Hepatitis B What Asian and Pacific Islander Americans Need to Know

• What is hepatitis B?
• What is chronic hepatitis B?
• Why are Asian and Pacific Islander Americans at higher risk?
• What are the symptoms of chronic hepatitis B?
• Who is at risk for hepatitis B?
• How can I protect myself and others from hepatitis B?
• How can I protect my baby from hepatitis B?
• Where can I get more information about hepatitis B?

Did you know that Asian and Pacific Islander Americans and other foreign-born Americans are at higher risk for chronic hepatitis B, which can lead to liver failure and liver cancer?

What is hepatitis B?

Hepatitis B is a liver disease spread through contact with blood, semen, or other body fluids from a person infected with the hepatitis B virus. The disease is most commonly spread from an infected mother to her infant at birth. Hepatitis B is also spread through sex, wound-to-wound contact, and contact with items that may have blood on them, such as shaving razors, toothbrushes, syringes, and tattoo and body piercing needles.
Hepatitis B is not spread through casual contact such as shaking hands or hugging; nor is it spread by sharing food or beverages, by sneezing and coughing, or through breastfeeding.

What is chronic hepatitis B?

Hepatitis B may start as a brief, fl ulike illness. Most healthy adults and children older than 5 completely recover after the body’s immune system gets rid of the virus.
Hepatitis B becomes chronic when the body’s immune system can’t get rid of the virus. Over time, having the virus can lead to inflammation of the liver; scar tissue in the liver, called cirrhosis; or liver cancer. Inflammation is the painful red swelling that results when tissues of the body become infected. Young children and people with weakened immune systems are especially at risk. People who were infected as infants have a 90 percent chance of developing chronic hepatitis B.¹

¹Weinbaum CM, Williams I, Mast EE et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. Morbidity and Mortality Weekly Report Recommendations and Reports. 2008 September 19;57(RR–8):1–20.

Why are Asian and Pacific Islander Americans at higher risk?

Since 1986, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. The vaccine, however, is unavailable—or has only recently become available—in many parts of the world. You are at higher risk for hepatitis B if you or your mother was born in a region of the world where hepatitis B is common, meaning 2 percent or more of the population is chronically infected with the hepatitis B virus.¹ In most Asian and Pacific Island nations, 8 to 16 percent of the population is chronically infected.²

² Custer B, Sullivan SD, Hazlet TK, Iloeje U, Veenstra DL, Kowdley KV. Global epidemiology of hepatitis B virus. Journal of Clinical Gastroenterology. 2004 November;38(10 Suppl 3):S158–S168.

What are the symptoms of chronic hepatitis B?

Hepatitis B is called a “silent killer” because many people have no symptoms, so the disease often progresses unnoticed for years. Unfortunately, many people first learn they have chronic hepatitis B when they develop symptoms of severe liver damage, which include

• yellowish eyes and skin, called jaundice
• a swollen stomach or ankles
• tiredness
• nausea
• weakness
• loss of appetite
• weight loss
• spiderlike blood vessels, called spider angiomas, that develop on the skin

Who is at risk for hepatitis B?

Anyone can get hepatitis B, but some people are at higher risk, including

• people who were born to a mother with hepatitis B
• people who have close household contact with someone infected with the hepatitis B virus
• people who have lived in parts of the world where hepatitis B is common, including most Asian and Pacific Island nations
• people who are exposed to blood or body fluids at work
• people on hemodialysis
• people whose sex partner(s) has hepatitis B
• people who have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• injection drug users
• men who have sex with men

May is Hepatitis Awareness Month and Asian American and Pacific Islander Heritage Month

May is Hepatitis Awareness Month and Asian American and Pacific Islander Heritage Month. This year, CDC's Division of Viral Hepatitis is focusing on raising awareness about hepatitis B among Asian Americans and Pacific Islanders (AAPIs) and encouraging AAPIs to talk to their doctors about getting tested for hepatitis B.

What should AAPIs know about Hepatitis B?

Hepatitis B affects 1 in 12 Asians Americans and Pacific Islanders
Hepatitis B is common in many parts of the world, with an estimated 350 million people living with the disease worldwide. In the US, an estimated 1.2 million Americans are infected. However, hepatitis B disproportionately affects Asian Americans and Pacific Islanders because it is especially common in many Asian and Pacific Island countries. While AAPIs make up less than 5% of the total U.S. population, they account for more than 50% of Americans living with chronic hepatitis B.
Hepatitis B is serious
If left untreated, up to 25 percent of people with hepatitis B develop serious liver problems such as cirrhosis and even liver cancer. In the US, chronic hepatitis B infection results in thousands of deaths per year. Liver cancer caused by the hepatitis B virus is a leading cause of cancer deaths among Asian Americans.
As many as 2 in 3 Asian Americans with hepatitis B don't know they are infected
People can live with hepatitis B without having any symptoms or feeling sick. Many people with chronic hepatitis B got infected as infants or young children. It is usually spread when someone comes into contact with blood from someone who has the virus. As many as 2 in 3 AAPIs living with the virus do not know they are infected. Often, people do not know they have hepatitis B until they have been tested.

Who should get tested for Hepatitis B?

• Anyone born in Asia or the Pacific Islands (except New Zealand and Australia)
• Anyone born in the United States, who was not vaccinated at birth, and has at least one parent born in East or Southeast Asia (except Japan) or the Pacific Islands (except New Zealand and Australia)

Hepatitis B testing identifies people living with chronic hepatitis B so they can get medical care to help prevent serious liver damage. Testing also helps to find other people who may not have hepatitis B, but are at risk for getting infected. This can include people living with someone with hepatitis B.
For more information, talk to a doctor about getting tested for Hepatitis B.

How can I protect myself and others from hepatitis B?

Get tested if you are from an Asian or Pacific Island nation or other region where the hepatitis B virus is common. The sooner you get tested, the sooner you can take steps to protect yourself and others.
A health care provider can test your blood to see if you are currently infected or were infected in the past. If you test positive, your doctor may measure virus and liver enzyme levels in your blood to determine if the virus is active or causing liver injury. The doctor may use ultrasound—a procedure that uses sound waves to create images of the body's internal tissues and organs—to screen for liver cancer, also called hepatocellular carcinoma. You may not need treatment right away, but you will need periodic tests to monitor the health of your liver. Encourage your family members and other close personal contacts to get tested.
Hepatitis B is preventable. Get vaccinated if you have not been infected. The hepatitis B vaccine is given in three shots over 6 months. You must get all three shots to be fully protected. The vaccine is safe for people of all ages, including pregnant women and infants.
If you think you have been recently exposed to the hepatitis B virus, see your doctor right away. The first dose of hepatitis B vaccine combined with hepatitis B immune globulin—an injection of antibodies that temporarily protects against hepatitis B infection—may prevent infection.
No cure exists for hepatitis B, but several medicines are approved for treating chronic hepatitis B. The goal of treatment is to reduce the risk of liver damage, liver cirrhosis, and liver cancer by decreasing liver inflammation and the amount of virus in the body. Current medicines do not completely get rid of the virus, so treatment is often lifelong. People with chronic hepatitis B should avoid alcohol, drugs, supplements, and herbal medicines that may harm the liver.

How can I protect my baby from hepatitis B?

Getting tested for hepatitis B is especially important for pregnant women. If you are not infected, get the vaccine. If you have hepatitis B, make sure the doctor and staff that deliver your baby know so they can minimize your baby’s risk of infection. The hepatitis B vaccine and hepatitis B immune globulin should be given to your baby immediately after birth, greatly reducing the chance of infection.

Where can I get more information about hepatitis B?

Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Viral Hepatitis
1600 Clifton Road, Mailstop G–37
Atlanta, GA 30333
Phone: 1–800–232–4636
TTY: 1–888–232–6348
Fax: 404–718–8588
Email: cdcinfo@cdc.gov
Internet: www.cdc.gov/hepatitis