For some Asian Pacific Islanders, it might be surprising to find out the prevalence of Hepatitis B Virus among the API population in the United States. With approximately five to fifteen percent of Asian immigrants diagnosed with HBV (compared to .05 percent for Caucasians), the disease has impacted the API community in multiple ways, the most severe being liver cancer for those chronically infected.
There are several ways people can become infected with HBV. The primary method of transmission is through contact with contaminated blood, such as from mother to infant during childbirth. HBV can be transmitted by blood transfusions, sharing needles for injections, and unprotected sex. It can also be contracted from using toothbrushes or razors that have come into contact with infected blood, or through infected medical/dental tools. HBV cannot be spread by coughing, hugging, sneezing, shaking hands, breast feeding, or sharing utensils or drinking glasses.
APIs are particularly at risk for HBV infection. According to Dr. Chia Wang, of the Benaroya Research Institute of Virginia Mason, the prevalence of HBV in APIs can be attributed to a lack of awareness in Asian countries. Asians in their mother countries are not conscious of the need to vaccinate to prevent infection. As a result, the disease carries over to API immigrant populations in the U.S., where more than half the total infected population are APIs.
The lives of infected APIs dramatically change after becoming diagnosed with HBV. Yoon Huh, a Korean American who contracted HBV at age 34, recalls that by the time he was diagnosed, his illness had reached the point of becoming life-threatening. As a result, Huh significantly altered his life to accommodate his disease.
Huh said, “I had to become more conscious of what I ate, choosing natural over artificial foods. I also had to stop drinking alcohol.” Because of these changes, Huh has been nearly symptom free for more than fifteen years. He attributes his success to healthful eating habits and reduced stress levels resulting from lifestyle modifications and regular exercise.
Huh’s case is not unusual for many APIs suffering from HBV. Without appropriate management and screening, approximately one-fourth of those infected by HBV will die from liver cancer or cirrhosis. Because half of infected individuals exhibit little or no symptoms for a long period of time, the disease has the possibility of remaining undetected until it is too late. When symptoms eventually do show up, the illness has most likely reached a later stage of development, culminating in severe damage to the liver and even cancer.
There is hope, however, for APIs who educate themselves about HBV. To prevent infection, doctors advise people to get tested for HBV. It is important to get tested before getting vaccinated because the vaccine will not work if a person already has chronic HBV.
Dr. Wang reiterates, “The most important thing is to get tested. Sometimes doctors don’t know there is a prevalence of HBV in API populations. It’s good for us to become our own advocates.” Currently there are two tests for HBV: hepatitis B surface antigen (HBsAg) and surface antibody (anti-HBs). Asking one’s doctor for both of these tests can prevent possible infection. If one’s tests are negative, the next step is to get vaccinated. People who should receive the vaccine are the following: infants and unvaccinated children and adolescents aged 0-18 years, people with multiple sexual partners, injecting drug users, and travelers to regions of widespread HBV infection.
Because of the prevalence of Asian immigrants living here in Seattle, the city is particularly at risk for high rates of HBV. Individuals such as Dr. Wang and Dr. Kris Kowdley are learning ways to treat the disease and educate the public about vaccination. They are joining in a nationwide effort known as Hepatitis B Clinical Research Network that supports research on HBV.
There are numerous ways to get involved in raising awareness of HBV. Perhaps the best way to participate in HBV awareness is to educate oneself and family. Joining organizations such as the Jade Ribbon Campaign and San Francisco Hep B Free will also teach the public ways to prevent further infection in the API population. Organizations such as these promote greater consciousness of HBV and help to increase vaccinations in the API community.
On a global scale, HBV affects about 350 to 400 million people. Approximately one million people worldwide die every year from HBV. Especially in the API community, it is necessary to become informed about HBV and the importance of getting vaccinated to prevent further infections. Starting with one’s family and branching out into the community will not only increase awareness of the disease on the local level but also help bring about change in the worldwide effort to eradicate this disease.
For those infected with HBV wishing to participate in the Hepatitis B Clinical Research Network, they can reach the clinic at (206) 341- 1452.