KEYWORD1:
Hepatitis B, Adult, Screening, Immunization

BACKGROUND:
Hepatitis B virus (HBV) is a known cause of cirrhosis and liver cancer. Individuals who immigrated to the U.S. from the countries of SE Asia and Pacific Islands (AAPIs), Africa, the Middle East and Amazon Basin in South American, are at high risk for infection. Fully 50% of the 1.25 million Americans with chronic HBV infection are AAPIs. Moreover, 80% of liver cancer in AAPIs is caused by HBV infection. Higher immunization rates could reduce these numbers.

OBJECTIVE:
Provide HBV screening to uninsured Asian adults to identify individuals and families at risk for infection;Immunize adults at risk to decrease vertical and horizontal transmission of HBV infection; Provide culturally appropriate HBV education for disease prevention.

METHOD:
The Hepatitis Education and Prevention Program of the Illinois Health Education Consortium/AHEC offered hepatitis B screening and immunization, at no cost, to uninsured adults in 8 Asian communities and 1 African immigrant community in Chicago. A talk about hepatitis B given at each screening event included the importance of HBV screening, implications of results and follow-up. Each person completed a risk factor survey.

RESULT:
Over 800 adults were screened for HBV and more than 500 doses of adults hepatitis B vaccine were given. 11% of those screened were HBsAg positive, confirming national estimates, however, rates varied with ethnicity from 5 to 17 %; 54% of cases were anti-HBs positive indicating the presence of circulating antibodies acquired from previous exposure or immunization; among antigen positive cases there was a 2 to 1 male to female ratio; the greatest number of antigen positive results was found in age group 21-30 years; 30% of HBsAg positive cases had elevated liver enzymes and positive HBeAg, providing evidence of active replication.

CONCLUSION:
Hepatitis B screening and immunization has been provided effectively to uninsured Asian adults in partnership with local community organizations, state and local departments of public health, a pharmaceutical company, and organized by a local not-for-profit hepatitis prevention program.
LEARNINGOBJECTIVES:
Participants will understand strategies used to overcome barriers to hepatitis B screening and immunization among uninsured Asian and African immigrant adults.