Sometimes certain ethnic groups face particular health conditions, and that's the way it is with Asian Americans and hepatitis B. This potentially deadly virus attacks the liver and can lead to liver cancer, one of the most deadly forms of malignancy. And in the U.S., people of Asian and Pacific Island (API) descent account for 50 percent of those living with chronic hepatitis B infection.
Among the national leaders of the struggle against chronic hepatitis B infection is Su Wang, M.D., medical director of the Center for Asian Health at Saint Barnabas Medical Center, who recently won the Hep B Champion Award from Hep B United, a national coalition working to address and eliminate the virus and its effects.
Dr. Wang recently spoke with Morris/Essex Health & Life about hepatitis B awareness and prevention.
First, what is hepatitis B, and how widespread is it?
It's the world's most common liver infection, and it's caused by the hepatitis B virus, which attacks and can injure the liver. In the United States up to 2 million people are infected. One in 20 individuals in the world has hepatitis B, but in the Asian community it's 1 in 10. Worldwide, 350 million people have hepatitis B, while 150 million have hepatitis c and 35 million have HIV.
Why is hepatitis B so prevalent in the Asian community?
We don't know why Asians are more heavily affected than others, but we do know that mother-to-child, also known as perinatal, transmission is the main route of transmission in Asians. Because infants do not have fully developed immune systems, 90 percent of infants who are infected become "chronic" and can have the infection for life. Adults who are infected often are sick for a short time but then fight the virus off.
What makes hepatitis B so deadly?
It's responsible for 80 percent of the world's liver cancer cases. It can slowly destroy the liver without causing noticeable symptoms. Thus we call it a "silent killer." The virus causes ongoing inflammation of the liver that may go undetected until the individual develops cirrhosis or liver cancer.
So raising awareness of the problem could save lives?
Absolutely. If they're diagnosed early with a simple blood test and treated with regular medical care, routine blood work and in some cases antiviral medication, people with hepatitis B can live long, healthy lives and avoid complications. However, it is estimated that two-thirds of those with hepatitis B have never had a blood test for it and don't know they have the infection.
Newly released guidelines recommend that all API individuals should be tested. (See "Hepatitis B Screening as a Part of Preventive Care,") But this is not always done, because many primary care physicians are not aware of this issue. That's one of our main goals—raising awareness among doctors as well as in the API population.
What about prevention?
Unlike many viruses, such as hepatitis C and HIV, there is a vaccine for hepatitis B that can protect people from getting the infection. It's safe and can be given to people of all ages, including pregnant women, and 95 percent of those who receive the series of three shots will develop immunity. The vaccine was developed in the 1980s, and since 1991 it has been the standard of care for all infants to receive this lifesaving vaccine. But many adults have never been vaccinated, and in hepatitis B screening programs held by the Charles Wang community health center in New York City, we found that up to 40 percent of Chinese adults are not immune.