If Tony Ngo had not tried to donate blood five years ago, he would not be alive today. His blood was rejected because he was infected with hepatitis B, a silent disease that can sometimes ravage the liver.

Ngo, 42 at the time, had no idea how or when he was infected. After all, he felt well and seemed in good health.

But the hepatitis virus had already begun its quiet rampage in his body. In the next two years, the virus decimated Ngo’s liver cells, leaving in its wake a network of scars that blocked the vital organ from working properly.

“I thought, `I’m going to die,’” Ngo said. And the father of two from Fountain Valley nearly did.

Stories like Ngo’s are heard and told too often in Orange County, Calif.’s Vietnamese community. People find out they have hepatitis B only when it has already attacked the liver or when they are diagnosed with liver cancer.

Health advocates are trying to change this with awareness and prevention efforts.

A WIDESPREAD DISEASE

Hepatitis B is an epidemic in the Vietnamese-American community, said Leonard Tran, executive director of the Vietnamese American Cancer Foundation in Fountain Valley, Calif. Still, studies show that one in eight Vietnamese-Americans has chronic hepatitis B. It’s a disease that can damage the cells of the liver and form scars that disable the organ. It is not a temporary illness like hepatitis A. And it’s more likely to be transmitted sexually than hepatitis C.

But most Vietnamese-Americans are unaware that they are at high risk.

Hepatitis B is more prevalent in adults than in children for several reasons: The virus is transmitted through sex. Children born in the United States starting in 1990 usually received the hepatitis B vaccine. Native Vietnamese may not have received the vaccine there.

Mothers may pass the virus to their infants during pregnancy, Tran said.

SCREENING IS IMPORTANT

Many health-care providers do not know of this group’s high risk and therefore do not routinely screen Vietnamese patients for the hepatitis B virus, said Dr. Thai-Van Nguyen, a hepatologist and chairwoman of a hepatitis and liver- cancer awareness campaign in Orange County.

Screening can lead to early detection and enable patients to receive treatments that may prevent or mitigate liver damage and death. And screening, which involves blood tests, can help prevent hepatitis B transmission. Infants born to mothers infected with hepatitis B can be vaccinated shortly after birth; people who learn that they are infected can take the necessary precautions, including using protection during sex.

By the time they find out they have hepatitis B, some might have liver cancer, which is the second leading cause of cancer deaths among Vietnamese-American men, Nguyen said. To be clear, not everyone who develops hepatitis becomes a lifetime carrier and not everyone develops liver damage and cancer. Researchers do not know why some develop immunity.

And even when doctors order liver health tests, they won’t find hepatitis B because tests are not designed to look for it.

“Hepatitis B is a silent killer,” Nguyen said. Patients may feel fine for many years before the virus starts destroying the liver. So patients may delay treatment because they feel no symptoms.

Others may avoid getting tested for hepatitis B because of misconceptions surrounding the disease, Nguyen said. They mistakenly believe that hepatitis B can be spread by kissing or sharing meals. And there’s stigma. Some people are afraid to tell others and seek help, believing their loved ones, friends and neighbors will shun them.

A STORY OF SURVIVAL

It’s this type of thinking that Ngo is hoping to dispel. He tells people to get tested. He tells them to get immediate treatment if they are infected.

“I talk about it to anyone and everyone who will listen in the Vietnamese community,” he said. He believes it’s the least he can do after being given another chance at life.

Two years ago, Tony Ngo thought he was going to lose the battle against hepatitis B. Fluid was building up in his stomach, a complication of liver damage. He was in and out of the hospital as doctors worked to drain the fluid from his body and prevent more liver damage. He made the liver-transplant list, but the right match was tough to find.

Ngo looked at other options. He asked family members and friends if they would donate part of their liver for a risky procedure in which a portion of a healthy liver is transplanted with hopes it will regenerate to become a whole organ.

None of Ngo’s nine siblings was an eligible donor. All had hepatitis B.

As he became sicker, Ngo and his family felt more desperate. One evening, Ngo sat in bed as Jimmy, the older of his two sons, approached him.

“Daddy, wait until I’m 18 so I can give you my liver,” said Jimmy, who was 14 at the time. Ngo embraced his son and together, they wept quietly.

Ngo prepared for his death. He taught his wife how to check the oil in their cars and make minor repairs around the house. He asked her to have his body cremated and his ashes scattered in the Pacific Ocean.

“I came to America on the water,” he said, the images of his 1982 exodus from Saigon by boat still clear in his mind. So he deemed it fitting to leave America by water, as well.

In May 2003, three years before Jimmy would turn 18, Ngo’s doctor, Dr. Tram Tran at Cedars-Sinai Medical Center in Los Angeles, called him with news that changed everything: A liver match had been found.

More than a year later, Ngo grins as he lifts his shirt to show off a scar dividing his abdomen into three sections. The scar resembles a Mercedes-Benz logo lined with tiny rays.

Underneath the skin and layers of flesh, a new liver works hard. Ngo knows it is a generous gift of life, even if he does not know from where it came. Lifelong medication will work to prevent rejection of the liver and to keep hepatitis B from damaging the organ. Being on the regimen does not faze him.

Ngo has a fresh purpose in life: To educate others about hepatitis B and liver cancer. He hands out fliers on the diseases at festivals and other events in the Vietnamese- American community. He travels to Cedars-Sinai to soothe patients and hold their hand when they are too fearful to undergo a liver transplant.

As for the final journey by ocean, Ngo has no plans to board that boat any time Soon.

HEPATITIS B AFFECTS THE LIVER

The liver is a triangle-shaped organ essential to life. The hepatitis B virus (HBV) can damage the liver, causing it to shut down or develop cancer.

Liver’s functions:

Stores vitamins

Removes waste

Controls cholesterol

Makes clotting factors to stop excessive bleeding

Releases bile to digest food

Breaks down fats, other substances

Weight: 3 pounds

Size: About the size of a football; the body’s largest organ

Hepatitis B effect:

The virus enters the body and multiplies rapidly to attack liver cells.

The hepatitis B virus destroys liver cells. Afterward, scar tissue grows in the liver, blocking blood flow through the organ and preventing it from functioning properly.

SCREENING TESTS TO DETECT HEPATITIS B

Antibody core antigen (anti-HBc):

Results can be ambiguous.

If you test positive for hepatitis B core antibodies, you may have a chronic infection or you also may be recovering from an acute infection or have a slight immunity to HBV that can’t be detected.

Results of this test are used with the other tests.

Antibody to surface antigen (anti-HBs):

A positive result means you have antibodies to HBV either due to a prior HBV infection from which you’ve recovered or because you may already have been vaccinated.

You can’t infect others or become infected.

Surface antigen (HBsAg):

Hepatitis B surface antigen is the outer surface of the virus.

Testing positive means you can pass the virus to others.

A negative test means you’re not currently infected.

Source: Hepatitis B Foundation