Hepatitis B Screening and Immunization is Critical for Early Clinical Management of HBV Infection for Asian Americans in Ohio

Disproportionately higher rate of chronic Hepatitis B virus (HBV) infection and liver cancer mortality among Asian Americans represent a neglected health disparity.This project examined knowledge, family history, past screening, current infection and treatment of HBV among a diverse group of 1180 Franklin Country,Ohio residents (85% Asians, 7.5% African American, and 6.5% White). Community health workers (CHW) helped in recruiting underserved and hard-to-reach Asians for screenings and follow-up. HBV screening was completed at health fairs, restaurants, churches and temples over a four year period. Results from the survey and blood serum analyses showed HBV infection rate was 5.5% (5.3% Asian, 0.3% non-Asians). Asians had significantly higher rates of HBV infection and family history of liver as compared to other racial ethnic groups (P=.001). Disparity in HBV infection also existed within the Asian community, with Cambodian (10.5%), Vietnamese (10.2%) and Chinese (8.1%) participants disproportionately infected with the virus than other Asian subgroups (P<.001). Although vaccine eligible Asians were provided vouchers by Columbus Public Health Department to receive free vaccinations, compliance was only 11.5% in 2009-2010. CHW follow-ups showed time, low English Proficiency, and fear of side effects were common barriers to compliance. Further, many did realize the immunization involved a series of 3 shots. Hence, outreach education using CHWs for screenings, and vaccination/ treatment is vital for this high risk group. Advocacy and policy changes have resulted in the establishment of a hepatitis free clinic for providing culturally and linguistically appropriate treatment for low income Asian Americans in Franklin County.