# Sex with Asian People in North America & Hepatitis B **URL:** \ **Category:** Factual Questions\ **Created:** [May 16, 2011, 2:17am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051 "2011-05-16T02:17:00Z")\ **Posts on this page:** 12\ **Page:** 1
**Author:** ![andrea\_green](https://avatars.discourse-cdn.com/v4/letter/a/ecccb3/32.png) [@andrea\_green](https://boards.straightdope.com/u/andrea_green)\ **Post date:** [May 16, 2011, 2:17am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/1 "2011-05-16T02:17:00Z")
In a recent conversation I had with a medical professional, I was informed that there is a significantly elevated risk of contracting (from unprotected sex) Hepatitis B from people in Asian communities than other ethnic groups in North America. The doctor who told me this was unable to narrow it down much more than Asian people but suggested possibly this statistic may be only applicable to Chinese communities. So is any of this true? If so, is there a widely-accepted reason for this? ---
**Author:** ![code\_grey](https://avatars.discourse-cdn.com/v4/letter/c/f4b2a3/32.png) [@code\_grey](https://boards.straightdope.com/u/code_grey)\ **Post date:** [May 16, 2011, 2:34am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/2 "2011-05-16T02:34:11Z")
my WAG would be as follows. Hepatitis B spreads via contaminated needles. Chinese health care system has already been known to infect poor people with HIV both through blood donations and through reusable syringes. So maybe it also infects some poor people with Hepatitis B. And maybe some of the people so infected get smuggled to America to become low paid laborers. Then they can infect prostitutes in their community and spread it further. Now if in reality my WAG is wrong and this shit turned up among married middle class people rather than among the lower class illegals with disordered sex life, that would be a much more exciting and weird thing. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 16, 2011, 3:38am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/3 "2011-05-16T03:38:29Z")
Something like 12% Asian women of childbearing age carry Hepatitis B, the exact number different for different countries. Taiwan and Korea are much lower as a result of immunization campaigns - down to something like 1%. A similar program in China will likely show similar results in years to come. Generally they caught it from their mothers at birth or in early childhood. Early infection tends not to cause severe disease, often it is even asymptomatic, but does tend to go into a chronic active or a carrier state fairly often. And those girls grow up to be women who give birth to kids who they in turn infect at birth. Chronic infection is associated with a greater risk of liver cancer (across the world the majority of liver cancer is associated with chronic Hepatitis B infection). Acute infection in adulthood with more fulminant hepatitis. According to [this FAQ](http://liver.stanford.edu/Education/faq.html) almost 9% of foreign born Asia and Pacific Islander (API) women in America have chronic Hepatitis B infection, compared to 1.4% among US born API and 0.13% among Caucasian Americans. ---
**Author:** ![TNWPsycho](https://avatars.discourse-cdn.com/v4/letter/t/47e85d/32.png) [@TNWPsycho](https://boards.straightdope.com/u/TNWPsycho)\ **Post date:** [May 16, 2011, 4:36am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/4 "2011-05-16T04:36:09Z")
My Hmong girlfriend does not have Hepatitis B but her mother, and two older sisters do. Her family was born in a very impoverished part of Thailand when the Hmongs were being prosecuted. That may have caused the infections? ---
**Author:** ![si\_blakely](https://avatars.discourse-cdn.com/v4/letter/s/d9b06d/32.png) [@si\_blakely](https://boards.straightdope.com/u/si_blakely)\ **Post date:** [May 16, 2011, 7:46am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/5 "2011-05-16T07:46:48Z")
> [@TNWPsycho](#): > > My Hmong girlfriend does not have Hepatitis B but her mother, and two older sisters do. > > Her family was born in a very impoverished part of Thailand when the Hmongs were being prosecuted. That may have caused the infections? As **DSeid** says, it was almost certainly maternal transmission. There are similarly high rates of chronic HepB in Polynesian populations in NZ, and somewhere along the line, I contracted the disease. It certainly wasn’t from my mother (she was never exposed to HepB) and I have never had a blood transfusion or other risky behaviour, so the source of my infection is unclear. Because HepB is so infectious from blood, it is considered likely that playground transmission from grazes/cuts etc is a [source of transmission](http://www.hepfoundation.org.nz/hepatitis-b-virus). By the time I was 17 (early 80s) I was identified as a sufferer during a regional mass screening program and have been monitored ever since. Due to increasing damage from the virus to my liver, I started antiviral treatment 18 months ago, and treatment is going well (HBV DNA currently undectectable, but no seroconversion). The screening/vaccination program in NZ continues, particularly with vaccination of all children and screening of pregnant mothers to prevent maternal transmission. Liver Cancer and Cirrhosis are the major risks associated with chronic HepB, particularly when alcohol consumption adds additional pressure on the liver. In some areas of China, liver cancer rates are very high due to the combination of chronic HepB, high alcohol consumption, and consumption of nuts/grains contaminated with [aflatoxins](http://en.wikipedia.org/wiki/Aflatoxins). Si ---
**Author:** ![TNWPsycho](https://avatars.discourse-cdn.com/v4/letter/t/47e85d/32.png) [@TNWPsycho](https://boards.straightdope.com/u/TNWPsycho)\ **Post date:** [May 16, 2011, 7:01pm UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/6 "2011-05-16T19:01:51Z")
> [@si\_blakely](#): > > As **DSeid** > > Liver Cancer and Cirrhosis are the major risks associated with chronic HepB, particularly when alcohol consumption adds additional pressure on the liver. In some areas of China, liver cancer rates are very high due to the combination of chronic HepB, high alcohol consumption, and consumption of nuts/grains contaminated with [aflatoxins](http://en.wikipedia.org/wiki/Aflatoxins). > > Si Just curious, is your case typical? From my research it seems chronic HepB is kind of rare. A lot of people can live their whole lives with no repercussions. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 16, 2011, 7:39pm UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/7 "2011-05-16T19:39:47Z")
That experience is not rare at all, just under-recognized. You may be interested in this report (warning pdf) by the US Department of Health and Human Services: [“Combating the Silent Epidemic of Viral Hepatitis”](http://www.hhs.gov/ash/initiatives/hepatitis/actionplan_viralhepatitis2011.pdf). > [@](#): > > Although it is a leading infectious cause of death and claims the lives of 12,000–15,000 Americans each year, viral hepatitis remains virtually unknown to the general public, at-risk populations, and policymakers (1–3); even health-care providers lack knowledge and awareness about these infections (1). As a consequence, most of the 3.5–5.3 million Americans living with viral hepatitis do not know that they are infected, placing them at greater risk for severe, even fatal, complications from the disease and increasing the likelihood that they will spread the virus to others. Viral hepatitis is a major cause of liver cirrhosis and liver cancer in the United States (1–4); persons living with viral hepatitis are at increased risk for both conditions. … > > … An estimated 3.5–5.3 million persons are living with viral hepatitis in the United States, and millions more are at risk for infection. Because viral hepatitis can persist for decades without symptoms, 65%–75% of infected Americans remain unaware of their infection status and are not receiving care and treatment (1). Most morbidity and mortality result from the chronic form of viral hepatitis caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. … Globally, an estimated 78% of primary liver cancer and 57% of liver cirrhosis cases are caused by viral hepatitis (36), and 1 million deaths from viral hepatitis occur each year (35,36). … Mother-to-child transmission of HBV is concerning, because 90% of HBV infected newborns remain infected throughout their lives. Of these infants, one in four dies from complications of viral hepatitis in later life (42,43). … ---
**Author:** ![si\_blakely](https://avatars.discourse-cdn.com/v4/letter/s/d9b06d/32.png) [@si\_blakely](https://boards.straightdope.com/u/si_blakely)\ **Post date:** [May 16, 2011, 10:08pm UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/8 "2011-05-16T22:08:19Z")
> [@TNWPsycho](#): > > Just curious, is your case typical? From my research it seems chronic HepB is kind of rare. A lot of people can live their whole lives with no repercussions. It 's only typical because of a concerted effort to profile the distribution of and (eventually) screen for HepB in NZ. The real problem with chronic HepB (and HepC, another chronic viral hepatitis) is that it is asymptomatic until you get really ill - you wake up one day yellow or vomiting blood, and by then, probably only a liver transplant can save you. In the US, with a much lower percentage of infections, the likelihood of detection (and thus annual monitoring similar to mine) is probably much lower. Si ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [May 16, 2011, 11:25pm UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/9 "2011-05-16T23:25:46Z")
The polite way of describing Hepatitis B in the developing world is “endemic”-meaning really, really common. 2 billion people worldwide have been infected, most clear it, some become chronic carriers, a few die from the initial infection. Chronic carriers may develop liver cancer or cirrhosis over time, and continue to remain infectious. Just in case you missed it the first time- **30% of the world population has been infected with Hepatitis B** , often at birth or in early childhood. Clean living isn’t the fix- vaccination is. > **[Hepatitis B](https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-b)** > > Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [May 17, 2011, 1:38am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/10 "2011-05-17T01:38:38Z")
> [@TNWPsycho](#): > > My Hmong girlfriend does not have Hepatitis B but her mother, and two older sisters do. > > Her family was born in a very impoverished part of Thailand when the Hmongs were being prosecuted. That may have caused the infections? I think you mean “persecuted,” as there have been no widespread court actions against the Hmong as a group. There has been and continues to be the standard day-to-day racism against the Hmong that you see from the Thais against any hilltribe. For example, I once saw a bus conductor give a Hmong a swift kick in the ass because he was sitting in the stairwell of the bus, in the way of passengers embarking and disembarking. He was sitting there because he was not allowed to sit on an actual seat. But this all pales in comparison with the Lao government’s treatment of the Hmong; there, they’ve suffered large-scale persecutions as a group because they had worked for the CIA during the Secret War. The Hmong refugees who crossed into Laos were rounded up and held in camps for decades; despite UNHCR requests not to do so, Thailand finally started forcefully shipping them back against their will these past couple of years. But hepatitis B. It is endemic over here, but I’m not sure how much of that has to do with it being Asia, as I believe it’s found in Latin America and Africa too? I was vaccinated free of charge by the state of Hawaii back when I lived there, due to a job I was doing. But that was because I was having to deal with junkies, not Asians. I understand if you pay for that on your own it’s pretty darned expensive. There is indeed an elevated risk of liver cancer from hep B. ---
**Author:** ![Monty](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/monty/32/47_2.png) [@Monty](https://boards.straightdope.com/u/Monty)\ **Post date:** [May 17, 2011, 3:44am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/11 "2011-05-17T03:44:12Z")
I’ve heard that Hep B is endemic in this part of the world because of everyone dipping their chopsticks into shared bowls. ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [May 17, 2011, 3:45am UTC](https://boards.straightdope.com/t/sex-with-asian-people-in-north-america-hepatitis-b/582051/12 "2011-05-17T03:45:31Z")
> [@Monty](#): > > I’ve heard that Hep B is endemic in this part of the world because of everyone dipping their chopsticks into shared bowls. I’ve heard of TB and similar diseases being spread because of that. But hep B is pretty much transmitted the same way as HIV, through unprotected sex and shared needles.