Prevalence of Hepatitis B Infection Among Young and Unsuspecting Hmong Blood Donors in the Central California Valley

Chronic hepatitis B virus (HBV) infection may result in cirrhosis and/or hepatocellular carcinoma and is one of the leading
causes of mortality in Asian Americans including Hmong Americans. The Central California Valley is home to a huge Hmong population.
To date, the true prevalence of HBV among Hmong is largely unknown. The aim of this study was to contribute to the limited
data on HBV prevalence and its trends in Hmong population in the Central California Valley. Between fiscal years 2006 and
2010, a total of 219, 450 voluntary donors were identified at Central California Blood Center in Fresno. Of these, 821 (399
males and 422 females) were Hmong donors. A cross-sectional review of the HBV (hepatitis B surface antigen) positivity among
all donors was carried out. Prevalence estimates with 95% confidence intervals (CI) were calculated. Ninety-two percent of
Hmong donors were between age groups 16 and 35 years, and only 8% were ≥36 years. The overall prevalence in Hmong was noted
at 3.41% (95%CI 2.3–4.9) compared to 0.06% (95%CI 0.05–0.07) in donors of all ethnicities. The calculated prevalence could
be an underestimate of the true HBV prevalence in Hmong as the study enrolled only healthy blood donors with predominant younger
age (≤35 years) population. These results underscore the persistent burden of HBV infection and potentially increased risk
of premature death even in the second generation Hmong community of the Central California Valley. This study reemphasizes
the unequivocal need to develop robust preventive and treatment strategies for HBV in Hmong community.