African Americans are infected with hepatitis at disproportionately high rates, and prevention efforts are urgently needed to reverse this trend, the National Medical Association (NMA) announced October 23.

"Hepatitis has reached epidemic proportions in the African American community," said Lucille C. Norville Perez, M.D., president of the NMA, which represents over 25,000 African American physicians and patients.

In a report entitled, Promoting Prevention of Viral Hepatitis in the African American Community, the NMA analyzed the findings of 46 published medical studies that addressed the relationship between ethnicity and hepatitis prevention, infection and treatment. The research revealed some daunting statistics.

For example, African American adolescents contract hepatitis B, a highly infectious form of the disease, at around four times the rate of Caucasian adolescents, according to the Centers for Disease Control and Prevention (CDC). And African American adults have the highest rates of chronic hepatitis C infection in the United States, compared to adults of other ethnicities. Once infected, 86 percent of African Americans go on to develop a chronic form of hepatitis C, compared to 68 percent of Caucasians, according to the report.

When it comes to eliminating hepatitis, prevention is key, said Dr. Perez, and the key to prevention is vaccination. "We have vaccines that protect against hepatitis A and B, so we can eliminate these diseases," she said. The Food and Drug Administration recently approved a combination vaccine, TwinRx, which protects against both forms of the disease. Separate vaccines are also available.

The NMA issued a broad range of recommendations for physicians, patients, educators and medical researchers, including the following:

• Every child, adolescent and young adult should be vaccinated against hepatitis, not just at-risk groups like men who have sex with men (MSM) and IV drug users.
   
• All patients should have access to affordable, quality health care, so they can receive appropriate hepatitis prevention, screening and treatment services.
   
• Colleges should require students to be vaccinated prior to admission, because the college environment, which includes sexual exploration, contact sports and fast food consumption, puts students at greater risk for infection, according to the NMA.
   
• Physicians should better educate their patients about hepatitis and the vaccines used to prevent infection.
   
• Medical researchers should include considerably more African American physicians and patients in hepatitis studies. "We need to be involved," said Dr. Perez.
   
• AIDS service organizations and the medical community should collaborate to raise awareness of hepatitis.

Hepatitis is a viral infection of the liver. Hepatitis A is spread through the oral-fecal route, such as rimming, and through contaminated food; hepatitis B is spread through bodily fluids and blood, and is sexually transmittable; and hepatitis C, which often becomes a chronic condition, is spread through blood.

Updated: Wednesday, 24 October 2001