Targeted hepatitis B virus screening effective in addressing infection, liver disease risk

Published online in Public Health Reports, the research involved screening 1,004 Asian American adults in Sacramento County at 28 different events over a one-year period. An outreach team from the UC Davis Comprehensive Cancer Center worked with Asian American community organizations and the UC Davis student-run clinics to promote and co-sponsor hepatitis B screening events. The effort was part of the national Hepatitis Testing and Linkage to Care Initiative, which aims to test those at highest risk for infection and to get those who test positive additional tests and counseling about next steps.

"We realized that a one-size-fits-all approach would not work because each ethnic group faced different barriers when it came to screening," said lead author Julie Dang, director of community engagement and outreach at the cancer center. "So we created different campaigns to target each of the communities and came up with the best screening plan for the individual populations."

Screenings were held at churches and community centers in the neighborhoods where the populations are concentrated, and interpreters were on hand at each event to facilitate communication with each person getting screened, Dang said.

Nearly all of those screened were born outside of the United States. Among them, 76 (or 7.6 percent) tested positive for the infection, including 31 Hmong, 23 Vietnamese, 17 Chinese, two Koreans and three from other Asian communities.

The researchers were not able to determine whether every positive individual received appropriate follow-up care; however, 67 percent of those screened and found to have chronic hepatitis B infection did receive follow-up counseling. Those who tested negative but were considered susceptible to the virus (220 individuals) were counseled to get an HBV vaccination through their primary care provider or through the free hepatitis B vaccine program sponsored by UC Davis Health System.

Sacramento has the nation's 10th largest Asian population in the United States, making it an excellent location for a hepatitis B screening effort. Globally, hepatitis B virus infection is the primary cause of cancer after tobacco use and, if untreated, an estimated 15 percent to 25 percent of those infected will die from a related condition. Among U.S. populations, Asian Americans/Pacific Islanders have the highest rate of liver cancer (up to 7.2 times higher than non-Hispanic whites).

Hepatitis B virus is spread through contact with an infected person's blood, semen or other body fluid. A pregnant woman infected with the virus can pass it to her unborn child. There are a variety of drugs now available to treat chronic hepatitis B, which can slow or prevent damage to the liver.

The researchers have already launched another two-year effort to screen an additional 2,000 Asian Americans for the hepatitis B infection. The second study also involves screening patients seen at UC Davis Health System, employs navigators for patients who test positive and follows up with patients six months after their first visit.

The report can be found online at: http://www.publichealthreports.org/issueopen.cfm?articleID=3560