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

Released: April 16, 2026

Trieu Pham
Trieu Pham, MD
Activity Information

Activity

Progress
1
Course Completed
Continue
Key Takeaways
  • Most people with HBV infection are asymptomatic and receive a diagnosis in late-stage disease.
  • Vietnamese people are a vulnerable population owing to significant infection rates at birth, before the HBV vaccine became available.

Two key points about the hepatitis B virus (HBV) are that it is silent and insidious. Most people with chronic HBV infection are asymptomatic, and approximately 50% to 70% of people do not know that they have an acute HBV infection. Blood and liver function tests might look entirely normal for years. That is because liver function tests may be elevated because of 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 caused by 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 HBV 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. 

Healthcare Professional Recognition of HBV
To me, it is important for healthcare professionals (HCP) in primary care, or other HCPs who treat patients with chronic HBV infection, to become familiar with HBV. The biggest mistake that HCPs can make is to overlook it. 

The first critical aspect is access to care, especially for immigrants. Of course, it is ideal for people to have health insurance when accessing healthcare in the United States. But even if you have good coverage, you also must see the right doctor to receive help. Although 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 infection.

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

HBV is a sneaky disease. But in my community, with the right focus and awareness, we can overcome these barriers.

Your Thoughts
How comfortable are you with testing for and treating HBV in your practice? You can get involved in the conversation by posting a comment below.

Continue