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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2015; 21(42): 11924-11930
Published online Nov 14, 2015. doi: 10.3748/wjg.v21.i42.11924
Hepatitis B among Asian Americans: Prevalence, progress, and prospects for control
Moon S Chen Jr, Julie Dang
Moon S Chen Jr, Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA 95817, United States
Moon S Chen Jr, University of California, Davis Comprehensive Cancer Center, Sacramento, CA 95817, United States
Julie Dang, National Cancer Institute-funded National Center for Reducing Asian American Cancer Health Disparities, University of California, Davis Comprehensive Cancer Center, Sacramento, CA 95817, United States
Author contributions: Chen MS Jr performed the literature review and drafted the majority of the paper; and Dang J revised, provided expertise, critical insights and clarity to the paper.
Conflict-of-interest statement: The authors report no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Moon S Chen Jr, PhD, MPH, Professor, Associate Director for Cancer Control, University of California, Davis Comprehensive Cancer Center, 2450 48th Street, Suite 1600, Sacramento, CA 95817, United States.
Telephone: +1-916-7341191 Fax: +1-916-7035003
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: June 2, 2015
Revised: June 18, 2015
Accepted: August 31, 2015
Article in press: August 31, 2015
Published online: November 14, 2015

After tobacco use, chronic hepatitis B (CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus (HBV). Though infection rates are low (< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B (HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, community-based efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC’s three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.

Keywords: Hepatitis B, Asian Americans, Chronic hepatitis B, Vaccination

Core tip: Hepatitis B viral infections disproportionately affect Asian Americans. Untreated, hepatitis B viral infections can lead to hepatocellular carcinoma that is almost universally fatal. Unfortunately, a vast majority of Asian Americans have not been screened. To reduce the HBV burden, screening both in community and clinical settings must be accelerated; and both physicians and patients must see the need for testing. Based on test results, those who screen positive must be referred to appropriate care and those without natural immunity, recommended for vaccination.