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 firstname.lastname@example.org.