Online Program

A picture of chronic hepatitis B infection among Asians and Pacific Islanders in Philadelphia

Monday, November 4, 2013

C. a. Cohen, MPH, DrPH(c), Department of Public Health Research, Hepatitis B Foundation, Doylestown, PA
Kuan-Lung Daniel Chen, MPH, CPH, Department of Public Health Research, Hepatitis B Foundation, Doylestown, PA
Amy Hueber, BS, Public Health, Hepatitis B Foundation, Doylestown, PA
Joan Block, RN, BSN, Hepatitis B Foundation, Doylestown, PA
A.a. Evans, ScD, School of Public Health, Drexel University, Philadelphia, PA
Background/Significance – Chronic hepatitis B (HBV) is a serious liver infection that disproportionately affects Asians and Pacific Islanders (API), leading to increased morbidity and mortality. Due to lack of surveillance, the impact of chronic HBV infection in foreign-born API communities remains under-estimated and up to 75% of infected APIs remain undiagnosed.

Objective/Purpose – This study investigated the prevalence of HBV infection and protection status among high-risk API communities in Philadelphia.

Methods – This IRB approved cross-sectional study took place from 2008-2012. Free HBV screening was offered at various community sites. Self-reported demographic data and HBV-related history were collected. Blood samples were analyzed for HBV infection or protection status (HBsAg and HBsAb). De-identified data were entered into an Excel database for analysis.

Results – Of 1,503 screened for HBV (ages 18-86), 93% were foreign-born, with 75% from China, Korea, Vietnam or Indonesia. Half of participants had a high school education or less; 21% had at least an undergraduate degree; 42% had health insurance and 46% had a regular physician. Only 20% indicated that they had been previously tested for HBV; 19% were unsure of their testing history. Almost 10% reported a family member with HBV infection. Overall prevalence of HBsAg in this sample was 7%, though prevalence varied greatly by country of origin (China=11.4%, Vietnam=8.6%). Half of participants (54%) had antibody against HBV. 38.6 % were susceptible to HBV and in need of vaccination.

Discussion/Conclusions – It is critical that individuals with chronic HBV infection are screened and referred to appropriate medical follow-up to reduce the risk of cirrhosis or liver cancer. These results indicate that chronic HBV prevalence is high among foreign-born API communities in Philadelphia; screening and vaccination rates remain low. Culturally competent programs are necessary to increase screening, referral for appropriate care and vaccination in these high-risk communities.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Describe the epidemiology of chronic hepatitis B infection in the U.S. Identify the hepatitis B related health disparities in Asians and Pacific Islanders in the U.S.

Keyword(s): Health Disparities, Hepatitis B

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For 10 years, I have planned, implemented and evaluated community programs and research on hepatitis B and liver cancer. My research focuses on reducing HBV health disparities, and developing models for improved health care access and management for chronic HBV infection, including the early detection and prevention of liver cancer. I am director of Hep B United Philadelphia, a campaign and coalition to increase testing and vaccination to fight hepatitis B and liver cancer.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.