Hepatitis B (Hep B) is a silent killer in the Asian American Community, especially in Philadelphia. While Asian Americans constitute only 6% of the population in the United States, they comprise over half of the nation’s 860,000 to 2.4 million people chronically infected with Hep B. This is one of the greatest racial health disparities in the United States.
According to the Hepatitis B Foundation, the largest at-risk groups are Asian American, Pacific Islander, and African immigrant communities. However, with the current addiction crisis, we are now seeing increases in acute hepatitis B infection among people who inject drugs.
“We’re seeing a lot of folks have these infectious diseases that are consequences of substance use disorder, as the rates of opioid use have increased in Philadelphia,” said Danica Kuncio, viral hepatitis program manager at the city Department of Public Health.慢性乙型肝炎的危险在于，发病期间通常没有症状，直到治疗时已经发现太迟了。
The danger of Chronic hepatitis B is that often there aren’t any symptoms until it’s too late to treat.
图片来源：Hepatitis B FoundationPhotographed by Hepatitis B Foundation
More than 60 percent of people with Hep B in the US are Asian and two in three Asian Americans with Hep B don’t know they are infected. Of the more than 212,000 people of Asian descent living in Philadelphia, less than 10 percent of the local AAPI communities have been tested or vaccinated.“费城乙型肝炎的主要驱动因素与出生在乙肝流行国家的人有关，在这些国家，乙肝是通过分娩传播的，包括撒哈拉以南非洲和东南亚的一些国家。” Kuncio说。“有些人从出生时就患有此病。”
“A primary driver of hepatitis B in the city is related to people being born in countries where it’s endemic, where it’s passed through childbirth,” including some countries in Sub-Saharan Africa and Southeast Asia,” said Kuncio. “Some people have had it since they were born.”
While confirmed Hep B infections can be found in every neighborhood in Philly the most up-to-date research suggests that North and South Philly have the highest rates of confirmed infection with the largest concentrations in Chinatown and the Elmwood neighborhood in Southeast Philly.
Data suggest medical racism and a host of sociocultural issues specific to immigrant communities stand in the way of saving lives from this silent killer. Language barriers, immigrant status, financial and institutional barriers have led to a poor understanding of Chronic Hep B and its complications, and a deeply entrenched stigma associated with the disease.
According to one study focused on the Korean American community, “The participants’ overall awareness of the disease and prevention methods demonstrated poor understanding of important characteristics and potential outcomes of the disease. Additionally, differences in cultural expectations and a lack of understanding and utilization of healthcare systems affected health literacy in further limiting participants’ motivation to seek care.”大多数患有慢性乙型肝炎的亚裔美国人是在出生时通过母婴传播或在幼儿期通过水平传播感染的。这使得他们患肝病的可能性比未感染者高200倍。超过90％的新感染婴儿、25-50％1岁至5岁之间感染的儿童、以及6-10％急性感染的老年、儿童和成年患者将发展为慢性乙型肝炎。
Most Asian Americans who are chronically infected with Hep B are infected at birth through mother-to-child transmission or during early childhood through horizontal transmission. Making them 200 times more likely to develop liver disease than those who aren’t infected. More than 90 percent of newly infected infants, 25-50 percent of children infected between ages one and five years, and 6-10 percent of acutely infected older children and adults will develop a chronic Hep B infection.
Philadelphia Chinatown Development Corporation (PCDC) has partnered with the Hepatitis B Foundation, as a member of the United Hep B Coalition, implementing an AAPI-focused Hep B project that raises awareness of Hep B and increases screening, immunization, and disease management opportunities.
图片来源：Hepatitis B FoundationPhotographed by Hepatitis B Foundation
“Using our deep roots in the community and taking advantage of our community space at the Crane Center, we have conducted three Hepatitis B screenings, two of them, standalone clinics, and the third during our annual EXPO in June,” said Kaizan Kollin, the Health Project associate of the PCDC. “In total, our clinics have screened more than 45 community members thus far, but we’re hopeful to reach universal screening in the future.”
“Our project takes a unique approach by combating Hep B stigma through storytelling,” said Kollin. “We conducted interviews with people who live in our community who have a lived experience with Hep B and disseminated their experiences through social media storytelling, including a three-month long Arts Contest to raise awareness of the disease that has reached a broad age range of individuals.”
“We’re trying to bring as much education as we can and promote cultural competency and language access amongst providers to ensure that it’s not just certain groups that can receive care for hepatitis B and C,” said Kuncio.
The Philadelphia Department of Public Health has a target goal of eliminating Hep B and C by 2030, The Hepatitis B and Hepatitis C Elimination Plan will contain strategies and activities to achieve these goals and will be updated annually to track progress and adapt their strategy as needs change.
Philly’s efforts may get a boost from a federal plan by the Biden Administration to eliminate hepatitis C across the US over the next five years with a proposed budget of 11 billion dollars, funding everything from tests to medications and cures.
“This is what we as a city can unite around to get people tested, treated, cured, vaccinated, educated, try to reduce some stigma,” said Kuncio. “These are conditions that in every zip code in Philadelphia, people are living with hepatitis B and C.”
Hep A and B vaccines are available through Philadelphia Pharmacies, while companies like Arbutus Biopharma are busy hunting for a functional cure for chronic Hep B. and already have several viable possibilities in the testing phase.
“挑战总在于确保人们受到科普，并确保人们知道有希望，有治愈方法，有事情可以做，” Kuncio说。
“The challenge is always making sure that people are educated and making sure people know there’s hope, there’s a cure, there’s something you can do,” said Kuncio.
“We have a Hep B luncheon on July 28 at the Crane Center in which a local provider will give a talk, and community members with lived experiences will share their Hepatitis B stories,” said Kollin.
