Stopping a silent killer in the underserved asian and pacific islander community: a chronic hepatitis B and liver cancer prevention clinic by medical students.

School of Medicine, Stanford University, CA, USA.
Asian Pacific journal of cancer prevention: APJCP (Impact Factor: 1.5). 01/2009; 10(3):383-6.
Source: PubMed

ABSTRACT 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.
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).
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.
More liver cancer prevention in the medically underserved API community is needed, including universal screening for HBV and follow-up for those chronically infected.

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