Hepatitis B Research
Hepatitis B virus (HBV) infection is a worldwide epidemic. Infection often results in chronic hepatitis, cirrhosis, or hepatocellular carcinoma. HBV is also the leading cause of liver cancer. Currently, over two billion people worldwide have been infected with hepatitis B virus and more than 400 million people have chronic HBV infection with majority of the population living in Asia and the Pacific Islands. HBV infection is transmitted through close contact and from mothers to babies. Treatment is available to slow down the progression of HBV infection, however, it is very difficult to detect HBV infection without blood test since most carriers do not display any symptoms. Individuals can also be vaccinated against HBV infection.
The spread of HBV virus is a rising health concern among the Asian American communities. Currently, there is no population based study of prevalence of HBV infection among Asian Americans nationally in the United States, however, regional studies have indicated that Asian Americans are affected by HBV disproportionately. According to Asian Liver Foundation at Stanford University, approximately 0.3% of the US population has chronic hepatitis B infection and Asian Americans make up more than half of the infected population. Regional assessments of the prevalence of HBV infection indicate that 10-15 % of Asian Americans are chronic HBV carriers, which is significantly higher than the national average. A recent study revealed that over 15% of Asians/Pacific Islanders have chronic HBV infection in New York City. This is a clear indication that interventions are necessary and important to reduce HBV infections among Asian Americans. Some suggestions of intervention method include educating the general public about HBV virus and promoting vaccinations against HBV virus. A survey study of Cambodian American women showed that only slightly more than half of recruited population had heard of HBV infection and less than a quarter of the population were aware that HBV could be transmitted through contact. These are alarming findings. Factors contributing to the lack of knowledge about HBV infection are low education and the presence of health disparity in United States.
HAAP's HBV screening and education program was initiated in the year of 2006. The objectives of the HBV screening and education program are to identify Asian American population who are chronic HBV patients, to provide educational information about hepatitis B disease to the Asian American community, and to promote vaccinations to those who have not been vaccinated. HAAP also studies the prevalence of HBV infection in the Midwest since most reports have focused on the east and the west coast of United States. Through annual health fairs, HAAP recruits Asian Americans to participate in the prevalence study of hepatitis B virus infection by providing free HBV screenings.
The goals of HAAP HBV study are: 1) to determine the prevalence of chronic HBV (hepatitis B virus) infection among Asian Americans in Michigan; 2) to bring awareness of this serious health threat to Asian Americans; and 3) to help control (treatment) and reduce (vaccination) the disease in Michigan.
Free HBV screening was offered at 8 health fairs to Asian Americans from Grand Rapids to Detroit in south Michigan for the past 2 years as a community service. Of the 849 persons attended these health fairs, 567 (67%) participated in HBV screening. Test results showed 6% were hepatitis B surface antigen positive indicating infection, 54% hepatitis B surface antibody positive indicating immunity and 40% negative for both markers indicating no prior exposure. Roughly 10% of the participants had family members with hepatitis B or liver disease. With the help of many community leaders from different Asian American communities, HAAP finished its Phase I HBV study.
In addition, HAAP participated in the RTI/ CDC hepatitis B screening project to screen 200 more people for hepatitis B, and these data are transmitted to RTI/CDC for their nation-wide HBV study.
In conclusion for the Phase I study, hepatitis B is a major health disparity for Asian Americans in Michigan. The next phase of our study is to implement hepatitis B education program in various Asian languages starting 2nd quarter of 2009. Culturally appropriate educational intervention is necessary to raise awareness among Asian Americans and engage more of them in HBV clinical studies.