July 28 marks World Hepatitis Day, and for the nearly 1 in 10 Asian Americans who carry the hepatitis B virus, it is another opportunity to emphasize the importance of getting screened and vaccinated.

Dr. Shie-Pon Tzung, a liver specialist at Northwest Gastroenterology Associates in Seattle, describes the virus as a silent killer because it has no initial symptoms. Because of this, many carry the virus without knowing it. If left untreated, about a third of cases lead to liver cancer and potentially other liver diseases, according to Dr. Tzung.

  “We have 30-, 40-year-old Microsoft and Amazon engineers who don’t know they carry the virus all their lives until they get tested. They have to quit their jobs and undergo treatment,” he said. “This is the tragedy we try to prevent.”

He said that screening is crucial for all at-risk populations and immigrants who come from high-risk regions. 

“Hepatitis B primarily impacts countries or continents that are underdeveloped or don’t have really good health care for pregnant women,” said Kim Nguyen, program manager of the Hepatitis B Coalition of Washington State (HBCW). According to the Centers for Disease Control and Prevention, Asian and African countries are disproportionately impacted, with many regions experiencing an over 8 percent prevalence of cases, a rate nearly four times higher than that in the United States. 

The virus is transmitted via blood and other bodily fluids. This usually means through IV, piercings, tattooing and sexual intercourse. However, for Asian Americans, it has primarily spread because infected mothers unknowingly pass it on to their children at birth. According to Dr. Tzung, there is a 90 to 95 percent chance of a baby carrying the virus if the mother does.

“It’s a liver disease that can be managed like other chronic diseases, but you have to know you have it first,” said Nguyen. She added that the HBCW works to teach at-risk populations how to prevent hepatitis B through multilingual informational messages and activities.

Michael McKee is the clinic operations and health services director at International Community Health Services in Seattle, an organization that collaborates with HBCW. According to him, there are misunderstandings surrounding how the virus is spread. A stigma is associated with hepatitis B because it can be sexually transmitted and people are less inclined to talk openly about the issue.

“We’re not concerned about sharing utensils, or hugging your grandmother goodbye or getting a kiss on your cheek from your mom,” he said. “We need to make sure that families understand that these common forms of family affection are not a risk for transmission if somebody in the house is diagnosed with chronic hepatitis.”

In the United States, all babies receive a three-shot vaccine that has proven 95 percent effective in preventing the disease. However, according to McKee, many immigrants fail to receive the vaccination and even some who do already unsuspectingly carry the virus.

“It is one of the few viral infections that we know leads directly to cancer that is preventable by a vaccine, but only if you get the vaccine prior to ever being infected,” said McKee.

About 1 million Asians live with hepatitis B worldwide. To the rest of this high-risk population, Dr. Tzung, in accordance with the World Health Organization and the CDC, had this to say: “Every Asian American needs to get screened and everyone must get vaccinated.”

The Hepatitis B Coalition of Washington offers free health messages in multiple languages for high-risk populations. For more information, visit The International Community Health Services offers hepatitis B testing and vaccination on a sliding-scale fee at their two community clinics in Seattle. For more information, visit

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