High prevalence of chronic viral hepatitis B and C in Minnesota Somalis contributes to rising hepatocellular carcinoma incidence

Table 1 Antibody and antigen biomarkers for hepatitis B and hepatitis C infections

	Chronic HBV	Resolved HBV	HBV vaccinated	HBV Susceptible	Chronic HCV
HBsAg	Pos	Neg	Neg	Neg	Pos/neg
HBcAb	Pos	Pos	Neg	Neg	Pos/neg
HBsAb	Neg	Pos/indeter/neg	Pos	Neg/indeter	Pos/neg
Anti-HCV	Neg/pos	Neg/pos	Neg/pos	Neg/pos	Pos

HBcAb: Hepatitis B core antibody; HBsAg: Hepatitis B surface antigen; HBsAb: Hepatitis B surface antibody; HBV: Hepatitis B virus; HCV: Hepatitis C virus; Indeter: Indeterminate; Neg: Negative; Pos: Positive.

Table 2 Frequency of hepatitis B virus- and hepatitis C virus-positive test results in Community Recruited Minnesota Somali Residents

Age group (yr)	Chronic HBV infection		Previous HBV exposure including spontaneous clearance		Chronic HCV infection
	HBsAg-positive/total males, n	HBsAg-positive/total females, n	HBcAb-positive/total males, n	HBcAb-positive/total females, n	Anti-HCV-positive/total males, n	Anti-HCV-positive/total females, n
≤ 20	0/8 (0)	0/9	1/8	2/9	0/8	0/9
21-30	10/89	6/74	29/89	12/74	3/89	0/74
31-40	20/92	12/92	24/92	29/92	3/92	2/92
41-50	12/72	5/82	32/72	27/82	5/72	1/82
51-60	12/50	10/64	23/50	24/64	3/50	3/64
61-70	6/35	11/40	20/35	16/40	5/35	10/40
> 70	6/43	10/29	20/43	12/29	17/43	7/29
Total	66/389	54/390	149/389	122/390	36/389	23/390
Age-adjusted frequency (per 1000 population)	125	116	323	297	67	57

HBcAb: Hepatitis B core antibody; HBsAg: Hepatitis B surface antigen; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 3 Rates of hepatitis B virus vaccination and susceptibility in Community Recruited Minnesota Somali Residents

Age group (yr)	HBV vaccinated		HBV susceptible
	HBV vaccinated1/total males, n	HBV vaccinated1/total females, n	HBV susceptible2/total males, n	HBV susceptible2/total females, n
≤ 20	4/8	4/9	3/8	3/9
21-30	27/89	37/74	23/89	19/74
31-40	22/92	23/92	26/92	28/92
41-50	15/72	19/82	13/72	31/82
51-60	8/50	13/64	7/50	17/64
61-70	4/35	5/40	5/35	8/40
> 70	10/43	4/29	7/43	3/29
Total	90/389	105/390	84/389	109/390
Age-adjusted frequency (per 1000 population)	299	305	253	282

¹Vaccinated: Hepatitis B surface antigen negative; anti-HBc negative; anti-HBs positive.

²Susceptible: Hepatitis B surface antigen negative; anti-HBc negative; anti-HBc negative.

HBV: Hepatitis B virus.

Table 4 Characteristics of 7 Somali participants who developed hepatocellular carcinoma

Patient no.	Age	Sex	Etiology	HCV genotype	Cirrhosis	MELD Score	Metastatic HCC	Portal hypertension	Fibrosis staging
1	69	Male	NAFLD	-	No	8	No	No	NR
2	65	Female	HCV	3	Yes	7	No	Yes	NR
3	76	Female	Unknown	-	No	7	No	No	NR
4	75	Male	HCV	4	No	7	Yes	No	2 to 3/4
5	77	Male	HCV	UTG	Yes	11	No	No	4
6	43	Male	HBV	-	No	7	Yes	No	NR
7	83	Female	HCV	UTG	Yes	6	No	No	3 to 4

UTG: Unable to genotype; NR: Not reported; NAFLD: Non-alcoholic fatty liver disease; HCV: Hepatitis C virus; HBV: Hepatitis B virus; MELD: Model for end-stage liver disease; HCC: Hepatocellular carcinoma.