Hepatitis B is the most significant health disparity affecting Asian Americans in the US: 10% of Asian Americans are infected with chronic hepatitis B compared with .1% of Caucasians. One in seven Vietnamese Americans is a chronic carrier of hepatitis B and the incidence of liver cancer, the final result of hepatitis B, is about five times higher in Chinese men than in Caucasian men.
Hepatitis B has been an old endemic throughout Asia. It has become a self-sustained disease among the Asian population as parents with the chronic infection pass the disease onto their children during birth. As newborns, their immune systems are weak, putting them at a 90% chance of developing the chronic infection. Other groups usually contract the virus later in their lives through sexual activity leading to only an acute infection.
Hepatitis B is a disease causing direct damage to the liver. There are two types of hepatitis: acute and chronic. Acute hepatitis is temporary lasting about six months with only 1% at risk of death. Chronic hepatitis is a fatal, life-long infection. It leads to the slow destruction of liver cells that the organ is unable to completely repair, leaving scar tissue. The scar tissues then cause resistance to blood flow, leading to further complications. Metabolic functions, like making proteins, are inhibited.
The outer manifestation of hepatitis B infection differs from individual and the status of the person’s immune system at the time of exposure. Most chronic carriers are not aware of their on-going infection, while some suffer persistent fatigue. Liver cancer and cirrhosis are the final results of chronic hepatitis B. According to World Health Organization, 25% of those with chronic infection will die later from liver disease or liver cancer.
Hepatitis B is found in blood, semen, vaginal secretions and saliva. Therefore, it can be contracted through sexual activity, blood transfusions, sharing needles during drug use, receiving a tattoo or acupuncture with a contaminated instrument and birth (an infected mother transmitting it to her baby during delivery).
Symptoms
30% of people infected with chronic hepatitis B have no symptoms. The following symptoms typically start at 40 to 60 years of age: Fatigue, joint aches and low-grade fever; jaundice and dark urine; nausea, vomiting, loss of appetite and abdominal pain.
Prevention
If the mother is infected, hepatitis B immune globulin, a shot containing a high level of antibodies, can temporarily protect a newborn upon leaving the birth canal. With subsequent vaccination, these newborns have a 95% chance of avoiding the disease.
For newborns whose mothers do not have hepatitis B, the infant may receive the shot anytime before leaving the hospital, even delayed until the 4th or 8th week after birth.
Adolescents who were not vaccinated as newborns should receive the vaccine series as early as possible to avoid later infection.
Treatment
Acute hepatitis does not need treatment, but there should be careful monitoring of the liver.
There are various treatments for chronic hepatitis:
Interferon Alpha: Administered by injection, these are natural proteins produced by the cells of the immune system in direct response to viruses, parasites and tumor cells. They prevent viral replication in newly infected cells.
Lamivudine, Entecavir and Adefovir Dipivoxil: Administered orally, these are antiviral drugs that slow the ability of the hepatitis B virus to multiply in the body.
