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Patient perspective in HBV care
My HBV Journey as a Vietnamese Immigrant and US-Based Physician

Released: April 27, 2026

Trieu Pham
Trieu Pham, MD
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Listen as Trieu Pham, MD, describes how healthcare professionals across specialties can improve hepatitis B virus (HBV) care for Asian American patients through better patient education, testing, treatment, and prevention. Topics include:

  • Key barriers to HBV care for Asian American patients
  • Healthcare professional recognition of HBV

This transcript was automatically generated from the audio recording and may contain inaccuracies, including errors or typographical mistakes.

Dr. Pham: Two key points about HBV virus are that it is silent, insidious. Most people with chronic hepatitis B virus are asymptomatic, and about 50-70% of people do not know that they have an acute HBV infection. Blood and function – and liver function tests may look entirely normal for years. That is because liver function tests may be elevated due to an acute HBV infection. But after a while, when the cells are damaged so much, they actually normalize. Doctors usually do not see much except a slight elevation due to inflammation, highlighting why HBV is a very sneaky and dangerous virus.

I find this is particularly common in my community, immigrants from Vietnam. For those who acquire HBV at a younger age, there are generally no apparent symptoms. It will continue to progress as they age until the liver is severely compromised and cirrhosis occurs, leading to complications and clearer symptoms.

I first found out that I had hepatitis B virus infection in 1997, shortly after I immigrated from Vietnam to the United States, and I now have multiple family members with HBV. This was a common issue for Vietnamese people who were born before 1997 because the vaccine was not available yet.

For immigrants in particular, the cultural barrier years ago was significant. People likely did not talk openly about HBV out of worry that others would look down on them. Fortunately, that has probably become less of a problem, in my opinion. Nevertheless, many Vietnamese people with HBV who are around my age, people in their 50s or 60s, now have cirrhosis and/or liver cancer because they have had an infection for so long, and many do not understand the seriousness of it. This is why people, especially immigrants from areas like Vietnam, must be aware and get tested for HBV. Those with confirmed HBV infection should be treated right away.

To me, it is important for doctors in primary care or other providers who deal with treating a chronic, happy patient to become familiar with HBV. The biggest mistake that healthcare providers can make is overlook it.

The first clinical aspect is access to care, especially for immigrants. Of course, it is ideal for people to have health insurance when accessing healthcare in the U.S., but even if you have good coverage, you also must see the right doctor to receive help. While screening for HBV involves a simple test, people must know what doctor to see next when their condition becomes severe. That linkage to care is important because people must see the appropriate specialist for their chronic HBV.

My surgeon – my transplant surgeon has said that he sees access as a problem. The people she treats are usually at a late stage of disease, suggesting they might have developed liver cancer because they could not access healthcare and see the right doctor in time. That is a major concern.

Hepatitis B virus is a sneaky disease, but in my community, with the right focus and awareness, we can overcome these barriers.

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