Family facing Hep B savors moments together

By Martha Ross

The Mercury News

BERKELEY, Calif.

It’s almost dinner time, and Alan Wang and his family are busy in the kitchen of their Berkeley hills home fixing shrimp tacos.

While his wife, Jill Cunningham, sautes red peppers, Wang, a TV news reporter, shows his second son, Ryan, 12, how to get the pit out of an avocado. Five-year-old Carly bounds in, talking about their pet chickens, then seeing if their dog Brahms will do tricks.

The couple don’t take this cozy weekday routine for granted. That’s because their family is affected by one of the world’s most prevalent but neglected, misunderstood and stigmatized global pandemics. Wang has hepatitis B, a viral infection that attacks the liver.

He is among 240 million people worldwide who are chronically infected. About 780,000 people a year die of complications, including cirrhosis and liver cancers, 80 percent of which are caused by the virus. To avoid being one of those statistics, he takes a daily pill to suppress the virus and submits to biannual blood and ultrasound tests.

One in 10 Asian-Americans is chronically infected.

There are several reasons hepatitis B is known as “the silent killer.” First, it often doesn’t produce symptoms in people for decades, so people aren’t aware they’ve got it until it has progressed significantly, says Huy Trinh, a San Jose hepatologist, or liver specialist. In the meantime, the disease progresses, and people transmit it unwittingly.

Shame and stigma also surround the disease. Among people of Asian descent, it’s often associated with drug use and risky behavior, says Wang, adding: “Asian people don’t like to talk about death.”

Among populations where hepatitis B is endemic, it’s most commonly spread from mother to child at birth, usually without the mother’s knowledge. That was the case with both Wang and A.J. Jabonero.

Jabonero, a gregarious radiology technician with three young children, died in March 2015, three months after being diagnosed with liver cancer.

For both Jabonero and Wang, a flare-up of jaundice alerted them and their families that they had the virus. Jabonero was 2 or 3 when he came down with a serious, flulike illness. Testing revealed that he, his parents and older sister were infected. This was in the 1980s, before the vaccine, developed in 1982 and now seen as a key way to prevent infection, was routinely given to newborns.

Shawne Lopes, Jabonero’s sister, adds that most primary-care doctors back then knew little about the implications of the infection.

In Wang’s view, many in the medical community are still in the dark. His first flare-up, when he was a young reporter in the 1990s, led to his diagnosis, but the doctor just told him he would “eventually shake if off.” He also remained “stupid and ignorant” when he started dating Cunningham and infected her.

It turns out her hepatitis B infection was acute, which meant it made her very sick. But as with most people infected as adults, she quickly got over it and no longer carries the virus.

They knew any kids they had would be fine, especially with the vaccine, but she wanted Wang to get his infection under control. And he did, seeking out the care of hepatologists just as he would regularly consult a cardiologist if he had a heart condition.

Up until late 2014, Jabonero seemed to be doing amazingly well. He began to devote himself to eating well and competing in triathlons, especially after he became the father of his first two children, now 7 and 3, his wife, Melissa Jabonero, says.

Lopes, though, says her brother wasn’t consistent with his tests, perhaps because he was busy with work and family. He also wasn’t under the care of a hepatologist, as everyone with hepatitis B should be. Everything changed when he went out for a long bike ride but came home to say he was having trouble breathing, says Melissa Jabonero, who was pregnant at the time.

Her husband died two months before their third child, Shiloh, was born.

“I still feel like he’s just on vacation,” Melissa says. “I always talk to the kids about him, I try to keep his stuff around to remind them of him. Thank goodness for the kids; they definitely help me out.”