About Hep B

• What is Hep B

• HBV & the API Community

• How HBV is Transmitted

• Symptoms

• HBV Vaccination & Testing

• Treating Hepatitis B

• Managing Hepatitis B

What is Hep B

Hepatitis B is a disease caused by infection with the hepatitis B virus (HBV). Infection with HBV can lead to cirrhosis of the liver, liver failure, and liver cancer. 80% of liver cancer worldwide is caused by HBV infection.

Since the diagnosis of hepatitis B is so easily missed by both patients and their physicians, the only way to diagnose for hepatitis B infection is through a simple and inexpensive blood test.

HBV infection and the liver cancer and liver failure associated with chronic infection are all vaccine preventable with the hepatitis B vaccine. It is so effective that the Centers for Disease Control and Prevention and the World Health Organization have called the hepatitis B vaccine the first “anti-cancer” vaccine.

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HBV & the API Community

350 – 400 million people in the world are chronically infected with hepatitis B. Hepatitis B takes a life every 30 seconds. Most of these lives are Asian.

Asian Americans tend to be infected at a much higher rate, with 1 in 10 Asians chronically infected with hepatitis B, compared to 1 in 1000 in the general population. Without treatment or monitoring, 1 in 4 of these individuals will die from liver cancer or liver failure. Many die at the prime of their lives and as early as 30 years of age, leaving behind family members and children.

The incidence of hepatitis B and liver cancer constitutes the greatest health disparity that exists between Asian & Pacific Islanders (APIs) and the general U.S. population.

In California alone liver cancer is the #1 leading cause of cancer deaths among Laotian American men, the 2nd leading cause of cancer deaths among Cambodian and Vietnamese men, the 4th leading cause of cancer deaths among Chinese and Korean men, and the 5th leading cause of deaths among Filipino men.

To learn more about HBV and liver cancer in API Americans,
download out fact sheet here.

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How HBV is Transmitted

Hepatitis B is silently transmitted and has a silent progression. Many people with chronic HBV exhibit no symptoms and feel perfectly healthy. They may even exhibit normal blood test for liver function. Because so many carriers feel fine, even with early stages of liver cancer, the disease can progress without the carrier even knowing it. If symptoms do appear they often are exhibited at the end stages of disease when treatment options are limited or ineffective.

Hepatitis B is 100 times more infectious than HIV. Because of its infectiousness and because it can survive outside of the body for up to 7 days, HBV can be spread through items such as shared razors and toothbrushes that have contaminated blood on them.

HBV is transmitted through infected blood in the following ways:

• From a mother to a child at the time of birth (most common for APIs)
• Contact with infected blood
• Unprotected sex

Among Asian & Pacific Islander community, transmission of HBV frequently occurs during the birth process when the virus is passed on from an infected mother, who is often unaware that she is a carrier, to her baby.

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Symptoms

Hepatitis B is a silent killer. It is asymptomatic so many carriers feel perfectly healthy. Only 30% of those with acute infections develop symptoms. Most APIs are infected at birth or early childhood, when symptoms may never develop. When symptoms of hepatitis B infection do develop, they include jaundice, fatigue, abdominal pain and loss of appetite.

For those who are infected as newborns, there is a 90% chance of becoming a chronic carrier. For those infected during childhood, there is a 30%-50% chance. Most Asians are exposed to the disease either during the perinatal period or during childhood.

There is a 8-15% prevalence rate of the number of chronic carriers within the Asian community. Perinatal transmission is the most common mode of infection. As a result, prevention of perinatal transmission is of utmost importance in the Asian community. Since HBV is very efficiently transmitted by unprotected sex, all API adults who are sexually active should be vaccinated to prevent infection.

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HBV Vaccination & Testing

Hepatitis B is preventable with a vaccine that has been available for over 20 years. The hepatitis B vaccine provides an easy and effective method for preventing HBV infection and its deadly implications. All people, including children, adolescents and adults should be vaccinated provided they are not already chronically infected with HBV.

Diagnosing HBV is done through a simple and inexpensive blood test that detects the presence of the hepatitis B surface antigen (HBsAg), a marker for chronic infection. Early detection of HBV will benefit the carrier as well as prevent the infection from spreading.

Because over 10% of the Asian & Pacific Islander community is chronically infected with hepatitis B, all members of the API community should be tested for HBV.

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Treating Hepatitis B

Not every case of hepatitis B needs to be treated. For those that do, there are several treatment options available. While no cure for hepatitis B has been found, treatment can be used to reduce the liver damage that may result in cirrhosis and liver failure. Effective treatment may also reduce the risk of liver cancer.

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Managing Hepatitis B

Steps for Chronic Carriers

1. Measure ALT every 6 months to assess whether treatment is appropriate. Elevated ALT levels in the blood stream can indicate active liver damage.

2. Have the AFP test done every 6 months to screen for liver cancer. AFP (Alpha-FetoProtein) is a test used to look for liver tumors in patients with chronic hepatitis B and those at high risk for liver cancer. High AFP levels can indicate the possibility of liver cancer.

3. Receive an ultrasound every year to screen for liver cancer.

4. Get the hepatitis A vaccine to avoid further damage to the liver.

5. Avoid alcohol, drugs, herbal supplements and other substances that could potentially damage the liver.

6. Have family members screened for HBsAg (Hepatitis B surface antigen) and HBsAb (Hepatitis B surface antibody), and get vaccinated if appropriate.

7. Cancer patients who are infected with HBV should start prophylactic HBV oral antiviral treatment before chemotherapy to reduce the risk of acute or fulminant hepatitis induced by cancer chemotherapy.

SOURCE: Asian Liver Center

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