Chen Moon S, Dang Julie
Moon S Chen Jr, Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA 95817, United States.
World J Gastroenterol. 2015 Nov 14;21(42):11924-30. doi: 10.3748/wjg.v21.i42.11924.
After tobacco use, chronic hepatitis B (CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus (HBV). Though infection rates are low (< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B (HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, community-based efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC's three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.
在烟草使用之后,慢性乙型肝炎(CHB)病毒感染是全球癌症的最重要病因,因为每3个人中就有1人感染过乙肝病毒(HBV)。尽管美国的感染率较低(<1%),但占人口约6%的亚裔美国人却承担了约60%的CHB负担。本文回顾了亚裔美国人中乙肝(HBV)负担的严重程度以及为减轻这一负担所取得的进展,主要是通过在当地社区开展工作,以增加亚裔美国儿童、青少年和成年人的筛查及疫苗接种。这篇综述揭示,尽管开展了众多基于社区的筛查工作,但绝大多数亚裔美国人仍未接受筛查,而且疫苗接种工作,尤其是针对成年人的接种工作,效果并不理想。迫切需要做出更大努力,促使医疗服务提供者在现有医疗体系内整合筛查工作。本文提供了基于证据的策略,以落实美国疾病控制与预防中心(CDC)的三项主要建议,即通过有针对性的筛查和加强疫苗接种工作来控制和预防乙肝。