Chronic Hepatitis B: Perceptions in Asian American Communities and Diagnosis and Management Practices among Primary Care Physicians

Abstract

Background: Asian Americans exhibit a high prevalence of chronic hepatitis B (CHB) compared with the general population in the United States. However, there are specific barriers to appropriate health care in the Asian American population, and CHB awareness is low. The aim of this study was to examine CHB awareness among the Asian American population and to assess the role and attitudes of primary care physicians in CHB diagnosis and treatment, particularly in relation to Asian American communities. Methods: Participants from the Asian American community were randomly selected using telephone directories, and completed a questionnaire regarding attitudes toward CHB during telephone interviews. Primary care physicians completed a structured, online questionnaire. Results: A total of 610 Asian Americans (Chinese, Korean, and Vietnamese communities) and 393 physicians participated in the study. There appeared to be some level of awareness of CHB and its seriousness among the Asian American participants; many respondents agreed with statements regarding the seriousness of the disease (66%) and a high proportion (71%) reported having had a blood test for hepatitis B virus (HBV). Of those who were found to be negative for HBV, only 61% reported that they had been vaccinated, and almost one-third agreed that vaccination was unnecessary (30%). Most primary care physicians perceived CHB to be an important disease (83% thought it was very or extremely serious). However, despite awareness of the high prevalence of CHB among the Asian American community, universal screening is not practiced by most physicians. Furthermore, there was low awareness of current major CHB guidelines (62% were unfamiliar with the major treatment guidelines). Conclusions: Improved education regarding CHB disease progression, prevention, and treatment is needed among both the Asian American community and primary care physicians to increase awareness of the seriousness of the disease and ultimately reduce the burden of CHB in the United States.