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5871 University Ave, Ste 334
San Diego, CA 92115
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E-mail: btran.aphc@sbcglobal.net


Results of Hepatitis B Screenings on 4/13/08


This is the second part of the Hepatitis B Screenings for the community organized by the UCSD-Asian Pacific American Medical Student Association (APAMSA) in collaboration with the Asian Pacific Health Center in San Diego with funding from the American Liver Foundation. Last year, on 4/1/2007, 54 patients were screened at the Quantum Adult Care Center, showing 13 (24%) persons not immune, 33 (61%) persons immune to Hepatitis B, and 8 (14.8%) having positive results. This year, 73 patients were tested on 4/13/08 at the Hanbit Church in San Diego. The protocol and results are given below.

SUBJECTS AND METHODS
Test subjects (73) were attendees of the Hanbit Church and members in the community who answered to the ads placed by the APAMSA members at diverse locations during prior weeks. Patients answered to a short 4-question survey. The blood samples were collected, spun at the site, refrigerated overnight, and routed to Quest Diagnostic labs for processing. Samples were tested for Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (HBsAb). Test results were then mailed to the patients with a letter explaining the meaning of the tests.

RESULTS
Demographic data were recorded on the patient intake form, and tabulated on the main collection sheet.
1. Age range: Nearly half of the number of persons screened was in the 18-29 age group (36 or 49%), followed by the 30-49 group (30 or 41%). (graph 1)
2. Gender: there were 32 men (44%) and 41 women (56%). (graph 2)
3. Birthplace: the quasi majority was born in Korea (68 or 93%). Five persons were from the US. (graph 3)
4. Ethnicity: Among the attendees were 71 Korean, 1 Chinese, and 1 Taiwanese. (graph 4)
5. Risk factors in the family:
Three persons have family members who have hepatitis B and five persons have family members diagnosed with liver cancer in the family (graph 5)
6. Hepatitis B carrier and immunization status:
Only one 47 year-old person stated that he is a hepatitis B carrier. Four did not know the status, and the rest 68 (93%) are not hepatitis B carriers. Twenty-nine (40%) had received immunizations in the past, 33 did not (45%) and 11 (15%) did not know (graph 6).
7. Hepatitis B test results:
Three cases were determined as follows:
Case 1: HBsAg (-) and HBsAb (-): 31 persons (42%) are in this group. The person does not have chronic hepatitis B infection, and is not a hepatitis B carrier. The person has no immunity against hepatitis B infection, and needs to be vaccinated, especially if he/she is in the younger age range (18-29), which is about half of the total number of persons screened on that day.
Case 2: HBsAg (-) and HBsAb (+): 42 persons (58%) belong to this group. The subject is not a carrier, and has developed immunity due to past infection or vaccination. No vaccination is needed. We recommend that other family members also go through the screening for Hepatitis B.
Case 3: HBsAg (+) and HBsAb (-): None. There was no positive Hepatitis B instances among the persons tested on that day.

DISCUSSION:
The demographics at the Hepatitis B event were strikingly homogeneous. Almost all attendees are Korean born in Korea. Half of the number of persons tested is under 30 years old, and 42 % of the total number has no immunity against Hepatitis B. This group of young people needs vaccination to prevent from the harmful effects of the disease which may lead to liver cirrhosis and liver cancer. 58% of persons screened are immune, thus don’t need the vaccinations. According to the statistics, Korean people have around 5 % positive cases of Hepatitis B. Our sample of 73 patients is very small, so cannot be generalized to the larger masses. We are testing a group of young college students and relatively affluent members in the community half of whom already received vaccinations in the past. Larger sizes of screenings in the future would yield more significant results.

Reported by Binh N. Tran
4/23/08


Paula Tran, Tim Almazan



APAMSA students and preceptors



Dr Ton Tran, Judy Nguyen, Paula Tran