03%-3.28%, depending on race/ethnicity) than the indirect estimations. Surveys of HBV infection specifically targeting foreign-born populations are needed to refine estimates of disease burden. The Kowdley study is particularly valuable in estimating HBV prevalence by country of birth, drawing attention to the diverse populations experiencing hepatitis B as a health selleckchem disparity. In the US, nearly 40% (≈515,000 persons) of all foreign-born persons living with hepatitis B come from three countries: China, Vietnam, and the Philippines.

However, a sizeable number of immigrants from other countries with increased burdens of HBV, including other countries of Asia (e.g., India [≈54,000 cases]), the Caribbean (e.g., Dominican Republic [47,000 cases]), and Africa (e.g., Ethiopia [≈14,500 cases]) rescale within the US. The vast differences in culture and language represented by these populations require the development of culturally appropriate HBV prevention programs. Hepatitis B is a vaccine-preventable disease, and immunization can virtually eliminate HBV transmission among vaccinated cohorts.6, 10 Global and US vaccination programs for newborn and infant hepatitis B immunization have resulted

in increased hepatitis B vaccination coverage among children and adolescents. However, many countries have only recently implemented hepatitis B immunization; many foreign-born persons who did not benefit from childhood vaccination programs in their countries of birth will be infected prior to arrival in the US. Interventions Selleckchem Tyrosine Kinase Inhibitor Library are needed in this country to identify and reach these populations. Since 2008, CDC has recommended HBsAg testing for all persons born in countries with HBsAg prevalence of ≥2%,

referral of infected persons to care, and referral of close contacts for testing and vaccination.11 This strategy is cost-effective, and given prevalence estimates by Kowdley et al., capable of capturing 89% of foreign-born persons living with chronic hepatitis B. However, the Lenvatinib clinical trial Institute of Medicine estimates that up to 65% of persons living with hepatitis B infection are unaware they are infected.6 To improve viral hepatitis prevention services, the US Department of Health and Human Services released a comprehensive plan outlining a set of actions for reducing health disparities among populations disproportionately affected by viral hepatitis, such as foreign-born persons.7 In accordance with this plan, several actions are being undertaken to improve availability of viral hepatitis data representative of foreign-born populations. For instance, the CDC’s REACH survey is targeting racial/ethnic minority communities to gather hepatitis B-related health information.