What do Asians need to know about hepatitis B?

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What do Asians need to know about hepatitis B?

Posted on 16 September 2010

Tags: 2010, Kris Kowdley, Vol 29 No 38 | September 18 - September 24

By Chinami Tajika

Northwest Asian Weekly

Hepatitis B is now gaining more attention from doctors in the United States.

Research shows that as many as 2 million people in the country and 30,000 people

in Washington state are living with chronic hepatitis B. Hepatitis B is known as

a silent killer because it can slowly damage the liver, sometimes without

causing symptoms for many years. Asians are particularly susceptible because

vaccination against the disease is not yet common in some Asian countries.

Dr. Kris Kowdley, director of the Liver Center of Excellence in the Digestive

Disease Institute at Virginia Mason Medical Center, has presented his research

on liver disease at more than 100 national and international medical centers.

NWAW: Why is hepatitis B such a serious problem?

Kowdley: An enormous number of individuals are affected worldwide (about 400

million), and the virus is a major cause of liver cancer and end-stage liver

disease, which is a serious condition that leads to liver failure.

NWAW: How is hepatitis B transmitted among Asian Americans?

Kowdley: One way is through maternal-neonatal mode, which means that the virus

can pass from a mother to her baby during pregnancy or childbirth. This is the

most common way that hepatitis B is transmitted among the Asian American

community. Mother to child transmission is also called vertical transmission.

[There is also] horizontal transmission, [which occurs] early in life, which

means transmission of hepatitis B between two adults or children. This occurs

through contact with infected blood or other bodily fluids.

NWAW: Why is hepatitis B more prevalent in Asian Americans?

Kowdley: The disease is endemic in many Asian countries with chronic carrier

rates of 5-15 percent. In these countries, transmission is primarily from mother

to child, resulting in high rates of transmission within families.

NWAW: What is the present situation in the Seattle area? Why is hepatitis B

spreading in this area more compared to other places?

Kowdley: Since approximately 20 percent of our population is of Asian descent,

and many are immigrants and children or family members of immigrants, our city

and region carry a higher burden of the disease.

NWAW: How can a person tell if they have a chronic hepatitis B infection? What

are the symptoms?

Kowdley: Most individuals have no symptoms. Waiting for symptoms is the wrong

approach to diagnosis because by the time symptoms develop, the patient has

advanced liver disease. Anyone who may have risk factors for or possible

exposure to hepatitis B should be tested and vaccinated, if appropriate.

Occasionally, patients with the disease may have fatigue or pain over the upper

right part of the abdomen (right upper quadrant).

NWAW: Do you think the government should do something in order to prevent

hepatitis B in people?

Kowdley: Universal vaccination for hepatitis B has been in place for several

years. There is an initiative from the CDC and NIH to emphasize testing in

at-risk populations and vaccination as appropriate. The National Institute of

Diabetes and Digestive and Kidney Diseases (NIDDK), which is an organization

that conducts research on hepatitis B and other serious diseases, has

established a Clinical Research Network to better understand and treat hepatitis

B. Benaroya Research Institute at Virginia Mason (along with the UW and Alaska

Native Medical Center) is one of a dozen national centers.

NWAW: What can people do to prevent themselves from getting hepatitis B?

Kowdley: First, get tested to see if you might have chronic hepatitis B or prior

exposure to the virus. Second, get vaccinated if you have not done so. Third,

seek care from a knowledgeable provider if you have chronic hepatitis B.

NWAW: What are the long-term complications associated with chronic hepatitis B?

Kowdley: Hepatitis B is a leading cause of liver cancer worldwide and can lead

to end-stage liver disease and premature death. In some U.S. populations, like

in California, hepatitis B is a leading cause of cancer death among young Asian

men. But with early diagnosis, highly effective therapies are available that

can stop the progression of the disease. Vaccination can both prevent chronic

infection and reduce the risk of liver cancer. ♦

Chinami Tajika can be reached at info@....