Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma

Abdirashid M. Shire; Dalbir S. Sandhu; Joseph K. Kaiya; Abdul M. Oseini; Ju Dong Yang; Roongruedee Chaiteerakij; Teresa A. Mettler; Nasra H. Giama; Rosebud O. Roberts; Terry M. Therneau; Gloria M. Petersen; Keith L. Knutson; Lewis R. Roberts

doi:10.1016/j.mayocp.2011.08.001

Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma

Abdirashid M. Shire, Dalbir S. Sandhu, Joseph K. Kaiya, Abdul M. Oseini, Ju Dong Yang, Roongruedee Chaiteerakij, Teresa A. Mettler, Nasra H. Giama, Rosebud O. Roberts, Terry M. Therneau, Gloria M. Petersen, Keith L. Knutson, Lewis R. Roberts

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30 Scopus citations

Abstract

Objective: To study the frequencies of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and their associations with hepatocellular carcinoma (HCC) in immigrant Somalis seen at Mayo Clinic in Rochester, Minnesota. Patients and Methods: We determined the frequencies of HBV and HCV infection and HCC in immigrant Somalis seen at Mayo Clinic from July 1, 1996, through October 31, 2009. Non-Somali Olmsted County residents served as controls. Results: For Somali males and females, age-adjusted proportions (per 1000 population) were 209 and 123 for hepatitis B surface antigen (HBsAg), 644 and 541 for hepatitis B core antibody (HBcAb), and 99 and 66 for anti-HCV. The comparative proportions in non-Somalis were 20 and 9 for HBsAg, 126 and 97 for HBcAb, and 32 and 17 for anti-HCV. Hepatitis C virus RNA confirmed that 68 of 73 Somalis (93.2%) and 261 of 282 non-Somalis (92.6%) with positive anti-HCV test results had active HCV infection. Of 30 Somali patients with HCC, 22 (73.3%) tested anti-HCV positive (odds ratio [OR], 31.3; 95% confidence interval [CI], 13.0-75.5; P<.001; compared with anti-HCV-negative Somalis), 5 (16.7%) were HBsAg positive (OR, 1.4; 95% CI, 0.5-3.7; P=.53), and 18 (60.0%) were HBcAb positive (OR, 1.8; 95% CI, 0.8-4.2; P=.16). Viral hepatitis was diagnosed coincident with HCC in 9 of 20 patients (45.0%) with HCV-associated HCCs. Only 4 of 24 cases of HCC (16.7%) were detected during surveillance. Conclusion: Both HBV and HCV occurred frequently in this sample of Somali immigrants. However, HCV was the major risk factor for HCC. Screening Somali immigrants for HCV infection may enhance the prevention, early detection, and optimal treatment of HCC.

Original language	English (US)
Pages (from-to)	17-24
Number of pages	8
Journal	Mayo Clinic Proceedings
Volume	87
Issue number	1
DOIs	https://doi.org/10.1016/j.mayocp.2011.08.001
State	Published - Jan 2012

Bibliographical note

Funding Information:
Grant Support: Dr L. Roberts was supported by the National Institutes of Health ( CA100882 and CA128633 and P30DK084567 [Mayo Clinic Center for Cell Signaling in Gastroenterology]). Dr R. Roberts was supported by the National Institutes of Health ( U01 AG006786 , K01 MH068351 , K01 AG028573 , and the Rochester Epidemiology Project [ National Institutes of Health grant R01 AG034676 ; Dr. Walter A. Rocca, principal investigator]). Dr Shire was supported by a KL2 grant ( 1KL2RR024151 ) from Mayo Clinic Center for Translational Science Activities .

Funding Information:
Potential Competing Interests: Dr L. Roberts has indicated research grants from Bristol Myers Squibb and MDS Nordion .

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Shire, A. M., Sandhu, D. S., Kaiya, J. K., Oseini, A. M., Yang, J. D., Chaiteerakij, R., Mettler, T. A., Giama, N. H., Roberts, R. O., Therneau, T. M., Petersen, G. M., Knutson, K. L., & Roberts, L. R. (2012). Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma. Mayo Clinic Proceedings, 87(1), 17-24. https://doi.org/10.1016/j.mayocp.2011.08.001

Shire, AM, Sandhu, DS, Kaiya, JK, Oseini, AM, Yang, JD, Chaiteerakij, R, Mettler, TA, Giama, NH, Roberts, RO, Therneau, TM, Petersen, GM, Knutson, KL & Roberts, LR 2012, 'Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma', Mayo Clinic Proceedings, vol. 87, no. 1, pp. 17-24. https://doi.org/10.1016/j.mayocp.2011.08.001

@article{925ddee1ca2d45c8b9c8afdb7a14bef3,

title = "Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma",

abstract = "Objective: To study the frequencies of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and their associations with hepatocellular carcinoma (HCC) in immigrant Somalis seen at Mayo Clinic in Rochester, Minnesota. Patients and Methods: We determined the frequencies of HBV and HCV infection and HCC in immigrant Somalis seen at Mayo Clinic from July 1, 1996, through October 31, 2009. Non-Somali Olmsted County residents served as controls. Results: For Somali males and females, age-adjusted proportions (per 1000 population) were 209 and 123 for hepatitis B surface antigen (HBsAg), 644 and 541 for hepatitis B core antibody (HBcAb), and 99 and 66 for anti-HCV. The comparative proportions in non-Somalis were 20 and 9 for HBsAg, 126 and 97 for HBcAb, and 32 and 17 for anti-HCV. Hepatitis C virus RNA confirmed that 68 of 73 Somalis (93.2%) and 261 of 282 non-Somalis (92.6%) with positive anti-HCV test results had active HCV infection. Of 30 Somali patients with HCC, 22 (73.3%) tested anti-HCV positive (odds ratio [OR], 31.3; 95% confidence interval [CI], 13.0-75.5; P<.001; compared with anti-HCV-negative Somalis), 5 (16.7%) were HBsAg positive (OR, 1.4; 95% CI, 0.5-3.7; P=.53), and 18 (60.0%) were HBcAb positive (OR, 1.8; 95% CI, 0.8-4.2; P=.16). Viral hepatitis was diagnosed coincident with HCC in 9 of 20 patients (45.0%) with HCV-associated HCCs. Only 4 of 24 cases of HCC (16.7%) were detected during surveillance. Conclusion: Both HBV and HCV occurred frequently in this sample of Somali immigrants. However, HCV was the major risk factor for HCC. Screening Somali immigrants for HCV infection may enhance the prevention, early detection, and optimal treatment of HCC.",

author = "Shire, {Abdirashid M.} and Sandhu, {Dalbir S.} and Kaiya, {Joseph K.} and Oseini, {Abdul M.} and Yang, {Ju Dong} and Roongruedee Chaiteerakij and Mettler, {Teresa A.} and Giama, {Nasra H.} and Roberts, {Rosebud O.} and Therneau, {Terry M.} and Petersen, {Gloria M.} and Knutson, {Keith L.} and Roberts, {Lewis R.}",

note = "Funding Information: Grant Support: Dr L. Roberts was supported by the National Institutes of Health ( CA100882 and CA128633 and P30DK084567 [Mayo Clinic Center for Cell Signaling in Gastroenterology]). Dr R. Roberts was supported by the National Institutes of Health ( U01 AG006786 , K01 MH068351 , K01 AG028573 , and the Rochester Epidemiology Project [ National Institutes of Health grant R01 AG034676 ; Dr. Walter A. Rocca, principal investigator]). Dr Shire was supported by a KL2 grant ( 1KL2RR024151 ) from Mayo Clinic Center for Translational Science Activities . Funding Information: Potential Competing Interests: Dr L. Roberts has indicated research grants from Bristol Myers Squibb and MDS Nordion . ",

year = "2012",

month = jan,

doi = "10.1016/j.mayocp.2011.08.001",

language = "English (US)",

volume = "87",

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TY - JOUR

T1 - Viral hepatitis among Somali immigrants in Minnesota

T2 - Association of hepatitis C with hepatocellular carcinoma

AU - Shire, Abdirashid M.

AU - Sandhu, Dalbir S.

AU - Kaiya, Joseph K.

AU - Oseini, Abdul M.

AU - Yang, Ju Dong

AU - Chaiteerakij, Roongruedee

AU - Mettler, Teresa A.

AU - Giama, Nasra H.

AU - Roberts, Rosebud O.

AU - Therneau, Terry M.

AU - Petersen, Gloria M.

AU - Knutson, Keith L.

AU - Roberts, Lewis R.

N1 - Funding Information: Grant Support: Dr L. Roberts was supported by the National Institutes of Health ( CA100882 and CA128633 and P30DK084567 [Mayo Clinic Center for Cell Signaling in Gastroenterology]). Dr R. Roberts was supported by the National Institutes of Health ( U01 AG006786 , K01 MH068351 , K01 AG028573 , and the Rochester Epidemiology Project [ National Institutes of Health grant R01 AG034676 ; Dr. Walter A. Rocca, principal investigator]). Dr Shire was supported by a KL2 grant ( 1KL2RR024151 ) from Mayo Clinic Center for Translational Science Activities . Funding Information: Potential Competing Interests: Dr L. Roberts has indicated research grants from Bristol Myers Squibb and MDS Nordion .

PY - 2012/1

Y1 - 2012/1

N2 - Objective: To study the frequencies of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and their associations with hepatocellular carcinoma (HCC) in immigrant Somalis seen at Mayo Clinic in Rochester, Minnesota. Patients and Methods: We determined the frequencies of HBV and HCV infection and HCC in immigrant Somalis seen at Mayo Clinic from July 1, 1996, through October 31, 2009. Non-Somali Olmsted County residents served as controls. Results: For Somali males and females, age-adjusted proportions (per 1000 population) were 209 and 123 for hepatitis B surface antigen (HBsAg), 644 and 541 for hepatitis B core antibody (HBcAb), and 99 and 66 for anti-HCV. The comparative proportions in non-Somalis were 20 and 9 for HBsAg, 126 and 97 for HBcAb, and 32 and 17 for anti-HCV. Hepatitis C virus RNA confirmed that 68 of 73 Somalis (93.2%) and 261 of 282 non-Somalis (92.6%) with positive anti-HCV test results had active HCV infection. Of 30 Somali patients with HCC, 22 (73.3%) tested anti-HCV positive (odds ratio [OR], 31.3; 95% confidence interval [CI], 13.0-75.5; P<.001; compared with anti-HCV-negative Somalis), 5 (16.7%) were HBsAg positive (OR, 1.4; 95% CI, 0.5-3.7; P=.53), and 18 (60.0%) were HBcAb positive (OR, 1.8; 95% CI, 0.8-4.2; P=.16). Viral hepatitis was diagnosed coincident with HCC in 9 of 20 patients (45.0%) with HCV-associated HCCs. Only 4 of 24 cases of HCC (16.7%) were detected during surveillance. Conclusion: Both HBV and HCV occurred frequently in this sample of Somali immigrants. However, HCV was the major risk factor for HCC. Screening Somali immigrants for HCV infection may enhance the prevention, early detection, and optimal treatment of HCC.

AB - Objective: To study the frequencies of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and their associations with hepatocellular carcinoma (HCC) in immigrant Somalis seen at Mayo Clinic in Rochester, Minnesota. Patients and Methods: We determined the frequencies of HBV and HCV infection and HCC in immigrant Somalis seen at Mayo Clinic from July 1, 1996, through October 31, 2009. Non-Somali Olmsted County residents served as controls. Results: For Somali males and females, age-adjusted proportions (per 1000 population) were 209 and 123 for hepatitis B surface antigen (HBsAg), 644 and 541 for hepatitis B core antibody (HBcAb), and 99 and 66 for anti-HCV. The comparative proportions in non-Somalis were 20 and 9 for HBsAg, 126 and 97 for HBcAb, and 32 and 17 for anti-HCV. Hepatitis C virus RNA confirmed that 68 of 73 Somalis (93.2%) and 261 of 282 non-Somalis (92.6%) with positive anti-HCV test results had active HCV infection. Of 30 Somali patients with HCC, 22 (73.3%) tested anti-HCV positive (odds ratio [OR], 31.3; 95% confidence interval [CI], 13.0-75.5; P<.001; compared with anti-HCV-negative Somalis), 5 (16.7%) were HBsAg positive (OR, 1.4; 95% CI, 0.5-3.7; P=.53), and 18 (60.0%) were HBcAb positive (OR, 1.8; 95% CI, 0.8-4.2; P=.16). Viral hepatitis was diagnosed coincident with HCC in 9 of 20 patients (45.0%) with HCV-associated HCCs. Only 4 of 24 cases of HCC (16.7%) were detected during surveillance. Conclusion: Both HBV and HCV occurred frequently in this sample of Somali immigrants. However, HCV was the major risk factor for HCC. Screening Somali immigrants for HCV infection may enhance the prevention, early detection, and optimal treatment of HCC.

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Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma

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