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发表于 2003-8-9 11:38
Why should Asians and Pacific Islanders be aware of hepatitis B?
Asians have the highest rate of hepatitis B of all ethnic groups. Hepatitis B rates for the API population range up to 15%, compared to the 0.3% among the general U.S. population. API make up more than half of the 1.3-1.5 million known hepatitis B carriers in the U.S. Included in the population at risk is the Bay Area's community of over 1.3 million API individuals [2000 estimates]. The most common route of infection among API is through perinatal sources. In the United States, API children were found to have low vaccination rates despite national vaccination guidelines and availability. Many children worldwide remain unvaccinated and may become chronic carriers as adults. The WHO (World Health Organization) estimates that there are 400 million people with chronic hepatitis B, many of whom are not even aware of their condition. Most hepatitis B carriers have no symptoms but they can still transmit the infection and develop liver cancer. Furthermore, the incidence of liver cancer among API ethnic groups is 1.7 to 11.3 times higher than rates among Caucasian Americans.
How is hepatitis B transmitted among Asians and Pacific Islanders?
While hepatitis B can be transmitted by blood transfusions, sharing needles, and unprotected sex, most API individuals become infected as infants or young children. Frequently, transmission of the hepatitis B virus occurs during the birthing process when the virus is passed on from the mother - who is often unaware that she is a carrier - or during early childhood through close personal contact with blood or bodily fluid of infected individuals, such as contact between open wounds or sharing contaminated toothbrushes. However, hepatitis B is not spread by contaminated food or water, as with other types of hepatitis.
Why is hepatitis B often not diagnosed?
The danger of hepatitis B lies in its silent transmission and progression. Many chronic hepatitis B carriers have no symptoms and feel healthy. If the proper tests are not administered, carriers may even appear to exhibit normal blood tests for liver function, granting them a deceptively clean bill of health. Diagnosis of hepatitis B cannot be made unless the doctor orders a specific blood test that tests for the presence of the hepatitis B surface antigen (HBsAg), a marker for chronic infection. Since the detection of hepatitis B is so easily missed, even by doctors, it is up to the patient to specifically request the HBsAg test. Early detection not only benefits the carrier, but will also prevent the infection from being passed silently between individuals of the same and subsequent generations.
How is hepatitis B life-threatening?
One out of four hepatitis B carriers die from liver cancer or cirrhosis (liver damage leads to scarring and eventual death due to liver failure). Some develop cancer as early as 30 years of age. Each year, approximately one million people worldwide, many of whom are Asians and Pacific Islanders (API), die from the disease because they are diagnosed at a point too late for possible effective treatment. Because many carriers look and feel healthy even in the early stages of liver cancer, the disease can progress silently without the carrier knowing. Symptoms often appear only during the late stages of the disease. All chronic hepatitis B carriers, whether they feel healthy or sick, are at risk for developing liver cancer or cirrhosis. Hepatitis B is one the largest health threats for Asians. Thus it is important for all API to be checked for hepatitis B and vaccinated if not previously exposed. Also, chronic carriers need to take control of their own health, learn about hepatitis B treatments available, and be regularly screened for liver cancer after a certain age.
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