Prevalence of Hepatitis B Virus Infection and Hepatocellular Carcinoma in Chinese-Americans

In view of the reported higher prevalence of hepatitis B virus markers and excess mortality due to hepatocellular carcinoma in Chinese from various parts of Asia, we studied the frequency of these events in 666 Chinese permanently residing in New York City. Hepatitis B surface antigen (HBsAg) was detected in 9.3% of the subjects tested, antibody to this antigen (anti-HBs) in 57%, and antibody to the core antigen (anti-HBc) in 8.8%. Fifty percent of mothers of the HBsAg carriers and 66% of their siblings were antigenemic. These rates are 10–40 times higher than those found in other ethnic groups. Nearly all persons positive for HBsAg and anti-HBs were reactive to the subtypes predominant in Asia (adw and adr), and very few of the HBsAg carriers exhibited presence of the e antigen. Prevalences of anti-HBc alone or anti-HBs alone tended to increase with advancing age, while prevalences of HBsAg and of coexisting anti-HBs tended to decrease with age. The age-standardized death rate from hepatocellular carcinoma in Chinese males, but not females, was four times higher than that among black males and 10 times higher than that among white males. An excess mortality was seen among Chinese of all age groups. Our findings, that Chinese-Americans are at a very high risk for both hepatitis B virus and liver cell carcinoma, provide additional evidence in support of the hypothesis that these conditions are causally associated.