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

Essa A Mohamed, Nasra H. Giama, Abubaker O. Abdalla, Hassan M. Shaleh, Abdul M. Oseini, Hamdi A. Ali, Fowsiyo Ahmed, Wesam Taha, Hager Ahmed Mohammed, Jessica Cvinar, Ibrahim A. Waaeys, Hawa Ali, Loretta K Allotey, Abdiwahab O. Ali, Safra A. Mohamed, William S. Harmsen, Eimad M. Ahmmad, Numra A. Bajwa, Mohamud D. Afgarshe, Abdirashid M. ShireJoyce E. Balls-Berry, Lewis R. Roberts

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


BACKGROUND Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are known risk factors for liver disease, cirrhosis and hepatocellular carcinoma (HCC). There is substantial global variation in HBV and HCV prevalence resulting in variations in cirrhosis and HCC. We previously reported high prevalence of HBV and HCV infections in Somali immigrants seen at an academic medical center in Minnesota. AIM To determine the prevalence of chronic viral hepatitis in Somali immigrants in Minnesota through a community-based screening program. METHODS We conducted a prospective community-based participatory research study in the Somali community in Minnesota in partnership with community advisory boards, community clinics and local mosques between November 2010 and December 2015 (data was analyzed in 2020). Serum was tested for hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody and anti-HCV antibody. RESULTS Of 779 participants, 15.4% tested positive for chronic HBV infection, 50.2% for prior exposure to HBV and 7.6% for chronic HCV infection. Calculated age-adjusted frequencies in males and females for chronic HBV were 12.5% and 11.6%; for prior exposure to HBV were 44.8% and 41.3%; and for chronic HCV were 6.7% and 5.7%, respectively. Seven participants developed incident HCC during follow up. CONCLUSION Chronic HBV and HCV are major risk factors for liver disease and HCC among Somali immigrants, with prevalence of both infections substantially higher than in the general United States population. Community-based screening is essential for identifying and providing health education and linkage to care for diagnosed patients.

Original languageEnglish (US)
Pages (from-to)5127-5229
Number of pages103
JournalWorld journal of gastroenterology
Issue number35
StatePublished - Sep 21 2022

Bibliographical note

Funding Information:
The authors would like to thank the study participants and their family members. In addition, the authors would like to thank the community partners who provided their community facilities to recruit, enroll, accrue and disseminate findings (i.e. Gargar Urgent Care and Clinic, Axis Medical Center, Masjed Abu Huraira, Masjed Al-Nur, Masjed Abubakr Al-Seddiq, and Mankato Mosque) and the Somali Health Advisory Committee, who ensured that we provided a culturally relevant and responsive manner in our efforts. In addition, the authors would like to thank Dr. Yu Wang, Dr. Chen-Chao Ma, the Mayo Clinic Clinical Trials and Research Unit and Lea Dacy for technical support.

Funding Information:
Supported by the Mayo Clinic Center for Clinical and Translational Science from the National Center for Advancing Translational Sciences (5UL1TR000135-10); the Mayo Clinic Hepatobiliary SPORE from the National Cancer Institute (5P50CA210964-04); the Mayo Clinic Center for Cell Signaling in Gastroenterology (5P30DK084567-14); and Gilead Sciences, Inc. (IN-US-174-0230).

Publisher Copyright:
© The Author(s) 2022.


  • African
  • Community engagement
  • Immigrant health
  • Liver disease
  • Viral hepatitis


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