Silent Killer: Hepatitis B

With a professional kickboxing career spanning more than ten years, five championship belts, his stunning fights broadcasted on ESPN and Youtube, Yia “the Bull” Mua boldly established himself as the first and most recognized Hmong figure to break into mainstream martial arts. To the eyes of fans and friends in our community, the world-class fighter seemed invulnerable, especially in the glossy photos and posters depicting his solid physique adorned with championship belts. But in the prime of his life, while training to compete in the new world of Mixed Martial Arts (MMA) and shooting in the movie Finding Hope Now, Yia Mua suddenly fell ill. For seven excruciating months he fought the final and biggest battle of his life in hospital rooms and chemo/radiation therapy sessions, his athletic physicality quickly deteriorating from liver cancer. At the age of 34, Mua passed away on January 15, 2010, leaving behind an unfinished legacy. But Mua’s case is only the tip of the iceberg – one example of the unspoken prevalence of a very urgent and important health crisis in our community today. In the wake of this tragedy, the Hmong Health Collaborative (HHC) has worked diligently to shed light on this silent killer…

Hepatitis B
Hepatitis B is a liver disease caused by HBV in the blood. The virus spreads through blood contact, often from an infected mother to her child during birth. Although hepatitis B symptoms vary from loss of appetite, nausea, vomiting, body aches, mild fever, dark urine, and jaundice, most people who are infected with HBV show no symptoms at all while acting as carriers of the virus. They can infect others, and they may develop liver diseases such as cirrhosis (scarring) and liver cancer, which can lead to death, as in Mua’s case.

According to the Asian Liver Center at Stanford University, 370 million people worldwide have chronic (life – long) hepatitis B infection compared with 33 million living with HIV. Without appropriate treatment or monitoring, 1 in 4 infected persons will die of liver cancer, cirrhosis or liver failure. Chronic hepatitis B takes a total of 700,000 lives each year. About two-thirds who carry HBV do not know they have it. Many, like Mua, do not discover it until they become seriously ill from cirrhosis or liver cancer.

Our community is at great risk. It is a frightening fact that hepatitis B, prevalent among Asian populations, is a silent epidemic among the 30,000 Hmong in Fresno County. According to studies, 1 of 6 of us could be infected. The Asian Liver Center at Stanford and a study conducted by Dr. Muhammad Y. Sheikh at the University of California at San Francisco-Fresno Medical Education Program state that as much as 16.7% of the Hmong in Fresno live with the disease, which is a higher infection rate than among foreign-born Asians as a whole. Experts predict that the disease could be more widespread in our community than what studies suggest.

Vaccination & Prevention
Despite the staggering percentage of our people who may be living with the infection, many of us go untested. A great number are unaware that the disease could be fatal and that they can receive vaccination to protect themselves. The first thing to do is to get checked. If you are not infected, you can get preventative vaccination. For those who test positive for HBV, they should have an ultrasound test of the liver, a process that should be repeated every 6 to 12 months. A blood test also needs to be done every 6 months to screen for liver cancer. It is critical that the blood and liver is monitored. If needed, medications can be used to suppress HBV from damaging the liver. Although there is no complete cure for those who are infected with HBV, treatment is available.

Since HBV spreads through blood contact, your child can be infected if you are an HBV carrier. Newborns that become infected have a 90% chance of developing chronic hepatitis B. Since 1991, U.S. national guidelines have recommended that all newborns be vaccinated against HBV. You can protect your own child against hepatitis B for life if given the three required shots: (1) dose of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) at birth, (2) second dose of hepatitis B vaccine at 1-2 months, (3) third dose of hepatitis B vaccine at 6 months.

Liver cancer is the most common cancer in our community. As a Hmong person, it is very important to get tested for HBV. “Too many patients receive medical care when it’s too late,” says Dr. Muhammad Y. Sheikh. If liver cancer is caught early, “We can actually save a life.”

Get checked today. Get vaccinated. Get treated. It’s the only way to stop this silent killer.

Hmong Health Collaborative
HHC is a partnership of Hmong-serving nonprofit agencies from Central to Northern California who organize, research, and work cooperatively to advocate and create systems change in the health and well-being of the Hmong communities in California. With major funding from The California Endowment, HHC has provided direct assistance to Hmong healthcare consumers, conducted research on healthcare needs and options for Hmong families, and successfully advocated for policies that increase culturally and linguistically competent care for the Hmong. One of the current goals of HHC is to shed awareness on the unspoken threat of hepatitis B on the Hmong community and the possibility of prevention by educating its members about the damaging effects of HBV and the availability of vaccination and treatment. To learn more about HHC, please visit