HBV & Asian Americans

Hepatitis B (for “Health Information”)

Hepatitis B is a disease caused by hepatitis B virus (HBV). There are two kinds of HBV infections: “acute HBV infection” or “chronic HBV infection”. The acute infection usually will run through a week or two; symptoms are often flu-like. The person recovered, should have immunity for the rest of his/her life. On the other hand, “chronic HBV infection” may not show any symptom, but is a deadly disease that may lead to liver cirrhosis or liver cancer.  

Asian Americans have about 8% prevalence of hepatitis B (based on 2020 census), in comparison to average American of < 0.5%. It is the highest health disparity among Asian Americans.

The following is a direct copy from the American Liver Foundation. There are many links for more information at the end of this section, including the more recently formed Hepatitis B Foundation to manage the HBV disease in the United States.

Hepatitis B and Asian Americans

Hepatitis B is a serious liver infection caused by the hepatitis B virus. It is more common among Asian Americans than other racial or ethnic groups in the U.S.

Why? Hepatitis B virus (HBV) is very common in many countries in Asia. Anyone who has not been vaccinated can get infected with HBV, but people from areas of the world where the virus is prevalent are more likely to become long-term carriers of HBV, and they may not know it. In regions where HBV is common, the virus is more typically acquired early in life—during infancy and early childhood. Because children’s bodies do not fight the virus as an adult’s would, these early cases often develop into chronic (long-term) hepatitis B, and it can be spread to others. Approximately one of every ten Asian Americans is chronically infected with HBV.

Hepatitis B is spread by contact with infected body fluids.

These fluids include blood, semen, vaginal secretions, and saliva. Among Asian Americans and immigrants from Asian countries where HBV is common, the virus is typically spread unknowingly from a mother to her infant at birth, or in early childhood from close contact with infected family members.

HBV infection can be prevented by vaccination.

Vaccination can also prevent the consequences of HBV infection, including cirrhosis and liver cancer. “Catch up” vaccination is needed for many Asian American children and adolescents. Of Asian Americans and Pacific Islanders born after 1993, 90% received HBV vaccine in time to prevent infection, but many born in the U.S. before 1993 and those born in countries where hepatitis B vaccine is not routinely given to newborns have not been vaccinated.

Most Asian Americans with hepatitis B are infected as infants or young children.

Those infected as infants are much more likely to become chronically infected (have long-term infection) than those infected as children or adults.

Hepatitis B infection is serious. Chronic (long-term) HBV infection can result in cirrhosis (scarring of the liver), liver failure, and liver cancer.

Because hepatitis B infection is more common among Asian Americans, so are its complications. For example, among Chinese American men, incidence of liver cancer is about 5 times higher than in Caucasian men and about 3 times higher than in black or Hispanic men.

Most patients with chronic HBV infection do not have symptoms and are unaware that they are infected until they have very advanced liver disease.

More than two-thirds of those who become infected with hepatitis B have no obvious sign or symptoms, and symptoms are less common in children than adults. Thus, many people who become carriers—and can pass the virus on to others—never know it. Even when typical symptoms (including fatigue, jaundice, nausea, abdominal pain, and loss of appetite) do become apparent, they are not always recognized as being caused by the hepatitis B virus. This is why screening for the virus is so important.

In the U.S., there are three approved treatments that can benefit some patients with chronic hepatitis B infection, and there are many more treatments in the pipeline (in clinical trials or awaiting FDA approval).

The approved treatments include Epivir-HBV (lamivudine) and Hepsera (adefovir dipivoxil), which are available as pills to be taken orally, daily. Intron A (interferon alpha), a drug given by injection, is the third approved treatment. Patients with high levels of virus and signs of active liver disease may benefit the most from treatment.

Not every chronic hepatitis B patient needs to be on medication.

Some patients only need to be monitored for the complications of HBV infection by their doctor regularly—at least once a year, or more. However, all people with chronic hepatitis B should visit their doctor regularly, whether they are receiving treatment or not.

Asian Americans from countries with high prevalence of HBV infection and those with a family history of liver disease or hepatitis B should be screened for hepatitis B infection.

Those who test positive should be evaluated to assess severity of liver disease and to determine if treatment will be of benefit. Those who have not been exposed to the virus should be vaccinated.

The information contained in this sheet is provided for information only. This information does not constitute medical advice and it should not be relied upon as such. The American Liver Foundation (ALF) does not engage in the practice of medicine. ALF, under no circumstances, recommends particular treatments for specific individuals, and in all cases recommends that you consult your physician before pursuing any course of treatment.

Supplemental Documents:

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