San Francisco Hep B Free Program Expanding Blood Tests for Asians and Pacific Islanders

Hepatitis B virus may impact 10% of Asian and Pacific Islander adults in the USA

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A public health campaign supporting Asian American and Pacific Islanders fight against hepatitis B and liver cancer is rapidly spreading in San Francisco.

Known as the ‘San Francisco Hep B Free’ program, which hopes to make the San Francisco Bay Area free of hepatitis B.

San Francisco Hep B Free Program Coordinator Richard So said in an Inquier.Net article “The program is geared towards the 1.7 million Asian and Pacific Islander residents of the Bay Area, or some 24 percent of the population.”

“Fortunately, hepatitis B is a vaccine-preventable disease,” said Richard So.

As many as 10 % of Asian and Pacific Islander adults in the United States are chronically infected with hepatitis B virus (HBV), and up to two-thirds are unaware that they are infected, reports the Stanford Medical Asian Liver Center.

Chronic hepatitis B is the leading cause of liver cancer and the largest health disparity between Asian/Pacific Islanders (APIs) and the general US population.

In the United States, an estimated 847,000 persons are living with chronic hepatitis B virus infection, and approximately 14,000 deaths are attributable to it each year.

About 2 of every 3 persons with chronic HBV infection are unaware of their infection, says the Centers for Disease Control and Prevention (CDC).

The virus, which is called hepatitis B virus, can cause lifelong infection, cirrhosis of the liver, liver cancer, liver failure, and death.

Early diagnosis is the best way to improve one's chances of surviving liver cancer, but the current screening blood test can miss 50 percent of the cancers. 

To benefit from liver cancer preventive measures, one must first be diagnosed with hepatitis B.

“Hepatitis B is a slow killer which can lead to liver cancer. Because the Hep B vaccine is now part of the routine vaccine series, most younger people are protected,” said Crockett Tidwell RPh, CDE, Clinical Pharmacy Services Manager, United Supermarkets Pharmacy.

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"Most adults, however, are not protected and too often don't know that they are at an increased risk. Recent immigrants and people that travel internationally are two groups that would benefit from information and vaccination,” said Crockett.

Because the vast majority of chronically infected individuals have no symptoms, the only reliable method to diagnose chronic hepatitis B is with a blood-based test for hepatitis B surface antigen (HBsAg).

Likewise, the only way to ensure that an individual is protected against hepatitis B is with a serologic test for hepatitis B surface antibody (anti-HBs), reported a recent study

Research studies have shown HBV screening programs are likely to be cost-effective. Compared with not-screening, the screen-and-treat strategy has an incremental cost-effectiveness ratio of $36,088 per quality-adjusted-life-years (QALYs), and incremental cost-effectiveness.

These clinically significant benefits accrue from identifying chronically infected persons for medical management and vaccinating their close contacts.

The HBV vaccination schedule most often used for adults and children has been three intramuscular injections, the second and third administered 1 and 6 months after the first. Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6 months of age, says the CDC.

Two single-antigen vaccines and two combination vaccines are currently licensed by the FDA in the United States:

Single-antigen hepatitis B vaccines:

  • ENGERIX-B
  • RECOMBIVAX HB

Combination vaccines:

  • PEDIARIX: Combined hepatitis B, diphtheria, tetanus, acellular pertussis (DTaP), and inactivated poliovirus (IPV) vaccine. Cannot be administered before age 6 weeks or after age 7 years.
  • TWINRIX: Combined Hepatitis A and hepatitis B vaccine. Recommended for persons aged ≥18 years who are at increased risk for both Hepatitis A virus and HBV infections.

But, some people should not get an HBV vaccine. Such as if the person has any severe, life-threatening allergies, or if the person getting the vaccine is not feeling well.

The CDC Vaccine Price List provides the private sector hepatitis vaccine prices for general information, and vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.