CONTINUING RISK FOR HEPATITIS-B VIRUS TRANSMISSION AMONG SOUTHEAST-ASIAN INFANTS IN LOUISIANA

Objective. Implementation and evaluation of a hepatitis B vaccination program for Southeast Asian infants in Louisiana. Methods. A baseline seroprevalence survey of hepatitis B virus (HBV) infection in US-born Southeast Asian children was conducted in 1991 before the implementati on of a vaccination program. Hepatitis B vaccination and postvaccinati on serologic testing of survey participants 10 years of age and younge r was performed. Eighteen months after the hepatitis B vaccine was int egrated into infant immunization schedules in July 1993, a vaccination coverage survey was performed. Results. Baseline serologic testing wa s conducted on 96% of persons from 225 randomly selected households in a Southeast Asian community in Louisiana. Of 676 US-born children, 28 (4.1%) had chronic HBV infection; 61% of children with chronic HBV in fection were born to hepatitis B surface antigen (HBsAg)-negative wome n. Among children born to HBsAg-negative women, the prevalence of chro nic HBV infection increased with age, reaching 7.3% for children 13 to 16 years of age. Children born to HBsAg-negative women and living wit h carriers were 5.4 times more likely to have evidence of HBV infectio n than were children who did not live with carriers. Before the survey , only one child had received three doses of hepatitis B vaccine. In J uly 1993, 43% of Southeast Asian infants 9 to 18 months of age born in Louisiana had received three doses of hepatitis B vaccine. Infants wh o received immunizations from private providers were more likely to be fully vaccinated than were infants who received services from public sector clinics (prevalence ratio, 2.1; 95% confidence interval, 1.4,3. 1). Conclusions. HBV transmission occurs throughout childhood in US-bo rn Southeast Asian children, and the prevalence of chronic HBV infecti on approaches that of the country of origin. Few US-born Southeast Asi an children have received hepatitis B vaccine. Because of the high rat es of early childhood HBV transmission and the high risk of chronic in fection in Asian and Pacific Islander communities, prevention efforts should be enhanced to ensure that all Asian and Pacific Islander infan ts receive hepatitis B vaccine in the first 12 months of life and that older children are vaccinated.