What is hepatitis B?Hepatitis B is a virus that infects the liver.

Liver: “King of Organs”Largest solid organPerforms many

important functionsBreaks down and

storage of fats and sugars

Detoxifies (cleans) body

all drugs, alcohol and toxins are processed by the liver!

Why does hepatitis B matter?Can lead to serious liver illness

Scarring Liver cancerLiver failure

It is contagious (can be given to others)

100X more infectious than HIV

Fastest growing racial population in the US in terms of percentage growth3.7 million in 1980 15.2 million* in 2006 About 66% are foreign born

California4.5 million API 1 in 8 Californians is APIPotentially 360,000 with chronic HBVWithout diagnosis and treatment, up to 80,000 API in CA will die of liver disease or liver cancer*including part-APIs

•Hepatitis B is one of the most neglected pandemics •One in 20 people (350 million) worldwide have chronic HBV infection – (Compare with 33 million living with HIV)•Without appropriate treatment or monitoring – As many as 1 in 4 will die of liver cancer, cirrhosis or liver failure

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8% =High* 2-7% = Intermediate* <2% = Low

Adapted from: Centers for Disease Control and Prevention. Morb Mortal Wkly Rep. 2008;57:1-16.

*Individuals born in locations with intermediate or high prevalence should be routinely screened for HBV infection

Prevalence of HBV Infection*

Hepatitis B is One of the Most Neglected Global Epidemics

1 CDC. Available at: www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm

2.WHO. Available at: www.who.int/csr/disease/hepatitis/en/

1 out of every 10 Asian Americans has hepatitis B

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Untreated Hepatitis B Can Cause Liver CancerHepatitis B virus is second

only to tobacco smoke in causing cancer deaths globally

Liver cancer caused by chronic hepatitis B is the 2nd leading cause of cancer death for Asian men in the US

The incidence of liver cancer is 9 times higher in Asian American men than their white counterparts

Asian Liver Center. 2007 Physician’s Guide to Hepatitis B: A Silent Killer. http://liver.stanford.edu/Education/2007Handbook.pdf. Accessed April 1, 2009.

Hepatitis B-Associated Liver Cancer Destroying Normal

LiverImage from netterimages.com

10% of Asians, including Asian-Americans, affected compared to 0.1% of US general population

Especially High Risk Populations:Filipino – 1 in 6Vietnamese - 1 in 8 Chinese - 1 in 10 Korean - 1 in 12

Transmission Revisited

Vertical Transmission (Mother to Child)

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Razors/Needles

Unprotected Sexual Contact

with HBV+

Transfusion/Organ

Transplant

Other Routes of Transmission Include2

Contact with Infected Fluids

1. Lin SY, et al. Hepatology. 2007;46:1034-1040.2. Centers for Disease Control and Prevention. Hepatitis B FAQs.

http://www.cdc.gov/print.do?url=http%3A//www.cdc.gov/hepatitis/B/bFAQ.htm%23overview. Accessed April 1, 2009.

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Clarifying Myths About Transmission of Hepatitis B

Hepatitis B is NotNot Transmitted by

Sharing Food, Water,

Utensils, Glasses

Mosquitoes Tears, Sweat, Urine, or Stool

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Asian Liver Center. 2007 Physician’s Guide to Hepatitis B: A Silent Killer. http://liver.stanford.edu/Education/2007Handbook.pdf. Accessed April 1, 2009.

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Clarifying Myths About Transmission of Hepatitis B

I’m Too Young to Be TestedWRONG!

I’m Too Old to Be TestedWRONG!

Hepatitis B Can’t Be Treated

WRONG!

Asian Liver Center. 2007 Physician’s Guide to Hepatitis B: A Silent Killer. http://liver.stanford.edu/Education/2007Handbook.pdf. Accessed April 1, 2009.

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Clarifying Myths About Transmission of Hepatitis B

Asian Liver Center. 2007 Physician’s Guide to Hepatitis B: A Silent Killer. http://liver.stanford.edu/Education/2007Handbook.pdf. Accessed April 1, 2009.

If I Have it, I’d Have

SymptomsWRONG!

I Was Diagnosed Years Ago so I

Shouldn’t WorryWRONG!

Hepatitis B Can’t Be

PreventedWRONG, HBV

can be prevented with

vaccination!

How do I know if I have hepatitis B?A simple blood test is the only way to be sure

Most people do not experience any symptoms until it is too late!

70% of people with chronic hepatitis B have no symptoms

Blood Test Results

Hepatitis B Surface Antigen (HBsAg)POSITIVE (+) result means: you have hepatitis BNEGATIVE (-) result means: you do NOT currently

have hepatitis B

Hepatitis B Surface Antibody (Anti-HBs)POSITIVE (+) result means: you are protected

against hepatitis BNEGATIVE (-) result means: you are NOT protected

Two tests are used to determine hepatitis B status

What next?

It depends on what your test results are!

Hepatitis B Surface Antigen POSITIVE (+)You have hepatitis B Next Step: Follow up with your doctor now to get regular

monitoring

Hepatitis B Surface Antibody NEGATIVE (-)You are not protected from hepatitis BNext Step: Begin the 3 dose hepatitis B vaccine series now

Hepatitis B Surface Antibody POSITIVE (+)You are protected from hepatitis BNext Step: Encourage your friends and family to get tested!

Tell me more about the vaccine

• Hepatitis B vaccineComplete 3 shots in six months for life-long

protection

1 2

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What if I have chronic hepatitis B?

Get regular check-ups with your doctorEat healthyAvoid alcoholTell your doctor which over-the-counter medications or herbal supplements you take

Protect others by preventing blood contactTell your family to get tested or vaccinated

Global NeedA Comprehensive Strategy to Prevent and Control Hepatitis BPrevent new infections VaccinationSafe injections Education

Early detection, education and access to treatment for persons who are chronically infected to reduce– Mortality and morbidity risksSocio-economic burden caused by premature deathTransmission to unprotected persons

San Mateo Hep B Free

1 CDC. Available at: www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm

2.WHO. Available at: www.who.int/csr/disease/hepatitis/en/

CAMPAIGN GOALSTo create public and healthcare provider

awareness about the importance of testing & vaccinating Asian Pacific Islanders (API) for hepatitis B.

To promote routine hepatitis B testing and vaccination within the primary care medical community.

To ensure access to treatment for chronically infected individuals.

San Mateo Hep B Free

1 CDC. Available at: www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm

2.WHO. Available at: www.who.int/csr/disease/hepatitis/en/

•HBV is common in our community •HBV infection is quick and easy to

detect; all you need is a simple blood test for HBsAg

•If you do not have hepatitis B, you should get vaccinated

•If you have hepatitis B, make sure you have routine follow-up appointments to manage your disease

•It's everyone's responsibility to spread the word about HBV –Make sure you and your loved

ones are tested

Questions/Comments/Concerns?christine@smhepbfree