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Chronic hepatitis B is far more prevalent among U.S. residents than previously reported

A new study says about 2.4 million U.S. residents may be infected with the disease.

Doylestown, March 10, 2021 – The number of adults living in the U.S. who have chronic hepatitis B infection may be as high as 2.4 million, which is nearly three times greater than the federal government’s official estimate, according to a new analysis by a team of public health experts, scientists and physicians.

The authors conducted a meta-analysis, calculating updated prevalence estimates among foreign-born persons in the U.S. by country of birth. A report on the analysis, “An Updated Assessment of Chronic Hepatitis B Prevalence among Foreign-Born Persons Living in the United States,” is published in Hepatology, the journal of the American Association for the Study of Liver Diseases.

The authors combined data from 2,800 published studies, representing 112 million people from 99 countries, and triangulated the data with immigration patterns. The resulting prevalence estimate of up to 2.4 million people living with chronic hepatitis B is almost three times higher than the estimate of 840,000 from the National Health and Nutrition Examination Survey (NHANES), a program of the U.S. Centers for Disease Control and Prevention (CDC) and the federal government’s official source for health statistics.

“Using our robust study methodology, we believe that 2.4 million is a much more accurate estimate of the number of people living with chronic hepatitis B in the U.S.," Dr. Robert Wong, primary author of the study and clinical associate professor (affiliated), Stanford University School of Medicine, said. "However, the importance of continuing to raise awareness of chronic hepatitis B and the need for more effective implementation of screening and vaccination programs are key to success in our viral hepatitis eradication efforts.” 

Dr. Robert Gish, lead study author and medical director of the Hepatitis B Foundation, said: “The NHANES estimate underrepresents foreign-born populations, even though NHANES attempts to oversample Asians. The lack of inclusion of foreign-born, limited English proficient individuals leads to an underestimated prevalence.”

The new study suggests that the number of people living with chronic hepatitis B in the U.S. has increased since 2011. Yet diagnosis and treatment rates have not greatly improved over the past decade.

According to Chari Cohen, senior vice president of the Hepatitis B Foundation: “Most infected individuals in the U.S. remain undiagnosed and untreated. Risk-based screening guidelines are almost impossible to implement, and we are failing millions of infected people.”

The Hepatitis B Foundation called for universal hepatitis B screening in the U.S. in 2018, as the only screening strategy that will help us make progress towards the 2030 goal of eliminating hepatitis B in this country.

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