Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2022; 28(35): 5217-5229
Published online Sep 21, 2022. doi: 10.3748/wjg.v28.i35.5217
High prevalence of chronic viral hepatitis B and C in Minnesota Somalis contributes to rising hepatocellular carcinoma incidence
Essa A Mohamed, Nasra H Giama, Abubaker O Abdalla, Hassan M Shaleh, Abdul M Oseini, Hamdi A Ali, Fowsiyo Ahmed, Wesam Taha, Hager Ahmed Mohammed, Jessica Cvinar, Ibrahim A Waaeys, Hawa Ali, Loretta K Allotey, Abdiwahab O Ali, Safra A Mohamed, William S Harmsen, Eimad M Ahmmad, Numra A Bajwa, Mohamud D Afgarshe, Abdirashid M Shire, Joyce E Balls-Berry, Lewis R Roberts
Essa A Mohamed, Nasra H Giama, Hassan M Shaleh, Abdul M Oseini, Hamdi A Ali, Fowsiyo Ahmed, Wesam Taha, Hager Ahmed Mohammed, Jessica Cvinar, Hawa Ali, Loretta K Allotey, Eimad M Ahmmad, Numra A Bajwa, Abdirashid M Shire, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
Essa A Mohamed, Joyce E Balls-Berry, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN 55905, United States
Nasra H Giama, School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
Abubaker O Abdalla, Division of Digestive Diseases, Emory School of Medicine, Atlanta, GA 30322, United States
Hassan M Shaleh, Ibrahim A Waaeys, Abdiwahab O Ali, Safra A Mohamed, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
Wesam Taha, Department of Internal Medicine, NewYork-Presbyterian Queens, Flushing, NY 11355, United States
Hager Ahmed Mohammed, Department of Pediatrics, University of Nevada Las Vegas, Las Vegas, NV 89154, United States
William S Harmsen, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States
Mohamud D Afgarshe, Department of Medicine, Gargar Urgent Care and Clinic, Minneapolis, MN 55406, United States
Abdirashid M Shire, Office of the Director, Shire Scientific, Minneapolis, MN 55405, United States
Joyce E Balls-Berry, Department of Neurology, Washington University School of Medicine in St Louis, St Louis, MO 63130, United States
Joyce E Balls-Berry, Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63130, United States
Author contributions: Mohamed EA, Giama NH, Abdalla AO, Shire AM, Shaleh HM, Oseini AM, Ali HA, Ahmed F, Taha W, Ahmed Mohammed H, Cvinar J, Waaeys IA, Ali H, Allotey LK, Ali AO, Mohamed SA, Harmsen WS, Ahmmad EM, Bajwa NA, and Afgarshe MD, Balls-Berry JE, and Roberts LR contributed to the study concept and design, acquisition of data, data analysis and interpretation of data; Mohamed EA, Giama NH, Abdalla AO, and Shire AM drafted the manuscript; Shaleh HM, Oseini AM, Ali HA, Ahmed F, Taha W, Ahmed Mohammed H, Cvinar J, Waaeys IA, Ali H, Allotey LK, Ali AO, Mohamed SA, Harmsen WS, Ahmmad EM, Bajwa NA, Afgarshe MD, Balls-Berry JE, and Roberts LR contributed to the critical revision of the manuscript; All authors contributed to manuscript revision, read and approved the submitted version.
Supported by the Mayo Clinic Center for Clinical and Translational Science from the National Center for Advancing Translational Sciences (5UL1TR000135-10); the Mayo Clinic Hepatobiliary SPORE from the National Cancer Institute (5P50CA210964-04); the Mayo Clinic Center for Cell Signaling in Gastroenterology (5P30DK084567-14); and Gilead Sciences, Inc. (IN-US-174-0230).
Institutional review board statement: The study was reviewed and approved by the Mayo Clinic Institutional Review Board (19-001670).
Clinical trial registration statement: This study does not include any interventions and is not a randomized controlled trial. The study is registered on ClinicalTrials.Gov (NCT02366286).
Informed consent statement: Written informed consent was obtained from study subjects prior to enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Roberts.Lewis@mayo.edu. No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lewis R Roberts, MBChB, PhD, Professor, Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 55905, United States. roberts.lewis@mayo.edu
Received: January 19, 2022
Peer-review started: January 19, 2022
First decision: March 8, 2022
Revised: March 28, 2022
Accepted: August 17, 2022
Article in press: August 17, 2022
Published online: September 21, 2022
Abstract
BACKGROUND

Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are known risk factors for liver disease, cirrhosis and hepatocellular carcinoma (HCC). There is substantial global variation in HBV and HCV prevalence resulting in variations in cirrhosis and HCC. We previously reported high prevalence of HBV and HCV infections in Somali immigrants seen at an academic medical center in Minnesota.

AIM

To determine the prevalence of chronic viral hepatitis in Somali immigrants in Minnesota through a community-based screening program.

METHODS

We conducted a prospective community-based participatory research study in the Somali community in Minnesota in partnership with community advisory boards, community clinics and local mosques between November 2010 and December 2015 (data was analyzed in 2020). Serum was tested for hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody and anti-HCV antibody.

RESULTS

Of 779 participants, 15.4% tested positive for chronic HBV infection, 50.2% for prior exposure to HBV and 7.6% for chronic HCV infection. Calculated age-adjusted frequencies in males and females for chronic HBV were 12.5% and 11.6%; for prior exposure to HBV were 44.8% and 41.3%; and for chronic HCV were 6.7% and 5.7%, respectively. Seven participants developed incident HCC during follow up.

CONCLUSION

Chronic HBV and HCV are major risk factors for liver disease and HCC among Somali immigrants, with prevalence of both infections substantially higher than in the general United States population. Community-based screening is essential for identifying and providing health education and linkage to care for diagnosed patients.

Keywords: Viral hepatitis, Liver disease, Community engagement, African, Immigrant health

Core Tip: This prospective community-based study evaluated the prevalence of chronic hepatitis B and C among the immigrant Somali community. Through community partnerships we were able to demonstrate a framework that can be used with other immigrant and/or minority communities at-risk for infectious diseases such as hepatitis B and C.