May 19 is National Asian & Pacific Islander HIV/AIDS Awareness Day and World Hepatitis Day. This blog post is one of a series on the impact of HIV and Hepatitis B in Asian & Pacific Islander communities. As A&PIs, you may not believe that you are at risk for these diseases, but you are. Follow our posts throughout the week for different perspectives and stories from our community.

May 19 is World Hepatitis Day, and it should be a time for our community to pause and think about the hepatitis A, B and C virus, or HAV, HBV and HCV. For Asians & Pacific Islanders, hep B is of particular concern. Though an effective vaccine exists, few A&PIs get screened or vaccinated and most people chronically infected with hep B have no idea, since the disease often has no symptoms. In the US, 1 in 10 A&PIs are chronically infected with hep B, compared to 1 in 1000 in the general population. A&PIs account for half of all hep B-related deaths due to liver cancer or failure. This is a huge health crisis for our communities, and one that can be prevented with a simple vaccine.

What is HBV?
Hepatitis refers to any disease that inflames the liver, regardless of how it was contracted. HBV is the virus that causes hepatitis B. Chronic hep B infection can lead to liver cirrhosis, liver failure and liver cancer. Worldwide, 60-80% of primary liver cancer is caused by chronic HBV infection.

How is HBV transmitted?
HBV is transmitted very much like HIV. Blood transfusions, dirty needles, and unprotected sex are ways that you can contract HBV, but usually HBV is passed from mother to child. HBV is not transmitted through air, food, water, breastfeeding, casual contact like kissing, hugging, sharing utensils or dishes.

However, HBV differs from HIV with respect to how long it can live outside the body. HIV is very weak, and can be killed easily. HBV on the other hand is robust, and can survive over 7 days outside the body. Spread of HBV within the household can occur from sharing toothbrushes or razors.

Why is HBV a Concern for A&PIs?
In particular, Asians & Pacific Islanders are at high risk for HBV. HBV is often endemic in Asian and Pacific Island countries, meaning that HBV infection is common and found among a large percentage of the population. In some Pacific Rim countries, as many as 1 in 5 people are chronically infected with HBV.

In the US, HBV disproportionately affects A&PIs. Depending on the country of origin, it is estimated that as many as 5-15% of A&PI immigrants have chronic HBV. It is estimated that over half of chronic HBV infections in the US are among A&PIs. 1 out of every 10 A&PIs in the US are chronically infected with HBV.

Do I have HBV?
Most people who are chronically infected don’t realize it until it’s too late. Two-thirds of HBV cases don’t exhibit any symptoms, making HBV a silent killer in our community. If symptoms do develop, they mirror the flu: fever, fatigue, joint and/or muscle pain, nausea and vomiting. Jaundice may or may not develop. Because it’s hard to tell whether or not you have HBV, you should get screened!

Get screened and vaccinated!
Developing liver cancer is long and costly. In most cases, getting screened can be free and quick at community screening centers. Or if you have private insurance, ask your doctor to include a screening for you during your next blood tests. If your tests come back negative, you should consider getting the HBV vaccine. Getting vaccinated requires three shots scheduled over a series of weeks. Newborns should be vaccinated at birth.

For more information, please visit the following websites:
CDC’s Hepatitis Information Page: http://www.cdc.gov/hepatitis/B/PatientEduB.htm
Asian Liver Center at Stanford University: http://liver.stanford.edu/
National HIV & STB Testing Locations (find sites that do HIV/STD/HBV screenings and HPV Vaccinations): http://www.hivtest.org/std_testing.cfm
Asian & Pacific Islander Wellness Center in San Francisco provides free HBV screening and vaccinations on Wednesdays and Fridays: http://www.apiwellness.org/