Hepatitis B and Asian Americans
Hepatitis B is a serious liver infection caused by the hepatitis B virus. It is more common among Asian Americans than among other racial or ethnic groups in the U.S. About one in ten Asian Americans is chronically infected with HBV.
FAST FACT
Approximately one in ten Asian Americans is chronically infected with the hepatitis B virus (HBV).
Hepatitis B virus (HBV) is very common in several countries in Southeast Asia. In regions where HBV is more prevalent, the virus is typically acquired during infancy or early childhood. Because children are not able to fight the virus like adults, early hepatitis B infection often leads to chronic (long-term) hepatitis B. People from areas of the world where the virus is more common are more likely to become long term carriers of HBV, but some may not even know it and can infect others. Anyone who has not received the vaccination can become infected.
Hepatitis B is spread by contact with infected body fluids.
The hepatitis B virus is found in blood, semen, vaginal secretions and saliva. Among Asian Americans and immigrants from Asian countries where HBV is common, the virus is typically spread unknowingly from a mother to her infant at birth or during early childhood from close contact with infected family members.
HBV infection can be prevented by vaccination.
Vaccination can help prevent the spread and consequences of HBV infection, including cirrhosis of the liver and liver cancer. About 90% of Asian Americans and Pacific Islanders born after 1993 received the HBV vaccine in time to prevent infection. However, people born in the U.S. before 1993 and those born in countries where the hepatitis B vaccine is not routinely given to newborns may not have been vaccinated. A "catch up" vaccination is needed for many Asian American children and adolescents.
Most Asian Americans with hepatitis B are infected as infants or young children.
Those infected during infancy or early childhood are more likely to become chronically infected than those infected during childhood or adulthood. These individuals especially need to be screened for liver cancer.
Chronic (long-term) HBV infection can result in cirrhosis (scarring of the liver), liver failure, and liver cancer.
The hepatitis B infection is more common among Asian Americans and so are its complications. For example, in Chinese American men, the incidence of liver cancer is about five times higher than in Caucasian men and about three times higher than in Black or Hispanic men.
Most patients with chronic HBV infection do not have symptoms and are unaware that they are infected until they have very advanced liver disease.
Approximately 30% of those who become infected with hepatitis B have no obvious signs or symptoms; symptoms are less common in children than adults. As a result, many individuals who are chronically infected can unknowingly pass the virus onto others. Even when symptoms typical of liver disease (fatigue, jaundice, nausea, abdominal pain, and loss of appetite) do become apparent, they are not always recognized as a result of the hepatitis B virus.
In the U.S., there are several approved treatment options that can benefit some patients with chronic hepatitis B infection.
FDA-approved treatments for hepatitis B include Epivir-HBV (lamivudine) and Hepsera (adefovir dipivoxil), which are available as pills to be taken daily. Intron A (interferon alpha), a drug given by injection, is also an approved treatment. Patients with high levels of the virus and signs of active liver disease may benefit the most from treatment.
Not every chronic hepatitis B patient needs to be on medication.
Some patients do not need treatment but must be monitored annually (or more frequently) by their doctor for complications of HBV infection. However, all individuals with chronic hepatitis B should visit their healthcare providers regularly, whether they are receiving treatment or not.
Asian Americans from countries with high prevalence of HBV infection and those with a family history of liver disease or hepatitis B should be screened for the hepatitis B infection.
Individuals who test positive for hepatitis B should be evaluated to assess the severity of liver disease and determine if treatment will be beneficial. Those who do not test positive may have naturally developed antibodies to the hepatitis B virus. Healthcare providers should determine if vaccination or treatment is appropriate.
Asian Americans and Hepatitis B
