1 in 10 foreign-born Asian Americans has hep-B; most don’t know it
• Most contracted disease through their mothers at childbirth
• Can be diagnosed with simple blood test
• Disease is preventable
CDC PHOTO
NEW YORK, New York — As many as 1 in 10 foreign-born Asian Americans is affected by hepatitis-B, a rate over 20 times higher than that of the overall U.S. population, reports Gilead Sciences.
Chronic hepatitis B is a potentially fatal liver disease caused by the hepatitis B virus (HBV). HBV is up to 100 times more easily transmitted than the AIDS virus.
Chronic hepatitis B can slowly destroy the liver over many years – even decades – without producing symptoms. It may cause life-threatening complications including liver cancer or cirrhosis (severe liver scarring).
Worldwide, approximately 240 million people are living with chronic hepatitis B infection, with as many as 2 million living in the United States.
Although anyone can become chronically infected with hepatitis B, Asian Americans are particularly impacted. About 1 million Asian Americans are living with chronic hepatitis B infection – more than any other ethnic or racial group in the United States.
Asian Americans chronically infected with HBV are at an increased risk of liver cancer. Without appropriate monitoring and treatment, Asian Americans are 2.7 times more likely to develop liver cancer than whites and 2.4 times more likely to die from the malignancy – the most significant cancer disparity between Asian Americans and whites.
Transmission
HBV is found in blood and other body fluids, and can be transmitted by any activity that involves exposure to these fluids, including sexual contact, use of contaminated needles (e.g., injecting drugs or tattooing), or sharing some personal items like razors or toothbrushes.
However, most Asian Americans who have hepatitis B contracted the disease from their mothers during childbirth. This is because of historically low levels of hepatitis B testing and vaccination in some Asian countries.
It is important to know that hepatitis B is NOT transmitted through casual contact – it cannot be spread by sharing food, water or eating utensils, or by hugging, kissing, coughing or sneezing.
Importance of screening
Hepatitis B can be diagnosed with a simple blood test – yet alarmingly, as many as two-thirds of Asian Americans with chronic hepatitis B do not know they are infected. HBV screening is especially critical because patients with chronic hepatitis B usually do not experience any symptoms until advanced liver disease has already developed.
In order to address the high rates of hepatitis B among Asian Americans, screening guidelines by the U.S. Centers for Disease Control and Prevention (CDC) recommend that all U.S. residents born in areas that are highly impacted by hepatitis B, such as Asia, be tested for hepatitis B.
Similarly, the U.S. Preventive Services Task Force (USPSTF), a government-appointed independent panel of experts, issued guidance in May 2014 recommending hepatitis B screening for individuals born in areas that are highly impacted by hepatitis B.
The USPSTF recommendations mean that hepatitis B testing for high-risk populations must be covered without cost-sharing by most private insurers and Medicare, and may expand coverage for screening under Medicaid.
Prevention and treatment
The good news is that chronic hepatitis B is preventable, with a safe and effective vaccine that has been available for over 30 years.
For those living with hepatitis B who are closely monitored by a doctor, the disease can be manageable and treatable. Although there is no cure for chronic hepatitis B, there are several treatments available that can help protect the liver from further damage.
Studies have shown that over the long-term, hepatitis B treatment may help to reduce or reverse signs of serious liver damage caused by chronic hepatitis B infection. Yet it is estimated that only 41 percent of Asian Americans living with hepatitis B are under the care of a physician – and among those in care, less than half are receiving hepatitis B therapy.
Addressing hepatitis B
There are a growing number of initiatives taking place across the country to increase screening for hepatitis B and linkage to care for those who are infected. These include:
• The U.S. Department of Health and Human Services (HHS) has implemented a Viral Hepatitis Action Plan, which has been renewed for 2014-2016. Key accomplishments of the agency’s work to date include the provision of $6.6 million in CDC grants to expand viral hepatitis testing and linkage to care;
• The first-ever multilingual campaign to increase HBV testing among Asian Americans, “Know Hepatitis B,” has been launched by CDC and Hep B United, a national coalition focused on addressing and eliminating the disease;
• The Viral Hepatitis Action Coalition is a public-private partnership coordinated by the CDC Foundation to make meaningful advances in the prevention, screening and treatment of viral hepatitis.
Hepatitis B is a leading cause of liver cancer worldwide. By 2030, one study estimates that liver cancer among Asian Americans will increase by 132 percent. What is being done to address this alarming problem?
Dangerous Stigma
In many Asian families, serious illnesses like hepatitis B can carry a strong stigma and are often not discussed. But the truth is, anyone can get the hepatitis B virus, and the good news is that it can be treated and managed. How can we break through the stigma and start a dialogue about hepatitis B?
Tragically, the vast majority of hepatitis B cases among Asian Americans are transmitted from mother to baby during childbirth.
Oftentimes, several members of the same family from multiple generations are affected by this disease. How has chronic hepatitis B affected families in your community?
Asian American population growing
A U.S. Census Bureau report indicates that Asian Americans are the fastest growing racial group in the country.
It is therefore critical that hepatitis B and other serious health disparities among Asians be addressed. What policy and other changes are needed to ensure that the health needs of Asian Americans are met?
For more information about hepatitis B or to speak with expert physicians, community advocates or patients, contact (650) 574-3000 or [email protected]
