Stopping a silent killer in the underserved asian and pacific islander community: a chronic hepatitis B and liver cancer prevention clinic by medical students.
OBJECTIVE
To assess and alleviate the burden of chronic hepatitis B virus (HBV) infection among low-income, uninsured Asian and Pacific Islanders (APIs) in San Jose, California.


METHODS
From 2007 to 2008, we provided free HBV testing and follow-up to 510 patients, 74% of whom were foreign-born Vietnamese. Patients were tested for hepatitis B surface antigen and surface antibody. Chronically infected patients who elected to undergo follow-up monitoring were evaluated for liver damage (ALT), liver cancer (AFP), and HBV replication (HBV DNA).


RESULTS
Overall, 17% were chronically infected; 33% of these were unaware that they were infected. Of those who underwent follow-up monitoring, 100% had elevated ALT, 9% had elevated AFP, and 24% had HBV DNA levels that exceeded the threshold for treatment. Patients who were candidates for antiviral therapy were enrolled in drug assistance programs, and those with elevated AFP levels were referred for CT scans. Uninfected patients lacking protective antibodies were provided free HBV vaccinations.


CONCLUSIONS
More liver cancer prevention in the medically underserved API community is needed, including universal screening for HBV and follow-up for those chronically infected.
Lin
Steven Y
SY
School of Medicine, Stanford University, CA, USA. linsteve@stanford.edu
Chang
Ellen T
ET
So
Samuel K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D002140:California; D003151:Community Health Centers; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000378:metabolism; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D013337:Students, Medical; D014505:Urban Population; D014779:Virus Replication; D055815:Young Adult
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines