hepatitis B virus (HBV) infection should be 'corrected by taking into account HBV prevalence in immigrant populations and current estimates may be as high as 2 million' . The Hepatitis B Foundation (HBF) agrees with this statement, that the prevalence of chronic HBV infection in the United States is, in fact, significantly greater than the currently accepted estimate. We have performed our own calculation of the chronic hepatitis B prevalence estimate including the high prevalence rates of hepatitis B in immigrant populations. As a result, we estimate the current burden of chronic hepatitis B in the USA to be approximately 2 million people.We reason that an underestimation of the true number of infected individuals in the USA has occurred mostly because the highest-risk populations are under-represented in surveillance studies, and a large percentage of chronically infected individuals remain undiagnosed. Estimates of the number of HBV infections in the USA have been based on serosurvey data from the National Health and Nutrition Examination Surveys for the years 1976-1994 (NHANES II, III), which did not include significant numbers of Asians and Pacific Islanders (API, the ethnic groups most affected by hepatitis B), making it difficult to obtain accurate prevalence estimates . Also, the large influx of foreign born individuals from countries with moderate or high incidenceof hepatitis B increases the limitation of the NHANES estimate.