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Asian Americans and Pacific Islanders and Chronic Hepatitis B

Key Facts

  • Asian Americans and Pacific Islanders (AAPIs) make up less than 5% of the total population in the United States, but account for more than 50% of nearly one million Americans living with chronic hepatitis B. 
  • The burden of chronic hepatitis B in the US is greater among people born in regions of the world with high or moderate prevalence of chronic hepatitis B, including much of Asia and the Pacific Islands.
  • Nearly 70% of Asian Americans are foreign-born and estimates have found that approximately 58% of foreign-born people with chronic hepatitis B are from Asia
  • Left untreated, approximately 15% to 25% of those with chronic hepatitis B infection develop serious liver disease, including cirrhosis, liver damage, and even liver cancer
  • Asian Americans and Pacific Islanders are 8-13 times more likely to develop liver cancer than other groups, primarily due to hepatitis B infection
  • The liver cancer death rate is 60% higher for Asian Americans and Pacific Islanders than Caucasians

Hepatitis B Testing Recommendation for Asian Americans and Pacific Islanders

CDC recommend testing the following groups for hepatitis B:

  • All people born in regions of the world with high or moderate rates of hepatitis B. This includes all countries in Asia and the Pacific Islands
  • All people born in the United States, who were not vaccinated at birth, and who have at least one parent born in a country with high hepatitis B rates. This includes all countries in East and Southeast Asia, except for Japan, and the Pacific Islands
  • Household contacts and sexual partners of people with hepatitis B.
World map with countries shaded by rates of Chronic Hepatitis B Infection as measured with HBsAg. Areas with high rates of 8% or greater include most of Asia, sub-Saharan Africa, the Amazon River Basin in South America, and Greenland. Areas with a moderate rates of 2-7% are northern Canada and all of Alaska, much of southern Brazil, north-most African countries, and northern Asia. All remaining areas have a rates below 2%.

For additional information on other groups that should be tested for hepatitis B, see: Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection [PDF - 28 pages]

Rationale for the Recommendation

  • At least one-third of Asian Americans living in the United States are unaware of their chronic hepatitis B infection
  • Prompt identification of chronic hepatitis B infection is essential to ensure infected people receive necessary care to prevent or delay onset of liver disease and services to prevent transmission to others
  • Chronically infected patients have years of life to gain if medical evaluation and/or treatment is initiated early, before symptoms occur
  • Multiple medications have been approved for treatment of adults with chronic hepatitis B
  • Identifying people with chronic hepatitis B also allows for primary and secondary prevention. Close contacts can benefit from vaccination if never infected, or medical management if living chronic hepatitis B.

Guidelines and Recommendations

Chronic Hepatitis B Testing

Hepatitis B Vaccination

Healthcare Provider Resources

Patient Resources