The authors were interested in the prevalence of hepatitis B virus (HBV) infection, exposure, self-reported vaccination, vaccine-induced immunity, disease awareness and treatment in the United States by birthplace and race/ethnicity between 1999-2016. They identified 47,628 adult participants with complete HBV core antibody (anti-HBc) and surface antigen (HBsAg) tests and 47,618 adults who completed HBV surface antibody (anti-HBs) and anti-HBc tests. HBV infection was defined by positive HBsAg and past exposure by positive anti-HBc. Vaccine-mediated immunity was defined by positive anti-HBs and negative anti-HBc. The authors found that there was no significant change in the prevalence of HBV infection between 1999 and 2016, affecting 0.35% or 0.84 million adults. However, There was a significant decrease in HBV exposure and an increase in vaccine-mediated immunity was seen. US-born people had a significantly lower prevalence of HBV infection and exposure, as well as higher prevalence of vaccine-mediated immunity and self-reported vaccination than foreign-born people. The prevalence of HBV infection was highest in non-Hispanic Asians, both foreign- (3.85%) and US-born (0.79%) between 2011-2016. Among infected patients, liver disease awareness was only 15.19% and the rate of treatment was 4.60%. Therefore there are disparities in HBV infection prevalence between ethnic/racial groups and between US-born and foreign-born people. There was also a lack of awareness of liver disease and lack of treatment rate among infected patients.
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