San Francisco Hepatitis B Collaborative: Resources

Resources

General information about Hepatitis B

Four hundred million people worldwide suffer from chronic Hepatitis B virus infection, which tragically can lead to liver cancer and cirrhosis often early in adult life. Ultimately, 15-40 percent of all chronic Hepatitis B infections result in death, making it the 10th leading etiologic cause of death in the world. At the same time, the spread of the Hepatitis B virus is preventable with a simple, safe, and effective vaccine. This vaccine was declared the first anti-cancer vaccine by the CDC because of the overwhelming body of data which shows that hepatitis B infection is the predominant cause of hepatocellular carcinoma worldwide.

Worldwide, Hepatitis B infection has received considerable attention, particularly in endemic areas such as Asia. Regrettably, the same attention has not been given to Hepatitis B infection in the U.S., perhaps because only 0.1 percent of Americans have chronic Hepatitis B infection. This statistic, however, does not do justice to the reality that Asian and Pacific Islanders (API) living in the U.S. are disproportionately affected by the Hepatitis B virus. Ten percent of the U.S. API population are chronically infected with the Hepatitis B virus, and APIs make up 50 percent of Hepatitis B-related deaths in the U.S. The disparity in Hepatitis B prevalence is especially evident in San Francisco, where APIs represent the fastest growing segment of our population and already comprise one-third of our residents (238,133 people). Our own data from local screening programs confirm that approximately 10 percent of San Francisco APIs (24,000 people) have chronic Hepatitis B infection and thus require long-term care. Approximately 30 percent of APIs (71,000 people) are not immune to Hepatitis B and stand to benefit from vaccination.

What is Hepatitis B?

Hepatitis B is a serious liver disease caused by the Hepatitis B virus (HBV). HBV infection may be short-term (acute) or life-long (chronic). Some people may develop life-long protection after recovering from an acute Hepatitis B infection, but some people will never be able to clear virus and thus have chronic Hepatitis B. Chronic Hepatitis B can lead to permanent liver damage, scarring (cirrhosis), liver cancer, liver failure, and death.

Why should I care?

Hepatitis B virus is 200 times more contagious than HIV virus. While the chance of getting Hepatitis B is relatively low in the U.S. in general (one in 250 has Hepatitis B), Asians and Pacific Islanders are at a much higher risk. Approximately one in every ten Asian Americans is chronically infected with Hepatitis B. Hepatitis B can be prevented through vaccination.

How is Hepatitis B transmitted?

Hepatitis B is transmitted through blood and bodily fluids.

You may get infected with Hepatitis B:

by having unprotected sex with an infected person
by having tattoo, body piercing or acupuncture with infected needles
by injecting drugs with infected needles or equipment
by sharing shaving razors, toothbrushes or other personal items that may come in contact with blood
during birth when the virus passes from an infected mother to her baby (most common in Asian Americans and Pacific Islanders)

You cannot get Hepatitis B through:

sneezing or coughing
kissing or hugging
breast feeding
food or water
casual contact (such as an office setting)
sharing eating utensils or drinking glasses

What are the symptoms?

Short-term infection or acute Hepatitis B may present with:

loss of appetite
extreme tiredness (fatigue)
nausea/vomiting
yellow skin or eyes (jaundice)
pain in muscle, joints, and stomach

However, long-term infection or chronic Hepatitis B, which often leads to liver damage and other serious consequences, usually does not have any symptoms until it is too late.

How do I know if I have Hepatitis B?

The best way is to get tested. There is a blood screening test for Hepatitis B that can tell us whether you have or have had Hepatitis B and if you are protected against a new infection. The test involves drawing a small amount of blood from you arm. It typically takes about two weeks to get the results back. The possible results are:

you do not have Hepatitis B now and you are not protected against it
you do not have Hepatitis B now and you are protected against it
you do have chronic Hepatitis B

For more information on locations that test for Hepatitis B, click here.

How should I protect myself and others from getting Hepatitis B?

The best way is to get vaccinated. The Hepatitis B vaccination is a three-course series and it protects you against future Hepatitis B infection. You will get a first shot, then a second shot 1-2 months after the first one, and finally a third shot within 4-6 months of the first vaccine.

Like any medicine, there is an extremely small risk of severe reaction associated with the vaccine. If you choose not to have the vaccination, you can still reduce your chance of being infected by eating a balanced diet, exercising, limiting alcohol intake and avoiding behaviors that may put you at risk for Hepatitis B (as listed in "How is Hepatitis B transmitted").

For more information on locations that vaccinate for Hepatitis B, click here.

What should I do if I have Hepatitis B?

Do not panic even if your test shows that you have Hepatitis B. Acute Hepatitis B can often be cured and chronic Hepatitis B can be controlled with good management and follow-up. You should contact your physician about your condition. Your physician may prescribe medication for you, check your liver regularly through blood tests and radiographic studies, and may refer you to a liver specialist.

In addition, you should:

eat healthy, well-balanced meals
avoid alcohol, intravenous drug use (alcohol and other drugs may increase liver damage)
engage in regular physical activity for the benefit of overall health
check with a physician before using medications (e.g., Tylenol may damage the liver)
beware of certain herbal medications as some may cause serious liver damage
get vaccinated for hepatitis A

To prevent spreading Hepatitis B to others, you should:

have all family members tested
vaccinate all household members for both Hepatitis B and hepatitis A, if they are not already protected
avoid sharing anything that might have blood on it, such as a toothbrush, razor, needle, or syringe
use condoms whenever having sex
wear gloves whenever blood is touched

If you have family members or friends at risk for Hepatitis B, ask them to talk to their doctors about it.

Other online resources

Hep B Free San Francisco

"The SF Hep B Free Coordinating Council is a first-in-the-nation effort calling on the collaboration of a wide spectrum of organizations for testing and vaccinating all Asian and Pacific Islander residents, with the goal of making San Francisco free of Hepatitis B."
Asian Liver Center at Stanford University
(Jade Ribbon Campaign, 3 For Life)
"The Asian Liver Center at Stanford University is the only non-profit organization in the United States that addresses the high incidence of Hepatitis B and liver cancer in Asians and Asian-Americans. Founded in 1996, the center uses a three-pronged approach towards fighting Hepatitis B through outreach, education, and research."
Jade Ribbon Campaign at Asian Liver Center
(@ University of California, Berkeley)
"In May 2001, the Asian Liver Center launched the Jade Ribbon Campaign in the San Francisco Bay Area to spread awareness about Hepatitis B and liver cancer in the Asian community. Since then, the Jade Ribbon Campaign has spread across the country and the world."
SFHBC at the University of California, Berkeley
"SFHBC at [Berkeley] strives to aid [in SFHBC's mission] by providing interpreters and educators for the underserved, non-English speaking Asian immigrant population."
San Francisco Department of Public Health

"The mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. The Communicable Disease Prevention Unit, a section of the Health Department prides itself in promoting Hepatitis B awareness and prevention strategies, including vaccination and testing sites throughout the San Francisco community."
American Liver Foundation
(Northern California Chapater, Liver Disease Resources in Northern California)
"ALF is the nation's leading nonprofit organization promoting liver disease prevention and liver wellness. ALF provides research, education and advocacy for those affected by liver-related diseases, including hepatitis."
Asian Health Caucus at the University of California, San Francisco
"The Asian Health Caucus is a campus-wide organization that was founded in 1975 to promote mutual understanding and friendship among all members of the UCSF community, increasing awareness of the health needs of Asians and Asian-Americans in the United States and the world. Today, AHC continues to be one of hte oldest student run organizations at UCSF."