Posted: 10/23/2009 - 1 comment(s) [ Comment ]
- 52 trackback(s) [ Trackback ]
Category: Hepatitis B

 OCT. 19, 2009

Increased hepatitis vaccination in China would save thousands of lives, hundreds of millions of dollars, Stanford study shows


Aaron Kuo-Deemer description of photo

Although Chiina aims to give all newborns free hepatitis B vaccines, this child getting the shot and millions more fell through the cracks. A documentary about a pilot test of the vaccination program in China is available here.

A massive new program in China to provide “catch-up” inoculations against hepatitis B to more than 100 million unvaccinated children could prevent millions of infections, save tens of thousands of lives and return twice as much in savings to the Chinese economy as the program costs, according to a new study by engineering and medical researchers at Stanford University.

Hepatitis B is a pandemic in much of East Asia because it is easily transmitted from mother to child by blood or between sexual partners by other bodily fluids as well as blood. Meanwhile, the symptoms, until resulting diseases becomes life-threatening, are subtle, said Samuel So, MD, professor of surgery and the Lui Hac Minh Professor at Stanford, who is one of the study’s senior authors. Although many patients can fight off the virus, up to 300,000 a year die in China from hepatitis B-related liver cancer and other liver diseases.

“That means more people die in China each year from hepatitis B-related liver diseases than HIV/AIDS, tuberculosis and malaria combined,” said So.

In the paper posted online Oct. 19 by the journal Hepatology, the researchers predict that if China spent $423 million to inoculate an estimated 150 million unvaccinated children ages 1 to 19, it would produce a net return in the economy of $840 million from lower health-care costs. Moreover, their model indicates that inoculations would prevent 8 million infections along with 65,000 deaths. China’s program, designed by officials who have seen the Stanford research, will inoculate all unvaccinated children under age 15.

“It’s a virus that can be prevented with a safe and cheap vaccine, so stopping it is really a question of global public health action,” said Margaret Brandeau, PhD, professor of management science and engineering at Stanford and the other senior author of the study. She and So guided the work of the study’s lead author, management science and engineering doctoral student David Hutton, who developed the model used in the study.

China has provided free hepatitis B vaccines to all newborns since 2002, but millions of poor and rural youngsters have nevertheless not been inoculated. Children born before that initiative went into effect could benefit from “catch-up” shots as well. The vaccine has been available since 1986.

So has been working with Chinese and world health officials for years to combat hepatitis B. The Asian Liver Center at Stanford, which So directs, worked with Chinese officials in 2006 and 2007 to demonstrate the feasibility and effectiveness of a widespread catch-up vaccination program. In the remote Qinghai province, local governments, schools and the ALC provided more than 550,000 children with a free regimen of the vaccine’s three doses, as well as comprehensive education about the disease.

“Besides protecting future generations from this disease, one major impact of this is an effort to eliminate discrimination,” said So. “People who become chronically infected, often called hepatitis B carriers, are widely discriminated against in China. A lot of schools from kindergarten on up will test the children, and if they are positive, they will not be admitted.”

So’s experience and judgment about the need to expand vaccinations in China — and screening of immigrant populations in the United States — have made him an influential advocate within the world public health community. But there has been little data to guide policymakers.

“If you want a government to change a policy, you need to have cost-effectiveness data, but there was none,” So said.

In 2006, through a mutual student, Daniel Tan, So connected with Brandeau, whose specialty in the field of operations research is developing mathematical and economic models of programs to combat infectious diseases. Brandeau and Hutton began gathering data and building a model to determine the cost effectiveness of various measures to slow the spread of hepatitis B.

“As engineers, we could make a real difference by creating this model and proving, or disproving, that it’s a good thing to do,” Brandeau said.

In the study, the authors factored in many variables including the cost of the vaccine; likely infection, disease and mortality rates; current health-care costs in China; the vaccine’s effectiveness (about 95 percent); and vaccine compliance rates. The study also models what would happen if currently unvaccinated children are not inoculated.

The bottom line result, based on the most likely values of the variables, shows that the program will meet the international standard of “highly cost effective,” meaning that each additional year of life saved will cost less than the per capita gross domestic product in China, about $2,500.

The model allows for manipulating any of the variables to determine the program’s effectiveness under different conditions. What if, for instance, the price of the vaccine doubled? What if the virus became more virulent? In all but the most extreme cases, the program remains cost effective, Hutton said.

The research can be applied to other nations with similar hepatitis B pandemics, such as Vietnam, Myanmar, Laos and Cambodia, Hutton said.

“It would be easy to take data from a different country and put it into this model,” said Hutton, who recently won an award from the Institute for Operations Research and the Management Sciences for his hepatitis B modeling research.

The team performed the China study with no external funding.

“This is just something we thought was the right thing to do,” said So.

Posted: 10/13/2009 - 2 comment(s) [ Comment ]
- 69 trackback(s) [ Trackback ]
Category: Hepatitis B

Via New York Times -  October 13, 2009 - China to End Required Testing for Hepatitis B

BEIJING — Chinese health officials will abolish mandatory testing for hepatitis B during physical exams given to prospective college students, factory workers and government employees, according to Xinhua, the state news agency.

The new rules, announced Saturday by the Health Ministry, mean that people found to be carrying the hepatitis B virus will not be automatically barred from jobs and classrooms, a form of discrimination widely decried by health care advocates and the estimated 120 million people in China thought to be infected. It is not uncommon in China for hepatitis B carriers to be barred from medical school, teaching positions or jobs in the food production industry.

In announcing their decision, officials suggested that they were yielding to public pressure, especially from activists who in recent years have begun organizing on the Internet.

“On account of the questions brought up by media and society concerning hepatitis B testing, the Health Ministry has come to a consensus,” Deng Haihua, a spokesman said in comments posted on the ministry’s Web site. “The current social misunderstanding about hepatitis B patients is mainly a result of a lack of understanding. The experts believe that canceling blood testing for the purpose of employment and students entering schools will not affect the health of others, nor will it cause the disease to spread.”

Lu Jun, who runs an organization in Beijing that has been pushing the government to ease its testing policies, described the new rules as a victory for hepatitis B carriers as well as those trying to change society through public advocacy and legal action. “International standards have now been realized in China,” he said in an interview.

In July, the offices of Mr. Lu’s group, the Yirenping Center, were raided by the police, who confiscated literature they said had been illegally published.

Many of those who carry hepatitis B in China were infected by contaminated syringes during childhood inoculation campaigns in the 1970s and ’80s. Others contracted it from their mothers during childbirth.


Posted: 10/2/2009 - 0 comment(s) [ Comment ]
- 12 trackback(s) [ Trackback ]
Category: Hepatitis B


Chinese vice premier stresses orderly reform of health care  2009-09-27 20:47:36     Print

    NANCHANG, Sept. 27 (Xinhua) -- Chinese Vice Premier Li Keqiang has called for orderly implementation of the country's health care reform.

    Li, also head of the State Council's leading group on health care system reform, made the remarks at a symposium in Jiangxi's capital city Nanchang on Saturday.

    Li underscored major projects to be carried out to push forward the reform by the year-end:

    -- The expansion of basic medical insurance coverage to 72 million more urban workers and unemployed residents, and ensuring at least 90 percent of the rural population to be covered.

    -- Assistance for the vaccination of 23 million people below the age of 15 against hepatitis B and providing free folic acid supplements for 11.8 million rural women who intend to get pregnant or are in the early stages of pregnancy to prevent birth defects.

    -- Improving primary health care facilities, including county and township-level hospitals, village clinics, and community health centers.

    -- Ensuring about 30 percent of government-owned community health institutes and county-level hospitals use medicines on an essential drug list and sell them at controlled low prices.

    -- A pilot reform in about 100 state-run hospitals by the year-end to draw experience from trial projects to push forward the reform across the country.

    China's three-year plan for health care reform, involving an investment of 850 billion yuan (124 billion U.S. dollars), was unveiled in April. It aims to lay a solid foundation for equitable and universal access to essential health care for everyone in the country by 2020.

Editor: Anne Tang

Posted: 10/2/2009 - 2 comment(s) [ Comment ]
- 12 trackback(s) [ Trackback ]
Category: Hepatitis B

 Hello everyone,


I wanted to bring your attention to another article demonstrating the great work that individuals are doing in China to combat and eliminate HBV discrimination.


All the best,





09:23, September 25, 2009

Hepatitis B carriers challenge discrimination
The efforts of a young migrant worker from Fujian Province to become a cook in Beijing ended up creating a spectacle that involved reporters, disease control authorities and the police.

Mr Liao, who declined to give his full name, has the hepatitis B virus. He was applying for a health certificate at the Beijing Centers for Diseases Control and Prevention when reporters followed him on September 10. The certificate is required for all food catering workers.

There was hope for him to get it as a college student in Hangzhou became the first hepatitis B virus carrier in China to be issued the certificate on September 1. The new Law of Food Safety, which came into force on June 1, allowed hepatitis B virus carriers to enter catering.

But when reporters photographed his application process, the Beijing Centers staff became upset and finally called the police. Liao's application was put off.

"Beijing is Beijing. You cannot compare it to other cities," Liao quoted the Beijing Centers staff as saying. He was told this after asking why hepatitis B carriers could obtain the certificate in Hangzhou but not Beijing, he said.

Liao was not frustrated. He plans to visit the Centers again after a few weeks. "I have hundreds of thousands of people standing behind me," he said.

He is a core member of an online community for hepatitis B carriers. The website hbvhbv. com has accrued 370,000 members since it was launched in November 2007. Community members encouraged Liao to apply and showed him favorable laws and regulations. One of them accompanied him to the Beijing Centers.

A non-governmental organization (NGO) provided him with legal support. Beijing Yirenping Center counsels more than 100 people who come from around China every month and helps about 10 percent of them go to the court.

It was built with donations from hepatitis B carriers and foundations in December 2006.

Like Liao, hepatitis B virus carriers are no longer fighting alone for their rights. Many know each other on the Internet. They have clubs in a dozen major cities and have set up several non-governmental organizations in defense of their rights.

They believe that they have been discriminated against in the process of finding a school or looking for jobs. In spite of government regulations in their support, some of the best universities and institutions have closed their doors to hepatitis B virus carriers, and many Chinese and multinational companies prefer non-carrier candidates.

Hepatitis B carriers might be the largest marginalized group in China. China had 100 million chronic carriers of hepatitis B virus, according to a World Health Organization 2002 report, with the United States having 1 million and the world an estimated 350 million. China's Ministry of Health said in 2006 that the country had 93 million hepatitis B virus carriers.

Stepping into the light 

In spite of their large numbers, it is only in recent years that these marginalized people have made their voice heard. Before, they were either silent or neglected.

"Even now many hepatitis B virus carriers prefer to remain silent. They are afraid that they will lose their jobs and have difficulty in finding other jobs when people know that they carry the virus," said Yu Fangqiang, who is in charge of legal aid projects at the non-governmental Yirenping Center.

Zhang Xianzhu, a 23-year-old college graduate, became the first Chinese to launch a lawsuit on hepatitis B virus discrimination when he took the local government of Wuhu, Anhui Province to court in November 2003. He won the case, but "became so famous that he could not find or maintain a job," Yu said.

"He is still shifting from one job to another in southern China. He has to leave as soon as people know that he is the one who sued for hepatitis B virus discrimination."

A greater hero for many hepatitis B virus carriers is an executed murderer. Zhou Yichao, a graduate of Zhejiang University, stabbed to death a government official in the prefecture-level city of Jiaxing, northern Zhejiang Province, in March 2004. A month earlier, he had been denied the chance of working at the local government because he carried the virus.

"The greater majority of hepatitis B carriers whom I know have respect and even gratitude for him. They organize events to remember him on the annual tomb sweeping day. They visit his mother regularly," Yu said.

"If not for him, discrimination against hepatitis B carriers would have been taken for granted as before. We think that he was going to extremes. But we understand how he felt."

Months after Zhou's case, the central government issued a regulation in January 2005 stipulating that hepatitis B carriers can become public servants.

Hepatitis B carriers are allowed to work in jobs other than those prohibited by the Ministry of Health – such as at hospitals and laboratories – according to another regulation published in May 2007. The regulation also said that the privacy of hepatitis B virus carriers should be protected.

They can launch lawsuits if a potential employer discriminates against them, according to the Employment Promotion Law, which came into force on January 1, 2008.

Although they have the protection of laws and regulations, hepatitis B virus carriers still have the feeling that the virus harms their career.

"Many excellent people cannot get into good companies because they carry the virus. They can only stay at small companies and small places," said Dong, a hepatitis B carrier who accompanied Liao to the Beijing Centers.

Dong, who would not give his full name, said he could not join a major aviation company when he graduated from college in 2007. He is pursuing a master's degree at Beijing University of Aeronautics and Astronautics, and will finish his graduate studies next year.

"My only good choice was to be a public servant because the government has excluded the hepatitis B virus from pre-employment physical checkups. The companies that may use my skills almost all require information about the virus," he said.

Legal battles 

To get around the requirement about hepatitis B virus information, many carriers resort to cheating in the physical checkup, said Yu at the Yirenping Center. In a typical case, a carrier will pay a healthy person about 2,000 yuan, and have the latter's blood drawn under his name.

Others seek out the law. "Hepatitis B carriers know that the law is on their side, thanks to the publicity of previous cases," Yu said. Of those who turned to his organization for help, more than 100 went to court every year.

Multinational companies are more cooperative facing accusations of discrimination, according to Yu. "After all, they don't have this discrimination in their home country," he said.

More than 80 percent of the 96 multinational companies that his center surveyed in 2008 requested the hepatitis B virus information of potential employees, Yu said.

Of the approximate 100 hepatitis B virus carriers who went to court with the NGO's help, more than half reached an agreement with their employers or potential employers in the process of the lawsuit.

"Large companies don't like the publicity that comes with a discrimination case," Yu said.

About 90 percent of court decisions favor hepatitis B carriers when Yirenping is involved. However, compensation is nominal: about 4,000 yuan in Beijing and half that in smaller cities.

"It's not enough to have the law," Yu said. "We need to tell people that the virus is not as terrifying as they imagine. Otherwise discrimination will always be there."

Street hugs 

To explain the virus, hepatitis B carriers in a dozen cities have organized regular lectures. Dong said that he and his friends in the online community invited doctors and medical professors to give public lectures at least once a month at Beijing universities.

"Those who come to listen are often relatives and friends of hepatitis B carriers," he said.

Some hepatitis B carriers have taken more radical action to share their problems. Lei Chuang, a student of Zhejiang University in Hangzhou, held a banner and walked along the city's major streets for three hours on a Sunday in August 2007.

His banner said: "The hepatitis B virus is transmitted through sex, blood and during the delivery of babies. It does not transmit through food or water, or at workplaces. I am a hepatitis B virus carrier. Are you worried?"

He wanted to attract local media attention, and had one of his classmates call newspapers and television stations. But no reporters came until the end of his walk.

Even his classmate who accompanied him in the walk quitted halfway as he could not bear the way passers-by stared at them.

In the next two years, he walked another 10 times in Hangzhou and also Beijing. This August he and his friends dressed up as cartoon figures and stood at the gate of Peking University, accusing the institution of discriminating against hepatitis B carriers.

His efforts paid off. He became the first in China to receive a health certificate from the authorities on September 1, although he applied only to "test the enforcement of the law," he said.

"It is time for hepatitis B virus carriers to act as a group. We have to do something to change our fate," said the 22-year-old.

ABCs of hepatitis 

Hepatitis is inflammation of the liver. Inflammation is the painful, red swelling that results when tissues of the body become injured or infected. Inflammation can cause organs to not work properly.

It can have many causes including the viruses A, B and C. Hepatitis A causes an acute hepatitis that almost always gets better on its own. It is easily spread from person to person, in food and water, and can infect many people at once. Hepatitis C is almost always chronic and spreads only by blood. Hepatitis B can be both a short-term illness and a chronic, ongoing illness, and is spread through blood or other body fluids in various ways. Both hepatitis A and B can be prevented by vaccination, but not Hepatitis C.

Hepatitis B is diagnosed through blood tests, which can also show if you have chronic hepatitis B or another type of hepatitis.

Anyone can get hepatitis B, but some people are at higher risk, including:
ffpeople who were born to a mother with hepatitis B
ffpeople who live with someone who has hepatitis B
ffpeople who have lived in parts of the world where hepatitis B is common
ffpeople who are exposed to blood or body fluids at work
ffpeople on hemodialysis
ffpeople who have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
ffinjection drug users
ffmen who have sex with men
You can get hepatitis B through contact with an infected person’s blood, semen, or other body fluid.
You cannot get hepatitis B from
ffshaking hands with an infected person
ffhugging an infected person
ffsitting next to an infected person
Source: US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Source: Global Times


Posted: 9/17/2009 - 5 comment(s) [ Comment ]
- 11 trackback(s) [ Trackback ]
Category: Hepatitis B

Hello readers!


The following is an article from the LA Times on the effectiveness of the hepatitis B vaccine in reducing liver cancer. 


It is so exciting to see the media paying attention to hepatitis B!


All the best,


Hepatitis B vaccine reduces liver cancer cases

September 16, 2009 |  1:00 pm

HepB The hepatitis B vaccine, which became available in the United States and elsewhere around the world in the early '80s, has proved to be a very good idea. A study published today in the Journal of the National Cancer Institute found cases of liver cancer have dropped significantly in children who received the vaccine.

Researchers in Taiwan collected information on almost 2,000 cases of liver cancer among people ages 6 to 29 at the time of diagnosis between the years of 1983 and 2004. Among people who vaccinated, there were 64 cases over almost 38 million person-years (the number of years times the number of people in the study) compared to 444 cancer cases in unvaccinated people in almost 80 million person-years.

Some people who received the vaccine developed liver cancer, the authors said. But records show they were born to hepatitis-infected mothers or did not get enough of the vaccine. The hepatitis B vaccine is a three-shot series. The first shot is usually given to newborns, followed by two booster shots in the months thereafter.

"This study provides evidence of effective long-term cancer prevention by vaccination and supports the conclusion that the HBV vaccine is a good cancer-preventive strategy," the authors wrote.

Global immunization rates vary, however. Almost 86% of U.S. children are vaccinated compared to only about 28% in Southeast Asia, according to the study.

-- Shari Roan

Photo: A child receiving a hepatitis B shot. Credit: Norm Dettlaff / LasCruces Sun-News  /  AP.

Posted: 9/15/2009 - 3 comment(s) [ Comment ]
- 13 trackback(s) [ Trackback ]
Category: Hepatitis B

Good morning!


I just wanted to sare some exciting hepatitis B news from China.  Recently, the Chinese government wrote a draft regulation that states that Chinese kindergartens and nurseries will shortly no longer be allowed to turn down children carrying hepatitis B who have normal liver function.  This is a great step towards eliminating regulations that discriminate against hepatitis B infected individuals by not allowing them to go to school or seak employment.


Please read the article below and follow my blog for updates on these new regulations for China's children.


All the best,




China's kindergartens to take normally functioning hepatitis B children 2009-07-31 17:03:11    

BEIJING, July 31 (Xinhua) -- Chinese kindergartens and nurseries will shortly no longer be allowed to turn down children carrying hepatitis B who have normal liver function, says a draft government regulation.


The draft, which is open to public feedback till Aug. 15, is expected to replace the current regulation, a simplified version that took effect in December 1994 which did not include such a requirement, a source with the Ministry of Health said Friday.


The draft regulation, applying to all kindergartens and nurseries hosting children aged under six, also requires them to report to medical authorities and enforce strict sterilization measures if infected children are found.


Children will have to present health records issued by authorized medical institutions on entry into nursery institutions, and their guardians will be required to take them for treatment should they display infectious disease symptoms.


When they return to their preschools, children will be required to show medical recovery documents. Those who take three months or longer leave will have to present a new health check record if they want to return to the nursery or kindergarten.


The draft also requires medical staff in child care centers to have a fundamental knowledge of child care, sterilization, infectious disease control and dietary management.


Kindergartens will be required to recruit at least one professional medical staff member for every 150 children. Nurseries with less than 150 children are required to have at least part-time medical staff, the draft regulation says.


Preschool center staff will have to have an annual health examination and will not be allowed to continue work if they have an infectious disease. A return to work will be dependent on full recovery.


The regulation also bans people with a record of psychiatric disorder from working in kindergartens and nurseries.



Posted: 9/11/2009 - 0 comment(s) [ Comment ]
- 7 trackback(s) [ Trackback ]
Category: Hepatitis B

As the Global Health Coordinator for the Asian Liver Center at Stanford University, I find it refreshing to find positive and successful hepatitis B and liver cancer-related stories from around the world.  Today I wanted to share a success story from Kuwait.


Hepatitis B in Kuwait: Immunizations Making an Impact

Source: U.S. Department of Housing and Urban Development
Posted on: 7th September 2009

The Public Health Matters blog welcomes requests from its readers. Recently, a reader asked us to address the issue of Hepatitis B in Kuwait. Dr. Frank Mahoney, a CDC medical epidemiologist who has worked extensively in the Middle East, wrote this response:

The global burden of disease due to cirrhosis (hardening) of the liver and hepatocellular carcinoma (HCC—liver cancer) is high (~ 2% of all deaths) and expected to increase over the next 20 years. Liver cancer is already the 4th leading cause of cancer deaths worldwide. Studies of patients with cirrhosis and HCC in the Eastern Mediterranean Region indicate more than 75% is caused by hepatitis B virus (Hep B) or hepatitis C virus (Hep C) infection. The World Health Organization (WHO) estimates approximately 4.3 million persons are infected each year with Hep B and 800,000 persons with HCV in the Eastern Mediterranean Region. Numerous studies suggest that most Hep B and Hep C infections in the Eastern Mediterranean Region are acquired due to unsafe injections and medical procedures. The cost to treat patients with chronic Hep B or Hep C infection far outweighs the cost of implementing prevention programs (like immunizations and infection control). A wide-ranging strategy is urgently needed to prevent spread of these blood-borne pathogens throughout the Eastern Mediterranean Region and other parts of the world.


Kuwait is a small country within the Eastern Mediterranean Region, located between Iraq and Saudi Arabia and bordered on one side by the Persian Gulf. In 1990, Kuwait was one of the first countries in the Eastern Mediterranean Region to introduce Hep B vaccine in their national immunization program. Before vaccine introduction, ~ 25% of adults had evidence of Hep B infection, including 2.5% with chronic (lifelong) infection. Hep B vaccination began with infant immunizations and included the delivery of a dose at birth to prevent Hep B transmission from mother to child. Kuwait reports high numbers of children receiving the Hep B vaccine. While no formal studies have been conducted to document the impact of introducing Hep B vaccine in Kuwait, it is likely that the program has significantly protected children born since 1990, resulting in a reduced prevalence of chronic Hep B infection and associated morbidity and mortality (chronic liver disease and HCC). Kuwait also offers Hep B vaccination to health care workers with occupational exposure to blood.


WHO estimates about 1.8% of the Kuwait population have evidence of Hep C infection. The epidemiology of Hep C infection in Kuwait is not well-studied.

Posted: 9/11/2009 - 0 comment(s) [ Comment ]
- 8 trackback(s) [ Trackback ]
Category: Hepatitis B

Hello everyone!


Dr. Samuel So, Director of the Asian Liver Center, is currently in Washington DC at the National Summit on Viral Hepatitis, where politicians, medical experts and community advocates will gather for 2-Day Conference to develop an action plan to combat hepatitis B and C in the United States.


Here is some additional information on the National Summit on Viral Hepatitis:


Chronic viral hepatitis is a leading cause of liver cancer and cirrhosis that costs the nation's health system hundreds of millions of dollars each year, yet attracts little public attention.  As many as 2 million people in the United States are living with chronic hepatitis B and an estimated 3.2 million are chronically infected with hepatitis C.  However, most do not even know they are infected and miss out on getting early medical care, putting them at increased risk for developing serious liver disease.

To address this public health challenge, government, medical and community experts will meet September 10-11 in Washington, D.C. to plan an improved national response to viral hepatitis.  The conference "The Dawn of a New Era: Transforming our Domestic Response to Hepatitis B & C" will feature keynote addresses, panel discussions and scientific poster sessions focused on enhancing the prevention and detection of viral hepatitis and improving care for people who are already living with the disease.

Journalists are encouraged to participate in all aspects of the summit, and will enjoy unprecedented access to leading experts on viral hepatitis.  A press room will be available.

Speakers include:

  • John W. Ward, MD, Director, U.S. Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis
  • Congressman Bill Cassidy, MD (R-LA), Gastroenterologist and Associate Professor of Medicine, Louisiana State University Health Sciences
  • Anna S.F. Lok, MD, Director of Clinical Hepatology, University of Michigan
  • Eugene R. Schiff, MD, Director, Center for Liver Diseases, University of Miami School of Medicine
  • Ronald O. Valdiserri, MD, MPH, U.S. Department of Veterans Affairs
  • Jeff Caballero, Executive Director, Association of Asian Pacific Community Health Organizations


Sponsors and supporters of the summit meeting include the Centers for Disease Control and Prevention (CDC), the National Institute of Allergy and Infectious Diseases, the American Gastroenterological Association's AGA Institute, the U.S. Department of Veterans Affairs, Gilead Sciences, Bristol-Myers Squibb and Vertex Pharmaceuticals.

September 10-11, 2009
(Opening Keynote Address begins at 8 A.M. on Thursday, September 10)

Washington Marriott Wardman Park Hotel
2660 Woodley Road NW (between 27th St. and Connecticut Ave)
Washington, DC 20008


  • The hepatitis B virus is up to 100 times more infectious than HIV and causes up to 80 percent of liver cancer cases worldwide, making it second only to tobacco as a cancer-causing agent in humans.
  • Chronic infection with the hepatitis C virus is the most common reason for liver transplantation among adults in the United States.
  • More than $1 billion is spent each year on hospitalizations related to hepatitis B, and hepatitis C is responsible for more than $600 million annually in medical costs and lost productivity.
  • Public awareness about viral hepatitis is low; too few physicians conduct routine screening and many patients are not benefiting from  improved treatment options.

SOURCE: The Dawn of a New Era: Transforming our Domestic Response to Hepatitis B & C
Lauren Graham, +1-201-463-1057,



We all look forward to hearing about the progress being made nationally on hepatitis B policy and action.


All the best,


Posted: 9/11/2009 - 0 comment(s) [ Comment ]
- 12 trackback(s) [ Trackback ]
Category: Hepatitis B

Get Married, Get Hep B Vaccine

By: Mike Aldax

09/10/09 9:30 AM PDT

Young and happy couples fetching marriage licenses at City Hall are also poised to receive this piece of not-so-fun advice: Don’t forget to receive your Hepatitis B vaccinations!


On Wednesday Mayor Gavin Newsom directed The City and County Clerk to offer additional preventative information about the dangerous disease to couples applying for marriage licenses, including where they can be tested or receive vaccinations.


The Newsom directive says Hepatitis B largely affects The City’s Asian and Pacific Islander population and can cause acute illness and chronic infection including cirrhosis, liver failure and liver cancer. It is easily transmitted from mother-to-child at birth, through unprotected sex or by contaminated blood on toothbrushes, razors or needles, the mayor said.


“An estimated 1 in 10 people of (Asian or Pacific Islander) descent in the Bay Area has an undiagnosed HBV infection compared to 1 in 1000 in the general population,” the mayor said in his executive directive.



Alena's Blog:  One of my collegues recently told me that all new marriage liscences issued at San Francisco City Hall will come with a Know HBV brochure!  Yes, the very same one that the Asian Liver Center created!
Click here to find out more!






Posted: 9/1/2009 - 0 comment(s) [ Comment ]
- 14 trackback(s) [ Trackback ]
Category: Hepatitis B

Hello East Villagers!


It is now September and the summer has come to a close.  My summer interns have finished their projects (but will still be happily involved with the ALC in one form or another).  And we continue to make progress in the fight against hepatitis B and liver cancer.


This morning I found this alarming article on blood tainted with hepatitis B in norther India (see below):


Police arrest 6 for supplying blood tainted with hepatitis B, C to hospitals in northern India


LUCKNOW, INDIA — Police charged six people, including a doctor, for spreading infectious diseases after they allegedly supplied blood contaminated with hepatitis B and C to blood banks in northern India, police said Tuesday.


Police raided blood banks in Lucknow, the capital of Uttar Pradesh state, last month and seized about 60 pouches of blood ready for delivery to hospitals and private clinics, said Vinay Chandra, a senior police official. Each pouch contained a unit, or 3/4 of a pint (350 millilitres), of blood.


The seized samples had a low hemoglobin count and were unfit for human use, superintendent of Police Paresh Pandey said, adding he initially suspected animal blood had been mixed with human blood, but later discovered it was diluted with saline water.


Some of the blood samples tested positive for the hepatitis B and C viruses. Others had been diluted to make three units of blood from a single unit, Chandra said.

The men running the blood supply racket bought blood from professional donors who were paid as little as 25 rupees (50 U.S. cents) a unit. Diluted blood was sold to blood banks for 1,000 to 1,500 rupees (US$20-$30) a unit, Pandey said.


The suspected leader of the scam was a doctor who works at a state-run hospital, while three others were medical technicians employed at pathological laboratories in Lucknow, Chandra said. No details were available about the other two suspects.


Chandra said the men were arrested Sunday on charges of forgery and fraud, spreading infectious diseases, and for violating the Drug and Cosmetics Act. If found guilty, they could be sentenced to life terms in prison.


The fraud became known last month after a woman tested positive for hepatitis B after surgery at a Lucknow clinic. The virus was traced to a blood transfusion during the operation.


Lack of stringent legislation and oversight allows blood banks in India to supply untested blood to hospitals. Last week, media reports said at least four children in Rajasthan state were given blood donated by a man who later tested positive for HIV.



It saddens me to think that may innocent people became infected with hepatitis B through unsafe blood.  This situation clearly points to the necessity for a comprehansive initiative to eliminate hepatitis B transmission, and one that unites all people against hepatitis B and liver cancer.

Posted: 8/12/2009 - 2 comment(s) [ Comment ]
- 8 trackback(s) [ Trackback ]
Category: Hepatitis B

Today I presented on the Jade Ribbon Campaign as a model program for engaging the API population in HBV outreach, education and screening events at the CDC National Conference on Health Communication, Marketing and Media.  (Whew, that was a mouthful!)  I have to say that I was actually a little nervous (and Amy pointed out to me afterwards that I did get a red during my presentation…) but I quickly got over any anxiety when I started speaking about the Jade Ribbon Campaign and expressed my genuine passion for eliminating the silent killer and health disparity, hepatitis B.  The Asian Liver Center has given me many opportunities to grow both personally and professionally.  This presentation to the CDC was another example of an exciting chance to showcase our center’s work and even highlight some of the projects that I have been working on over the past year.  I will be uploading my presentation to the Asian Liver Center’s website when I return from Atlanta so please feel free to check it out!

The CDC Health Marketing Conference has brought together some interesting and insightful speakers, as well as a gung-ho group of twittering tweeters who are all using the conference hashtag #nchcmm09.  This has really been my initial experience to see firsthand how twitter, hashtags and tweets work in the professional setting.  Everyone at the conference has been actively updating their status with interesting facts from speakers and information about their own organizations.  In fact, a tweetup has been scheduled for this evening!  We’ll just see how adventurous I get.  I feel like I may have to study my key twitter vocab words before I go so I don’t make a fool out of myself (and embarrass Amy).  If you want to help me figure out twitter and follow my daily activities at the Asian Liver Center, please follow me @AlenaGroopman.  And who knows, maybe one day when I master this whole twitter thing, my twitter updates will automatically update my eastvillagers status or viceversa...

Posted: 8/11/2009 - 1 comment(s) [ Comment ]
- 18 trackback(s) [ Trackback ]
Category: Hepatitis B

Article from JHSPH News (August 10, 2009):

Women with Hepatitis B Virus (HBV) infection who experience multiple pregnancies have a reduced risk of developing hepatocellular carcinoma, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Researchers evaluated the incidence and risk factors for hepatocellular carcinoma among pregnant women in Taiwan who were screened for HBV infection to prevent transmission of the virus to their infants.  They found that markers of active HBC viral replication were associated with a greater risk of later developing hepatocellular carcinoma than those who had inactive chronic HBV infection. The results are published in the July 15, 2009, issue of the Journal of the National Cancer Institute.

“Previous studies have primarily focused on the relationship between HBV and hepatocellular carcinoma in men, since the rate of hepatocellular carcinoma among men infected with HBV is 2 to 6 times higher than among HBV-infected women. This is the largest published study that examines the association of HBV infection with liver cancer among women,” said Kenrad Nelson, MD, author of the study and professor with the Bloomberg School’s Department of Epidemiology. “Although chronic HBV- infected women are at increased risk of developing hepatocellular carcinoma, we found that the more pregnancies an HBV-infected woman experienced, the lower her risk of developing liver cancer within the next 12 years. Thus leading us to question of whether estrogen and progesterone secretion during pregnancy may have provided some protection from HBV-induced liver cancer. These data help explain why the rates of hepatocellular carcinoma have been significantly higher among men than women in every population that has been studied.”

Nelson, along with colleagues from the Bloomberg School of Public Health, Academia Sinica, the National Taiwan University and the Centers for Disease Control of Taiwan, used data from four population based registries and examined information about pregnant women who were tested for hepatitis B surface antigen and e antigen between 1983 and 2000 and subsequent diagnoses of hepatocellular carcinoma. Researchers found that risk for hepatocellular carcinoma during follow-up was statistically significantly higher among pregnant women with chronic, active or persistent HBC infections or who underwent hepatitis B surface antigen seroclearance, than among HBV-unexposed women. Risk decreased as parity increased, independent of hepatitis B surface antigen status and age. 

Hepatocellular carcinoma is the most common form of liver cancer in adults that stems from the major cell type of the liver, hepatocytes. Hepatocellular carcinoma is not as common in the U.S. as it is in Asia, however it has increased significantly in the U.S. during the past two decades. The recent increased incidence is thought to be related to an increased number of persons with chronic infections with hepatitis C and B viruses. Worldwide, liver cancer is a leading cause of cancer death, especially among men, and is especially prevalent in parts of Asia and Africa where chronic HBV infections that have been acquired at birth or in early childhood are common.

“Although women who were persistently hepatitis B surface antigen-positive had an approximately threefold increase in hepatocellular carcinoma risk compared with those who cleared hepatitis B surface antigen, the loss of hepatitis B surface antigen was still associated with an approximately eightfold increased risk for hepatocellular carcinoma compared with those with no evidence for chronic HBV infection. This suggests that the initiation of cacinogenesis by HBV may proceed independent of the degree of activity of the HBV infection in many persons with chronic HBV infection,” said lead author and Bloomberg School graduate Chyng-Wen Fwu, PhD.

“Hepatitis B Virus Infection and Hepatocellular Carcinoma Among Parous Taiwanese Women: Nationwide Cohort Study” was written by Chyng-Wen Fwu, Yin-Chu Chien, Gregory D. Kirk, Kenrad E. Nelson, San-Lin You, Hsu-Sung Kuo, Manning Feinleib and Chien-Jen Chen.

The research was supported in part by the Department of Health, Executive Yuan, Taiwan.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or

Posted: 8/11/2009 - 3 comment(s) [ Comment ]
- 14 trackback(s) [ Trackback ]
Category: Hepatitis B

It’s been a busy summer at the Asian Liver Center!  I can’t believe that when I make it back to the Bay Area after this brief work trip to the East Coast that some of our wonderful summer interns will already be heading back to school (or taking a well-deserved vacation!)

YLC was incredible!  I am completely amazed by all of the creativity and passion of the high school participants, the enthusiasm and energy of the Jade Ribbon Youth Council, and the dedication and fun-loving spirits of the ALC Summer Interns.  Together with the great leadership of our Outreach Coordinator, Ms. Amy Yu, we have completed our Seventh Annual Youth Leadership Conference on Asian and Pacific Islander Health.  And can you believe that we’re already starting to plan for even more exciting speakers and team challenges next year?  We’ll keep you all updated…

I am currently in Atlanta, Georgia with @missamyyu for the CDC National Conference on Health Communication, Marketing and Media…and whew, it is HOT!  Thank goodness for air conditioning, something you really don’t find yourself ever needing when the fog rolls in over San Francisco.  I am just getting myself ready to present on the Jade Ribbon Campaign tomorrow morning so wish me luck!  Want to follow the conference’s events and updates on twitter?  #nchcmm09

Have a wonderful day!


And yes, for all my zumba peps out there, I will be teaching on Thursday night so be there!

Posted: 7/28/2009 - 2 comment(s) [ Comment ]
- 47 trackback(s) [ Trackback ]
Category: Hepatitis B

One of our ALC Interns has been dedicated to working on Filipino Community Outreach, especially in the Bay Area. 

GMANews.TV is a prominent Filipino news source.  On the front page of their "Pinoy Abroad" section ( is a link to a longer article about hep B (!

Pinoys in California wage battle vs 'silent epidemic'
07/28/2009 | 06:41 PM

As the world focuses its attention on the A(H1N1) pandemic, Filipinos in California are gearing up to fight hepatitis B, a disease which they fear has become a “silent epidemic."

According to the World Health Organization (WHO), hepatitis B is “a potentially life-threatening liver infection caused by the hepatitis B virus."

It said that hepatitis B can cause chronic (long-term) liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer, making it “a major global health problem."

It said the disease can also cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting, and abdominal pain.

People can take several months to a year to recover from the symptoms.

Data from the WHO showed that worldwide, an estimated two billion people have been infected with the hepatitis B virus, and more than 350 million have chronic liver infections.

The Asian Liver Center (ALC) at Stanford University in California said that hepatitis B takes about 700,000 lives each year or about one life every 30 seconds.

But what’s noticeable, said the ALC, is that over 76 percent of people chronically infected with the virus live in Asia.

It noted that in the Philippines alone, an estimated 16 million people are living with chronic Hepatitis B, making liver cancer the second most common cancer among men.

The fight against the “silent epidemic"

To address this issue, several Filipino communities in California will be partnering with ALC in campaigning against the disease.

“Because there is such a large Filipino population in the county, the ALC is working to develop partnerships with local Filipino organizations so that community members are involved and empowered," Nicole Tantoco, a Stanford undergraduate student and intern at the ALC, told GMANews.TV in an e-mail.

Tantoco said they will be pushing for the “San Mateo Hep B Free Campaign" which seeks to test and vaccinate all Asian and Pacific Islander residents in the San Mateo County.

The San Mateo County, which includes cities like Daly City, San Bruno, and South San Francisco, is home to over 75,000 Filipinos – a tenth of the county’s population.

Because of this, she said they are working at “a more grassroots level" to provide free screenings and educational seminars about hepatitis B at local churches.

“This will bring services and information to the traditionally underserved community," she said.

Once the campaign is up and running this fall, Tantoco said they will finally be able to refer parishioners to local hospitals and clinic for free or low-cost services.

In addition, Tantoco said the ALC and the Philippine Department of Health are currently working together to produce informational brochures to distribute in health clinics and barangays. - GMANews.TV



How does hepatitis B spread?
• It is mainly transmitted in three ways: birth, blood, and sex
• It is not spread through air, food, water, breastfeeding, casual contact, kissing, hugging, coughing, sneezing, and sharing eating utensils or drinking glasses.

What do you do about it?
• Get tested for the hepatitis B surface antigen (HBsAg).
• If you are not infected, get vaccinated (3 shots over 6 months).
(The hepatitis B vaccine is 95 percent effective in preventing the infection and its chronic consequences. It is the first vaccine against a major human cancer.)
• If you are infected, see your doctor or a liver specialist for routine monitoring and treatment, if appropriate.
• Help promote awareness in your community.

- taken from the primer on hepatitis B of the Asian Liver Center at Stanford University


Posted: 7/27/2009 - 0 comment(s) [ Comment ]
- 12 trackback(s) [ Trackback ]
Category: Hepatitis B

Another busy week at the Asian Liver Center!

Alison and I just finished our training program with Shandong University School of Nursing.  On Friday at 5pm PST (8am in Shandong Province, China), the week-long nursing school program began with an official opening ceremony.  Dr. Samuel So, ALC Director, presented an overview of HBV and liver cancer and the Jade Ribbon Campaign.  Alison and I then presented on the outreach and education activities of our center and the fundamental basics on how to develop an outreach and education event in their own campus and communities.  We are excited to analyze our evaluation data to see the effectiveness of our education and training program.   This will really help us to reevaluate and revise our Know HBV online training tool that we have been developing over the past month.

We’ve also been getting ready for the Team HBV Conference and organizing the new and improved Team HBV Advisory Board.  Applications should be out by the end of the summer.

Now I am working on my upcoming presentation for the 3rd Annual National Conference on Health Communication, Marketing, and Media 2009 in August.  Wish me luck!

All the best,

Posted: 7/24/2009 - 0 comment(s) [ Comment ]
- 6 trackback(s) [ Trackback ]
Category: Hepatitis B

As our team of Staff, Interns and Volunteers get ready to launch the new Jade Ribbon Campaign reusable bag in partnership with 99 Ranch Market, Alison and I are busy getting ready for our first HBV training session with the Shandong University School of Nursing. At 5:00pm (PST)/ 8:00am (Shandong Province, China), Shandong University will begin its week long hepatitis B outreach and education training session. After the opening ceremony, Dr. Samuel So, Director of the Asian Liver Center will present an overview of the global burden of hepatitis B and liver cancer. Alison and I will then present on the basics of conducting community outreach with examples of outreach and education at the ALC.

Wish us luck!

All the best,


Posted: 7/15/2009 - 0 comment(s) [ Comment ]
- 7 trackback(s) [ Trackback ]
Category: Hepatitis B


We had a great meeting today at the Asian Liver Center with the Team HBV Chapter Advisors.  I am thrilled to see the enthusiasm and commitment to the expansion and redevelopment of Team HBV Collegiate Chapters in the US.  Just a few years ago a few passionate students began the Team HBV Collegiate Chapters, which work in support of the Jade Ribbon Campaign, and since then they have flourished and grown with such leaps and bounds that the ALC and Team HBV Advisors are developing better communication plans and manuals to keep up with its expansion. We will be setting up a new Advisory Board, introducing the new Chapter Manual, holding our first Conference, developing a new and improved Team HBV Website, and even designing a new logo! What excitement! And thanks to our team of Interns at the ALC and the enthusiasm and dedication from our Advisors and other volunteers, we hope to see all of these improvements by the end of the summer.

Ying Ying, our Team HBV ALC Intern, has been making wonderful progress on the Team HBV Conference, which will be held at Stanford University this fall.  There are lots of logistical and planning components to organizing a successful conference and I have been really impressed with how the program has been coming together.  For all of you Team HBV Chapter Presidents out there, you are in for a real treat!

We will not only have our national chapters participate at the first Team HBV Collegiate Conference, but there will also be representatives from the Team HBV chapters in China (sometimes called Sunshine Volunteers).  They will have some interesting stories and projects to share with us all.  The 14 Chinese representatives will have the opportunity to spend a week in the San Francisco Bay Area learning about hepatitis B and liver cancer from Dr. Samuel So and other liver cancer experts, visiting screening and vaccination sites that are part of the SF Hep B Free Campaign in the city, meeting and hearing from our team of wonderful Stanford undergraduate academic year interns, and even having the opportunity to explore San Francisco sights and the Stanford University campus.

Keep up the great work, Team HBV!

All the best,


Posted: 7/14/2009 - 1 comment(s) [ Comment ]
- 8 trackback(s) [ Trackback ]
Category: Hepatitis B

Hello fellow East Villagers!

Did you know that 1 in 10 Asian and Pacific Islanders are chronically infected with hepatitis B?  It sounds like a lot and even more so when you compare that 1 in 1,000 Caucasians.  In fact, 1 out of 4 of those chronically infected will die from liver cancer caused by HBV.  And 2 out of 3 of them didn't even know they were infected.

Does this sound like something that every Asian and Pacific Islander should know?  Are you interested in improving health and saving lives?  Want to spread the word about hepatitis B and liver cancer to your schools, workplaces and communities?  Passionate about being a partner to unite against HBV?

Yes? Then join the Jade Ribbon Campaign to unite against hepatitis B and liver cancer!

There are many ways that you can make a difference in the fight against HBV.  Here are some ways that you can get involved:

- Join our group on East Villagers

- Volunteer with the Asian Liver Center (Volunteer Form)

- Share educational materials with your friends and family (Materials)

- Start a Team HBV Chapter at your school

- Donate to the JRC

And much more!

We hope that you can help us to unite against hepatitis B and liver cancer.

All the best,


Posted: 7/13/2009 - 1 comment(s) [ Comment ]
- 7 trackback(s) [ Trackback ]
Category: Hepatitis B

Good afternoon!

A quick update here from the Asian Liver Center’s global activities and projects. 

Know HBV: Alison and I have been busy working on our new Know HBV online education and training program for nursing students.  If you know of any nursing students or nurses who would be interested in working with us on this project as we grow and expand, please let me know!

Team HBV: I am excited to see pages and pages of blogs from China related to Nancy’s EV Training in Shanghai.  If anyone participating in the PESI programs would like to form a Team HBV college chapter, which works to promote hepatitis B and liver cancer awareness within their college communities and support these Jade Ribbon Campaign, please let me know as well and we’d be happy to help you start a chapter!

Manila Hep B Free: As I mentioned in a previous blog, in May 2009, Dr. So and I visited the Philippines and met with the Metro Manila Health Department.  Dr. So gave a presentation to the hepatitis B perinatal coordinators in Metro Manila, Philippines.  The ALC will be working with the Metro Manila Health Department to develop informational resources for health care providers and pregnant women in Manila.  Tini, one of our tenured ALC Interns, and I have been working on the development of two new brochures, based on the ALC’s Know HBV and Moms-to-be Brochures, that will be Philippines’ focused in Tagalog. 

Shandong Hep B Free: We may have an opportunity to create a new province-wide HBV campaign in Shandong Province, China with the launch of a Shandong Hep B Free Campaign!  Alison and I have been working with a Visiting Scholar at Stanford from the Health Department of Shandong Province who is interested in partnering with the Asian Liver Center in the development of a HBV education and awareness campaign for pregnant women and health care providers in Shandong.  More updates to come shortly!

All the best,

Posted: 7/9/2009 - 2 comment(s) [ Comment ]
- 12 trackback(s) [ Trackback ]
Category: Hepatitis B


Another one of my exciting responsibilities as the Global Health Coordinator is working with the Team HBV Collegiate Chapters in the US and China.

Team HBV is the international coalition of student organizations and volunteers working with the Asian Liver Center to spread awareness about the Jade Ribbon Campaign and hepatitis B and liver cancer to their schools and communities.

Colligate chapters actively engage their campus and local communities in education and outreach activities, awareness events, and promotion of the Jade Ribbon Campaign. 

Collegiate Team HBV has active chapters in the United States at Cornell University, Duke University, the University of California Berkeley, the University of California Davis, Harvard College, Wesleyan University, the University of Pennsylvania, and the University of Illinois Champagne.  We are going to be starting five new Team HBV Chapters at Princeton University, Rice University, University of California Los Angeles, University of Southern California, and Stanford University.

There are many Team HBV Chapters in China, also known as the Sunshine Volunteers, including the chapters at Jiaotong University in China, Central University for Nationalities, and Tsinghua University. 

We have also been working to promote the utilization of East Villagers by all Team HBV Chapter members, which will increase Team HBV’s presence in the online community.

Ying Ying, one of our summer interns, has been working on developing a new Team HBV organizational structure, advisory board and online sharing resource, as well as on the first annual Team HBV Collegiate Conference, which will be held at Stanford University this fall.  We are excited to have all of the chapters come together for the first time to share their best strategies and experiences with each other. 

Students play a vital role in educating and promoting the correct information about hepatitis B prevention and control and working to reduce hepatitis B discrimination either in the school settings and local communities.  Students can be empowered to become active leaders in the prevention and eradication of hepatitis B for themselves and future generations.  Learning the correct information about hepatitis B transmission and passing this information on to others will help to reduce the misunderstandings and subsequent discrimination.

More exciting updating on Team HBV and the Team HBV Conference to come!  If you are interested in starting a chapter at your own school, please let me know!

All the best,


Posted: 7/8/2009 - 0 comment(s) [ Comment ]
- 18 trackback(s) [ Trackback ]
Category: Hepatitis B

Hello all,

It has already been a busy summer at the Asian Liver Center.  We are thrilled to have our new Summer Interns joining us in the fight against hepatitis B and liver cancer and they are working on many exciting projects!

Over the past year as the Global Health Coordinator at the Asian Liver Center, I have been actively working on our new global initiative, the Asia and Pacific Alliance to Eliminate Viral Hepatitis (APAVH), which is a sustainable global coalition to eliminate the transmission of viral hepatitis, and reduce the complications of chronic viral hepatitis through advocacy, education, vaccination and treatment, and by sharing best practices and development of regional and country-specific goals, and to promote the implementation of WHO regional recommendations.  APAVH was spearheaded by the Asian Liver Center, the US Centers for Disease Control and Prevention and the World Health Organization.

APAVH seeks to create a new sustainable regional coalition to prevent new infections and reduce the mortality and morbidity associated with chronic hepatitis B through education, advocacy, vaccination, and treatment.  This regional coalition will be a multi-disciplinary alliance of government agencies, public health practitioners, foundations, policymakers, academia, scientists, patient and advocacy groups, legal professionals, corporations, and the pharmaceutical industry.  By focusing on the 41 countries in the Western Pacific and South- East Asia regions that account for 76% of the global burden of chronic HBV infection, APAVH will spearhead the development and advocate for the adoption of comprehensive policies that will ultimately lead to the global elimination of chronic hepatitis B infection.  APAVH will serve as a model for replication and expansion to form a comprehensive global initiative.

Global health leaders convened in San Francisco on Sunday, November 2, 2008 for the Inaugural APAVH Partners' Meeting, which officially launched this new global initiative.   Following the meeting, the ZeShan Foundation announced its Commitment to Action at the Clinton Global Initiative Meeting in Hong Kong on December 2, 2008.

During our recent visit to Manila, Philippines, Dr. So and I met with the World Health Organization Western Pacific Regional Office, including Regional Director, Dr. Shin Young-soo.  Dr. So gave a presentation to the WHO Western Pacific Regional Office on the global burden of chronic hepatitis B infection and the formation of the Asia and Pacific Alliance to Eliminate Viral Hepatitis (APAVH).  Amy Zhen, Vice Dean and Associate Professor at the Shandong University School of Nursing, and Kathy Fristch, Regional Advisor in Nursing at Western Pacific Regional Office of the World Health Organization, were in the audience.  Ms. Zhen and Ms. Fristch expressed how nursing education in China neglects HBV training, but reflected on how important this tailored training is for advancing patient care, including timely HBV birthdose, three shot completion rates, and perinatal education, among others, and promoting their own health, including blood and injection safety and occupational health risks.

Alison Chang, an MPH student at UCLA and one of our summer interns, and I have been working on a new and exciting online hepatitis B education and training tool in partnership with the Shandong University School of Nursing.  The development of an online training tool specifically designed for nursing students stems from the need for comprehensive instruction regarding hepatitis B in the current nursing school curriculum offered in both the United States and in China.  We hope to eventually expand this online toolkit to be available for different schools and organizations around the world.

During our visit to Manila, Dr. So also gave a presentation to the hepatitis B perinatal coordinators in Metro Manila, Philippines.  The ALC will be working with the Metro Manila Health Department to develop informational resources for health care providers and pregnant women in Manila. 

Dr. So and I also met with Senator Cayetano in May 2009.  The ALC commends Senator Cayetano for her unwavering effort in the fight against hepatitis B and liver cancer.  In 2007 Republic of the Philippines Senator Pia Cayetano introduced Senate Bill 1060 (National Liver Cancer and Hepatitis-B Awareness Month), which designates the month of February of every year as “National Liver Cancer and Hepatitis-B Awareness Month” in order to draw and raise public attention and awareness about liver cancer and Hepatitis-B and the urgency to prevent and control the disease. In 2008, Senator Cayetano introduced Senate Bill 1654 (Mandatory Hepatitis-B Immunization), which is an act requiring mandatory basic immunization services against hepatitis B for infants, amending for the purpose of Presidential Decree No. 996. Senator Cayetano also introduced Senate Bill 2012, the "Mandatory Hepa-B Immunization Act," which expands the national immunization program by making basic immunization services against hepatitis B mandatory for infants within 24 hours from childbirth. The measure has passed the Senate but is still waiting for the House's final version.

More exciting updates on APAVH and our global project to come soon!

All the best,

Posted: 6/30/2009 - 6 comment(s) [ Comment ]
- 10 trackback(s) [ Trackback ]
Category: Hepatitis B

99 Ranch Market recently joined the Jade Ribbon Campaign!  Ranch 99 stores in Northern California will begin selling reusable shopping bags co-branded with the Jade Ribbon Campaign logo to show support for their local communities with all bag donations will be donated to the Jade Ribbon Campaign.  Partnering with the Asian Liver Center at Stanford University, Ranch 99 employees will receive hepatitis B educational materials that they can share with interested customers, including the "Know HBV" brochure developed by the ALC.  Ranch 99 and the Asian Liver Center will be hosting a press conference on Friday, July 24th at the Cupertino 99 Ranch Market with the Miss Asian America 2008 Court.

Posted: 6/30/2009 - 2 comment(s) [ Comment ]
- 7 trackback(s) [ Trackback ]
Category: Hepatitis B

The Clinton Global Initiative - Asia and President Bill Clinton recognized the Asia and Pacific Alliance to Eliminate Viral Hepatitis (APAVH) at the CGI Asia Meeting on December 2, 2008.  To view the Commitment to Action, visit:

Posted: 6/26/2009 - 0 comment(s) [ Comment ]
- 8 trackback(s) [ Trackback ]
Category: Hepatitis B

New Team HBV Chapters, collegiate chapters of the Asian Liver Center, are being started across the country by enthusiastic and motivated college students.  There are currently chapters at Duke, Cornell, Harvard, UC Berkeley, UC Davis, UPenn, and Wesleyan.  New chapters will be launched in the fall of 2009 at USC, UCLA, Rice, Princeton and Stanford.  If you are interested in starting a new Team HBV Chapter at your own school, or getting involved with a current chapter, please let us know!

Posted: 6/23/2009 - 0 comment(s) [ Comment ]
- 10 trackback(s) [ Trackback ]
Category: Hepatitis B

Viral hepatitis represents one of the most neglected pandemics in the world.  Without global attention, 1 in 12 people in the world have become chronically infected with hepatitis B and C, 350 million people have become chronically infected with hepatitis B and 170 million people have become chronically infected with hepatitis C.  HBV causes 60-80% of primary liver cancer and takes a 700,000 to 1 million lives a year.  Liver cancer is the sixth most common newly diagnosed cancer and the third most common cause of cancer mortality in the world, with an estimated 626,000 new cases and 598,000 deaths per year. The nearly equal numbers of incident cases and deaths reflect the high fatality rate of the disease, which has only 3-5% overall survival.  



Nokia's Policy on Hepatitis B Testing in China:

People who have hepatitis B can usually lead normal lives but are often discriminated against in China. In April 2007, a case was brought against Nokia by someone who claimed our operation in Dongguan decided not to hire him after a medical evaluation ordered by the company revealed he had hepatitis B. Nokia investigated the case to establish whether the Dongguan unit was in breach of our global policy. After this incident we reviewed the whole blood testing procedure in China and stopped testing for hepatitis B as part of the pre-employment medical evaluation. Instead, we now offer awareness training that provides accurate information on the disease and its contagiousness to help end discrimination against people with hepatitis B. We also offer voluntary hepatitis B vaccinations to our employees in China.




Over 80% of liver cancer cases worldwide occur in developing parts of the world, particularly Asia, Melanesia, and Africa.  Besides the adverse health impacts of viral hepatitis, millions bear the burden of discrimination.  Discrimination against HBV infected individuals is widespread in schools and the work place.  A survey released in 2007 showed that 77% of multinational companies in China would not hire people chronically infected with hepatitis B, and 70% of over 10,000 people surveyed said chronic HBV and HIV as the major causes of employment discrimination in China.

Posted: 6/23/2009 - 0 comment(s) [ Comment ]
- 293 trackback(s) [ Trackback ]
Category: Hepatitis B

The following entry is written by a Stanford student on April 30, 2009:

‘B’ Aware: It’s National Hep B Awareness Month!

May is National Hepatitis B Awareness Month!  In the spirit of hep B awareness, this blog entry will focus on hepatitis B and the role of marketing, particularly in China.  After working at the Asian Liver Center (a nonprofit that addresses the high incidence of hep B in the Asian Pacific Islander population) for two years, I am now always alert to anything hep B-related, and I noticed the significant shortage of hepatitis B marketing when I went to China fall quarter.  I’m not the only one who’s noticed. When the founder of the Asian Liver Center went to China a couple years ago, he was disappointed to find that there were no advertisements, billboards, or public service announcements to be found on the topic of hepatitis B.  HIV/AIDS, SARS, and avian bird flu posters, on the other hand, were remarkably visible.

In addition to the coverage that is lacking in physical spaces (airports, streets, subways, etc)there is also little news reporting on the subject of hepatitis B.  After a quick search of ‘hepatitis B’ on the major online Chinese newspapers that are in English, I found that the number of results that came up were far fewer than other diseases.  On the China Daily website, ‘hepatitis B’ returned 465 results in which the term was mentioned.  ‘HIV/AIDS’ returned 2322 documents, ‘SARS’ returned 8043 documents, and ‘bird flu’ returned 3701.  Similarly, the People’s Daily English website had 1911 documents for ‘HIV/AIDS’, 415 documents for ‘SARS’, and 3016 documents for ‘bird flu.’.  Granted, HIV/AIDS, SARS, etc are all serious public health crises that warrant public attention.  However, my experience thus far has definitely made me feel that there is a much heavier emphasis on HIV/AIDS than on hepatitis B despite the fact that more people in China are affected by the latter in China.

Television programming plays another important role for public health advocates.  Television ads addressing the public about a public health crisis is very popular nowadays, and celebrity endorsement of the cause is also commonly used.  A few years back, the United Nations Development Program and the Beijing-based Epin Media company created a program to increase awareness about HIV/AIDS and fight discrimination against HIV carriers and AIDS patients.  The public service announcement included Yao Ming and Magic Johnson, “calling on the public not to fear or discriminate against those with HIV/AIDS.”   It was aired in Beijing’s buses, taxis, and local TV channels.  A search for similar TV ads related to hepatitis B did not return any results, and according to the ALC, there are currently no hepatitis B public service announcements running in China.   In the analysis of hepatitis B and Chinese media, the absence of media products speaks just as loudly of the level of public awareness and the country’s attitude toward the issue.

In order to understand why hepatitis B should be prioritized higher in China, we must look at the severity of the disease’s effects on the population.  As of 2002, about 170 million Chinese are infected with the hepatitis B virus, which makes up 13% of the entire Chinese population.  The hepatitis B virus (HBV) can cause liver damage, liver cirrhosis, and liver cancer.  Liver cancer in association with the high HBV infection rate ranks second among the total cancer mortality in China, and about half a million mainland Chinese die each year from HBV related illnesses.   In comparison, HIV affects .05% of the Chinese population with 650,000 people living with the virus.   A hot topic in past years, avian bird flu, has had significant media coverage in China and the United States.  China has had a total of 30 cases of avian bird flu, and 20 deaths.   Given the above media coverage analysis, these numbers point to a significant problem in the public health of China today.  Hepatitis B, as a major contributor to cancer deaths, is being neglected in the media, thus contributing to the problem of public ignorance of the disease.  This ignorance creates significant challenges for hepatitis B patients, who are often discriminated in employment and education.
Though hepatitis B awareness has nowhere near reached the same celebrity status, it has a lot to learn and a lot to gain from the precedents set by the HIV/AIDS movement.  Many of the tactics that the HIV/AIDS movement used were very successful, including their use of big name endorsement and corporate support.  The universality of the disease became the resounding message.  Anybody could be affected, so everybody is responsible.  Hepatitis B in China definitely carries the same notion- anybody and everybody is at risk, so a collective effort should be made to fight the disease.  What has supported that statement is the emergence of celebrities who have come forward to acknowledge their hepatitis B status.  Television actor Cheng Lei discovered eight years ago that he was positive for the virus and has since then worked to lessen discrimination linked to hepatitis B.  Celebrity endorsement is one step in bringing positive popular attention to the disease.  The more attention there is, the more the media will respond to stories related to hepatitis B, and the more the government will take notice and actively combat the problem.   The HIV/AIDS movement has opened a lot of doors for other public health campaigns in China.  Just ten years ago, all condom advertisements were banned from television programming, but condom ads aimed at AIDS-prevention are now allowed.  There is now a much more open attitude towards discussing infectious diseases than there was before, so the hepatitis B campaigns are well-situated to make a big impact through the media.  Let’s hope China and other relevant countries take advantage of this opportunity to positively change the course of hepatitis B.

In other news, LIVERight 5k run/walk is this Saturday, May 2.  Hosted, by the Asian Liver Center, LIVERight is the first event of its kind in the US that celebrates the fight against hepatitis B and liver cancer!  Find out more at


Asian Liver Center at Stanford University:

Sun, Zongtang, et al. “Prevention and Control of Hepatitis B in China.” Journal of Medical Virology 67 (2002): 447-50.

UNAIDS, and WHO. “New HIV data show growing AIDS epidemic in China.” WHO Media Centre. 25 Jan. 2006. World Health Organization. 3 Dec. 2008 <>.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO.” WHO Media Centre. 10 Sept. 2008. World Health Organization. 3 Dec. 2008 <http://>