Hep B Blog

Category Archives: Hepatitis B Advocacy

Hepatitis B Foundation Mini-Grantees 2016

At the Hepatitis B Foundation, we have many research and programs throughout the year. With the Association of Asian Pacific Community Health Organizations (AAPCHO), we co-founded and co-chair Hep B United, a national coalition dedicated to reducing the health disparities associated with hepatitis B by increasing awareness, screening, vaccination, and linkage to care for high-risk communities across the United States. The coalition works to reduce the impact of hepatitis B through prevention and education efforts, addressing perinatal transmission, improving screening and linkage to care, contributing to national surveillance data, and advocating on a national level.

Last year, the Hepatitis B Foundation offered mini-grants for one year to Hep B United coalition partners working on hepatitis B education, screening and linkage to care activities. These grants ranged between $5,000 to $10,000 each. The mini-grants were offered to enhance the capacity of Hep B United coalition partners to conduct HBV education, testing and linkage to care in their local Asian American, Native Hawaiian and Pacific Islander (AA & NHPI) communities to advance the hepatitis B priority areas of the U.S. Department of Health and Human Services’ National Viral Hepatitis Action Plan (VHAP).

Courtesy of CPACS

The 2016-17 project year offered grants to 9 coalition partners, which included Center for Pan Asian Community Services, Inc (CPACS), Hepatitis B Initiative-Minnesota (HBI-MN), Midwest Asian Health Association (MAHA), Hepatitis B Initiative-DC (HBI-DC), Asian Services in Action (ASIA), Asian American Community Services (AACS), Asian Pacific Health Foundation (APHF), and HOPE Clinic. Together, Hep B United coalition partners screened 4,649 people, educated and reached out to 11,884 people, and distributed 13,112 handouts. Some coalition partners were featured in  newspapers, on TV with 496,189 views, and in a social media video. Mini-grantees also participated in activities such as developing key partnerships in local communities, providing linkage to care, and conducting provider training. One coalition partner also screened the “Be About It” documentary.

For 2017-2018 mini-grants, six Hep B United coalition partners (listed below) were recently awarded mini-grants. We are excited to kick off these projects and look forward to their future endeavors and results.

·     Asian American Community Services (Columbus, OH) -AACS’ Live Healthy – Hep Free project will use the H+EAL model to increase HBV education and awareness and encourage testing by targeting high school students and their parents.

·       Asian Pacific Community in Action (Phoenix, AZ) – APCA will be organizing community town hall events in collaboration with the #justB campaign across Maricopa County to collect and share stories that promote increased awareness and proactive approaches to treatment for hepatitis B.

·       Asian Pacific Health Foundation (San Diego, CA) – APHF will be working to increase community knowledge and awareness of hepatitis B, determine gaps in knowledge, develop in-language education materials, and provide hepatitis B screening within high-risk communities throughout San Diego.

·       Asian Services in Action (Cleveland, OH) – ASIA will be using community health outreach workers to increase HBV education and screening, including outreach to AAPI businesses in Akron and Cleveland, OH.

·       Center for Pan Asian Community Services (Atlanta, GA) – CPACS’ project focuses on expanding their Atlanta-based hepatitis B coalition, increasing the number of Georgia AAPI community members who know their HBV status through community and provider education, and improving testing and linkage to care services throughout the city.

·       Philadelphia Department of Public Health (Philadelphia, PA) -The Perinatal Hepatitis B Prevention Program auxiliary project will create new education modules for prenatal and pediatric care and conduct on-site provider education sessions to improve knowledge and care for infected mothers.

The 2017-18 project period expanded its priorities to address perinatal transmission and education through storytelling efforts with the #JustB Storytelling Campaign in addition to screenings and linkage to care.   The overall success of the Hep B United mini-grants has been proven through the significant number of high-risk populations educated, screened and linked into appropriate care for hepatitis B.   We look forward to updating you further in the coming months as we continue to highlight the national work of the Hepatitis B Foundation and Hep B United partners around the U.S.

Who is Ted Slavin? #virusappreciationday

“We will long remember Ted Slavin as a gallant man who loved life and who contributed greatly to our research efforts”

-Baruch S. Blumberg, Irving Millman, W. Thomas London, and other members of the Division of Clinical Research Fox Chase Cancer Center, 19851

Baruch S. Blumberg

“Who is Ted Slavin? Why haven’t I heard about him before?” crept into my mind as I was reading The Immortal Life of Henrietta Lacks. Rebecca Skloot wrote a short snippet about Ted Slavin, detailing the story of a hemophiliac who sold his antibodies and aided Dr. Baruch Blumberg in the discovery of the link between the hepatitis B virus and liver cancer, which eventually led to the first hepatitis B vaccine.2 I was surprised that I had never heard of him, and that his name was not enshrined on the walls of the Hepatitis B Foundation. I see the smiling and jovial face of Dr. Blumberg nearly every time I walk into the office, but never the image of a man who contributed so much to his efforts.

Blood Serum

Ted Slavin developed antibodies against hepatitis B after receiving infected blood transfusions to treat his hemophilia. The blood he received back in the 1950s was not screened for any diseases. His doctor helped him realize that his blood was valuable because of the copious amounts of antibodies for hepatitis B. At the time, those antibodies were a hot commodity as scientists were conducting research to learn more about hepatitis B prevention and treatment. Slavin decided to the sell his antibody-rich blood and even donated his blood to Dr. Blumberg’s research team at Fox Chase Cancer Center. He later formed Essential Biologicals, a company that collected blood from others like him. They were everyday patients who could turn their rare or unique blood into money making products, while at the same time advancing important research into diseases that were not well understood.2

As I read the brief overview of Slavin’s life, I initially perceived him as someone who was both lucky and smart: Slavin was lucky because his doctor gave him information on the value of his antibodies2; and smart because he knew how to make the best of something once considered a burden in his life.3 As I did a little more detective work, I realized Ted Slavin was not just a guy who made money off his cells, but someone who contributed to the fight against the hepatitis B virus, which I am passionate about!

My detective work led me to a deeper understanding of Mr. Slavin and his contribution to important milestones on the road to hepatitis B elimination.3,4,5,6,7 I found discussions and case studies on the ethics associated with his circumstance. Through my research journey, I learned more about him and my perception of Slavin started to change. He was, like many, struggling to make ends meet. He didn’t entirely profit off his antibodies because he donated a majority of the money he made to advance scientific research.4 At the same time, Slavin was “hopeful for a cure,” and he trusted Dr. Blumberg, his favorite researcher among the many studying hepatitis B, with his antibodies.1 To Dr. Blumberg and the researchers working with him, Ted Slavin was a brave, courageous man who helped save millions of lives.1

The story of Ted Slavin, like that of Henrietta Lacks, is not only a reminder of the importance of bioethics and the need for public health and scientific research; his story reminds us there is an invisible face behind every success. Because of Ted Slavin, there are tests to diagnose hepatitis B, ways to detect liver cancer linked to hepatitis B, and the first cancer preventative vaccine!

For more information about the hepatitis B vaccine, please visit our website here.

For helping looking for the hepatitis B vaccine, you can go  here or to the HealthMap Vaccine Finder.

 

References:

  1. Lavin, EFS. (2013). Exploring Life and Death at the Cellular Level: An Examination of How Our Cells Can Live Without Us. Quadrivium: A Journal of Multidisciplinary Scholarship, 5(1),
  2. Skloot, R. (2010). The Immortal Life of Henrietta Lacks. Crown Publishing Group.
  3. Ted Slavin’s Story and more. Retrieved from: http://tissuerights.weebly.com/ted-slavin.html
  4. Skloot, R. (2006, Apr 16). Taking the Least of You. The New York Times Magazine. Retrieved from: http://www.nytimes.com/2006/04/16/magazine/taking-the-least-of-you.html
  5. Angsana T. (2010, Nov 9). Second Story from Ted Slavin. Retrieved from: http://angsanat.blogspot.com/2010/11/second-story-from-ted-slavin.html
  6. C, Anna. (2012, Jul 26). World Hepatitis Day: The History of the Hepatitis B Vaccine. Retrieved from: http://advocatesaz.org/2012/07/26/world-hepatitis-day-the-history-of-the-hepatitis-b-vaccine/

 

2017 Commemoration of National African Immigrant and Refugee HIV & Hepatitis Awareness (NAIRHHA) Day

On Wednesday, September 13th, the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, Hepatitis B Foundation, and Coalition Against Hepatitis for People of African Origin (CHIPO) commemorated NAIRHHA Day by hosting a webinar discussing “Barriers and Strategies to Addressing HIV and Hepatitis B among African Immigrants: A NAIRHHA Day Webinar.” More than 100 people participated in the webinar. The majority represented government agencies and community-based organizations. This year is particularly exciting because lead organizers also submitted a request to HIV.gov (formerly AIDS.gov) to officially recognize NAIRHHA Day on Sept. 9th as a federal HIV awareness day for African immigrants and refugees in the U.S.

As discussed during the commemorating webinar, there is growing data related to the disproportionate impact of hepatitis B, as well as HIV on African immigrants in the US. African immigrants are underdiagnosed due to lower screening rates and present at a later stage of the disease compared to the general US population. Stigma is seen as the major barrier. In addition, the lack of knowledge about transmission, disease prognosis and treatment are widespread, reducing the likelihood that individuals will seek out testing and treatment services.

NAIRHHA Day was launched in 2014 in an effort to address these issues. It is a joint venture organized by the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, Hepatitis B Foundation, and Coalition Against Hepatitis for People of African Origin (CHIPO). As explained by Chioma Nnaji, Director at the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, “Several of the current awareness days are inclusive of African immigrant communities, but do not comprehensively address their unique social factors, cultural diversity as well as divergent histories and experiences in the US.”

In addition to providing an overview on HIV and HBV epidemiological data, the webinar highlighted findings from two national initiatives. A recent project lead by The Hepatitis B Foundation and Coalition Against Hepatitis for People of African Origin (CHIPO) was funded by the Centers for Disease Control and Prevention (CDC) to better understand the individual, interpersonal, community, and society‐level barriers and facilitators associated with HBV screening, vaccination and linkage to care among African immigrant communities in the US. This project established a 14-member African Immigrant Advisory Board representing non‐profit leaders, community health educators, academics/researchers, government partners, clinicians across 8 states. Through focus groups, interviews and in-person meetings, the Advisory Board documented cultural and religious beliefs, and the complexity of the US healthcare system as major barriers to hepatitis B testing and linkage to care. The Advisory Board also identified approaches to help overcome these barriers, such as working with trusted community leaders, using storytelling, and finding ways to incorporate Western medicine into traditional medicine practices. Next steps will include working with coalition members around the U.S. to develop specific hepatitis education and screening projects that incorporate these strategies.

The webinar also highlighted the Tulumbe! Project. Tulumbe is a Luganda word (language spoken in Uganda) that means, “Let us engage.” The Tulumbe! Project is funded by the Pipeline to Proposals Award under Patient Centered Outcome Research Institute (PCORI) to engage diverse stakeholders in defining areas of need and priorities in HIV services for African immigrants, and identify research topics important to the African immigrant community, African immigrants living with HIV, providers and other stakeholders. Pipeline to Proposals Award funds three tiers of awards that help individuals or groups build community partnerships, develop research capacity, and hone a comparative effectiveness research question that could become the basis of a research funding proposal to submit to PCORI or other health research funders. For more info: https://www.pcori.org/research-results/2017/tulumbe-project-tier-ii

Overall, NAIRHHA Day provides a means for organizations, providers, communities, families, and individuals to:

  • Raise awareness about HIV/AIDS and viral Hepatitis to eliminate stigma
  • Learn about ways to protect against HIV, viral Hepatitis and other related diseases
  • Take control by encouraging screenings and treatment, including viral Hepatitis vaccination
  • Advocate for policies and practices that promote healthy African immigrant communities, families, and individuals

Recognizing September 9th as National African Immigrant & Refugee HIV/AIDS and Hepatitis Awareness Day (NAIRHHA Day) is an important step to addressing issues of HIV and viral hepatitis in the African immigrant community in a culturally and linguistically appropriate way. We are asking you to speak out and support federally recognizing NAIRHHA Day on Sept. 9th by contacting:

  • your local health departments
  • local and national HIV and hepatitis organizations
  • the HIV.gov Team at @HIVGov

Facebook: https://www.facebook.com/NAIRHHA

Twitter: @NAIRHHADay

A Capitol Celebration: US Leaders in Hepatitis B Celebrate World Hepatitis Day

Hep B United (HBU), a coalition established by the Hepatitis B Foundation (HBF) and the Association of Asian Pacific Community Health Organizations (AAPCHO), held its fifth annual Hep B United Summit from July 26th to 28th in Washington D.C. The summit was held to promote screening and prevention strategies and advocate for a cure to further HBU’s mission to eliminate hepatitis B in the United States.

The summit is the largest gathering of hepatitis B leaders from around the country including public health agencies, national non-profit organizations, community coalitions, and individuals and family members affected by hep B. Catherine Freeland, MPH, Public Health Manager of HBF, said, “The summit is like a family reunion.” It’s an opportunity for HBU members to convene, share best strategies, and celebrate their wins over the past five years. The partnerships within HBU ensures that best practices and resources are shared as well. “Once we have a cure, we are committed to making sure chronically infected Americans get it,” Chari Cohen, DrPH, MPH, co-chair of HBU mentioned during the summit. Over the past year, HBU screened 22,556, educated 52,194, and reached over 6 million people with in-language hepatitis B messaging! That’s a win for sure!

As a part of the summit, HBU partners visited Capitol Hill to discuss with federal legislators the need to support hepatitis B and liver cancer research, education, screening, and treatment programs. A Congressional reception was also held to highlight the “#justB: Real People Sharing their Stories of Hepatitis B” storytelling campaign, which increases awareness of hepatitis B through personal stories. There were also meeting sessions focusing on capacity building, sustaining local hepatitis B coalitions, and best ways to utilize resources like the “Know Hepatitis B” campaign from the CDC and Hep B United and the #justB campaign. The Hep B United Summit is a way to celebrate World Hepatitis Day, which is on July 28th every year. Partners celebrated and raised awareness for World Hepatitis Day around Capitol Hill with a scavenger hunt!

At the Summit, HBU and its CDC partners presented five community leaders with the 2017 Hep B Champion Awards in recognition of their outstanding commitment to eliminating hepatitis B and liver cancer in their communities:

 Cathy Phan, the Health Initiatives Project Manager at HOPE Clinic in Houston, Texas, is recognized for her dedication to reducing health disparities, advocating for access to health care and health equity for underserved populations. Cathy brings unique perspectives, best practices and creative, innovative ideas from the local community clinics to the national level.

Vivian Huang, MD, MPH, the Director of Adult Immunization and Emergency Preparedness for the New York City Department of Health and Mental Hygiene and the medical director for the NYC Department of Health Immunization Clinic is recognized for her commitment to reducing the burden of vaccine-preventable diseases locally and globally including hepatitis B and liver cancer. Dr. Huang is a strong, tireless advocate for hepatitis B prevention, education, and treatment and health equity through health department engagement.

Hong Liu, PhD, the Executive Director of the Midwest Asian Health Association in Chicago, Illinois, is recognized for her innovative approaches to educating the public on hepatitis B and her willingness to share her best practices and experiences with others working in the field. This year, Dr. Liu’s leadership has led her organization to educating over 1,337 individuals in Chicago’s Chinatown district and screening close to 300 individuals for hepatitis B.

Dan-Tam Phan-Hoang, MSc., is program manager of HBI-Minnesota, a Minneapolis, Minnesota-based non-profit that she helped start in 2015. Dan-Tam is recognized for her leadership in Minneapolis, building strong collaborations with community leaders, healthcare providers, funders, and government agencies to address hepatitis B throughout the state and successfully establishing a hepatitis B outreach and prevention program for high-risk communities in the Twin Cities.

The National Task Force on Hepatitis B for AAPI, is a national organization that brings together scientists, health professionals, non-profit organizations, and concerned citizens in a concerted effort to eliminate the transmission of hepatitis B and to decrease health disparities among those chronically infected. The Task Force is recognized for increasing physicians’ awareness about hepatitis B and launching a new health care provider program, bringing together public health and health care professionals in regional meetings around the country. The Health Education for Liver Providers (H.E.L.P.) Training Program is designed to provide health care providers and their medical team core medical knowledge of hepatitis B and hepatitis C.

Read the summit press release here.

More pictures of the summit can be found on HBU’s Facebook album, Storify, and e-newsletter.

To read about the Hep B United 2016 Summit from last year, click here.

Join the Conversation at the Hep B United Summit; Watch Summit Sessions On Facebook Live!

Summit Image FB Insta (1)The annual Hep B United Summit, organized by the Hepatitis B Foundation, convenes in Washington D.C. from Thursday, July 27 through Friday, July 28. National and local coalition partners, experts, stakeholders, and federal partners will meet to discuss how to increase hepatitis B testing and vaccination and improve access to care and treatment for individuals living with hepatitis B.

You can watch many of these important sessions on Facebook Live. You can also follow the conversation at the Summit on Twitter with #Hepbunite!

Facebook Live is live video streaming available to all Pages and profiles on Facebook. Check out the agenda below and go to the HepBUnited Facebook Page to view the live broadcast. The session will be made available following the broadcast for those who are not able to join us live.

Here are the details on the sessions that will be broadcast on Facebook Live:

Day 1 – Thursday July 27:

8:30 – 10:00 AM:  Welcome and Introductions
Tim Block, PhD, President & Co-founder, Hepatitis B Foundation and Baruch S. Blumberg Institute, Chari Cohen DrPH, MPH, Co-Chair, Hep B United and Director of Public Health, Hepatitis B Foundation, Jeff Caballero, MPH, Co-Chair, Hep B United and Executive Director, AAPCHO

10:00 – 10:30 AM:  Time to Eliminate Hepatitis B
Dr. John Ward, Director, CDC Division of Viral Hepatitis 

10:30 -11:15 AM:  #justB Storytelling Campaign Panel: Real People Sharing their Stories of Hepatitis B
Rhea Racho, MPP, Public Health Program and Policy Coordinator, Hepatitis B Foundation and storytellers

11:15 – 12:00 PM: Know Hepatitis B Campaign Updates
Cynthia Jorgenson, DrPH, Team Lead and Sherry Chen, MPH, Health Scientist, Division of Viral Hepatitis, Centers for Disease Control and Prevention

12:00 – 12:30 PM:  Increasing Community Awareness and Education
Moderator: Catherine Freeland, MPH, Hepatitis B Foundation and Sherry Chen, CDC

3:00 PM – 4:15 PM:  Breakout Session: Increasing Awareness through Media Engagement
Facilitators: Jessie MacDonald, Vice President, Weber Shandwick and Lisa Thong, Account Supervisor, IW Group

4:15 PM – 5:00 PM:  State of Hep B United
National Advisory Committee
–  Strengthening Coalition Partnerships: Sharing Resources and
–  Overcoming Challenges
Kate Moraras, MPH, Director, Hep B United and Sr. Program Director, Hepatitis B Foundation and Catherine Freeland, MPH, Public Health Program Manager, Hepatitis B Foundation

 Day 2 – Friday July 28

11:30 AM:   Hepatitis B CME Provider Education Program
Amy Trang, PhD, Administrator, National Task Force on Hepatitis B
Focus on Asian Pacific Islander Americans

12:45 PM – 1:45 PM:  HBU Mini-Grantee Presentations
Moderator: Catherine Freeland, MPH, Public Health Program Manager, Hepatitis B Foundation

Not able to join the sessions with Facebook Live? Follow the conversation on Twitter using the #Hepbunite hashtag. Follow the events, Retweet and engage with event attendees and help us raise hepatitis B awareness in the U.S. and around the globe.

World Hepatitis Day is July 28th, and this Summit is a terrific opportunity to share with the world what we’re doing to help those living with hepatitis B in our communities. Other popular hashtags for World Hepatitis Day, and to raise hepatitis B awareness, include: #NOhep, #KnowHepB, #WorldHepatitisDay, #WorldHepDay, #WHD2017, #hepatitis, #hepatitisB, #HBV, #hepB, #justB. Connect with, follow and engage with fellow partners on twitter to keep the hep B conversation going during the Hep B United Summit and World Hepatitis Day events, and beyond.

Check out: @AAPCHOtweets, @AAHC_HOPEclinic, @AAHI_Info, @AAPInews, @apcaaz, @APIAHF, @ASIAOHIO, @CBWCHC, @cdchep, @cpacs, @HBIDC, @HepBFoundation, @HepBpolicy, @HepBProject, @HepBUnited, @HepBUnitedPhila, @HepFreeHawaii, @HHS_ViralHep, @MinorityHealth, @njhepb, @NVHR1, @nycHepB, @NYU_CSAAH, @sfhepbfree, @supportichs @wahainitiative @jlccrum

Missing from the list? Contact the foundation at info@hepb.org to be added.

Don’t forget to join the World Hepatitis Alliance  Thunderclap and register your World Hepatitis Day events  prior to World Hepatitis Day. Be sure to participate in the #ShowYourFace campaign.  and tell the world how you’re standing up against viral hepatitis.

Still have questions? Email us at info@hepb.org and we’ll help you get started!

Visit the Hep B United and Hepatitis B Foundation websites for more information about hepatitis B and related programs.

Learn Which Cancer, Arthritis or Asthma Drugs Can Reactivate Hepatitis B – Even If You’ve Cleared the Infection

Courtesy of Pixabay.
Courtesy of Pixabay.

By Christine Kukka

Drugs that suppress your immune system in order to treat cancers, rheumatoid arthritis, psoriasis, COPD and asthma can cause a life-threatening reactivation of your hepatitis B.

This dangerous viral rebound can occur if you are currently infected or even if you cleared the infection and now test negative for the hepatitis B surface antigen (HBsAg) and positive for the surface antibody (HBsAb).

These drugs weaken the immune system, which allows your infection to rebound with a vengeance, spiking your viral load and causing life-threatening liver damage within weeks of starting chemotherapy or high-dose steroids.

What’s behind this reactivation risk? Think herpes or chicken pox (shingles). You might get rid of the infections and the ugly blisters, but small amounts of virus remain and as we age and our immune systems weaken, they can reappear.

The hepatitis B virus (HBV) behaves similarly. When we lose HBsAg and/or develop surface antibodies, there are still small amounts of HBV lurking in our bodies. When we’re healthy, our immune systems effectively contain these trace amounts of virus, but old age, another serious medical condition or immune-suppressing drugs allow hepatitis B to reactivate.

Today, medical guidelines require doctors to test everyone they plan to treat with any immune-suppressing drugs for the hepatitis B core antibody (HBcAb) so they know who has been infected with hepatitis B. If a patient tests positive, doctors must run more tests to determine what risk the new drug will pose. When a patient is at risk of reactivation, doctors will simultaneously treat them with antivirals (either tenofovir or entecavir) and continue antiviral treatment for six more months after the immune-suppressing therapy ends to prevent reactivation.

U.S. CDC.
U.S. CDC.

This mandatory testing is important because some people don’t know they should tell their doctors about their past infection, and many don’t know they’re infected. Here is what happened to one person who contacted the Hepatitis B Foundation after her doctor failed to test her for hepatitis B:

“I recently had my first dose of chemotherapy and I did not mention (to) my oncologist that I was a carrier of hepatitis B, (because) I knew that it was not active. Then, after a week of chemo, I was really sick and got a high temperature. Then, my blood test came back (indicating) that my hepatitis B was reactivated. My liver doctor gave me medicine (an antiviral) to take to deactivate the virus.”

Her oncologist immediately stopped chemotherapy and monitored her HBV DNA (viral load) and liver enzymes (ALT/SGPT) to make sure the antiviral lowered her viral load before restarting chemotherapy. This example shows why it’s important to tell all doctors, including specialists, about a current or resolved hepatitis B infection. No one wants to be battling cancer and a reactivated hepatitis B infection at the same time.

According to experts, about 4.3 percent of people who have cleared hepatitis B will experience a reactivation when treated with immune-suppressing drugs.

Which drugs reactivate hepatitis B? Below is a summary of drugs that can reactivate your hepatitis B and require monitoring and preventive use of antivirals to reduce reactivation risk, according to American Gastroenterological Association (AGA) guidelines:

High-risk Drugs:

More than 10 percent of people with current or resolved hepatitis B infections will experience a dangerous reactivation if treated with:

  • Rituximab for non-Hodgkins lymphoma, or
  • Ofatumumab for chronic lymphocytic leukemia

Anyone with a current infection (HBsAg positive) treated with the following is also at high risk of reactivation:

  • Anthracycline derivatives (such as doxorubicin, epirubicin) used to treat cancers, including breast or bladder cancer, Kaposi’s sarcoma, lymphoma or acute lymphocytic leukemia, or,
  • Moderate-doses of prednisone/corticosteroids (10 to 20 mg daily) or high doses (more than 20 mg daily or equivalent) for four or more weeks. This steroid is used to treat inflammatory diseases including asthma, COPD, rheumatic disorders, ulcerative colitis, Crohn’s disease, MS, tuberculosis, shingles side effects, lupus, poison oak and tuberculosis among others.

Moderate-risk Drugs:

 Anyone with a resolved or current infection treated with the following drugs is at moderate risk of reactivation:

  • Tumor necrosis factor alpha inhibitors, such as etanercept, adalimumab, certolizumab, infliximab, for arthritis, inflammatory bowel disease, psoriasis and asthma;
  • Other cytokine or integrin inhibitors (such as abatacept, ustekinumab, natalizumab, vedolizumab), or
  • Tyrosine kinase inhibitors (such as imatinib, nilotinib)

 Also with a current infection treated is at moderate risk if treated with:

  • Low-dose (less than 10 mg prednisone daily or equivalent) corticosteroids for four or more weeks.

Also, anyone with a resolved infection treated with:

  • Moderate-dose (10—20 mg prednisone daily or equivalent) or high-dose (more than 20 mg prednisone daily or equivalent), or
  • Corticosteroids daily for four or more weeks, or anyone treated with anthracycline derivatives (eg, doxorubicin, epirubicin).

Low-risk Drugs:

Drugs that reactivate hepatitis B in fewer than 1 percent of patients include:

Current or previously-infected people treated with:

  • Traditional immunosuppressive drugs such as azathioprine, 6-mercaptopurine or methotrexate, or
  • Intra-articular corticosteroids
  • Any dose of oral corticosteroids daily for a week or less.

Previously-infected patients treated with:

  • Low-dose (less than 10 mg prednisone or equivalent) corticosteroids for four weeks or longer.

To see the entire list of immune-suppressing drugs, read the AGA guidelines.

Hepatitis B reactivation following successful hepatitis C treatment: New antivirals (such as Harvoni), used to cure hepatitis C do not suppress the immune system, but they leave coinfected people at risk of HBV reactivation once the dominant hepatitis C virus disappears. Coinfected patients need to be monitored carefully and treated with antivirals if their HBV rebounds.

Celebrate Father’s Day By Protecting Your and Your Family’s Health — Get Tested for Hepatitis B

William and his family.
William and his family. Click here to watch his story.

By Christine Kukka

After our daughter was diagnosed with chronic hepatitis B 20 years ago, my doctor explained that every household member, including my husband, had to be tested for the liver infection that’s transmitted by direct contact with blood and body fluids. ASAP.

The good news was my daughter was healthy and had no signs of liver damage, but my husband and I were shaken to the core by her diagnosis. Weighed down by worry and ignorance, I feared we might all be infected and faced a death sentence.

I drove out to my husband’s work and we went for a walk. I explained what the doctor had said and explained he had to get tested. It was one of those moments when fear and denial play out over the course of a conversation. Like everyone, he was afraid to get tested. He felt fine, at first he didn’t want to know whether he was infected. For a few moments, he thought ignorance might be less painful than finding out he had hepatitis B.

And, as in most families, this disclosure wasn’t easy. He had children from his first marriage who were with us every weekend and they had to be tested too. He would have to share this information with his former wife. This disclosure was going to upend two households. After a few minutes of waffling and processing, he did what courageous fathers do. He got tested and made sure his children were tested too.

Poster-GetTested_SuperDad-2-235x300The news was all good. His children had been immunized and were fine, he was not infected and was immediately immunized. Today, we are all doing fine, including our daughter.

Every father’s day, I think about that moment, when my husband refused to  retreat into denial, and put his family’s health ahead of his initial impulse to hide from a frightening and messy situation. It is what being a good father is all about, and it takes courage.

For another story about hepatitis B and fatherhood, please view the Storyteller video featuring William’s Story: #justB Dad by clicking here.  

Excited by the impending birth of his first child, William decided to plan for his family’s financial future. He was shocked to learn through a required health insurance blood test that he had hepatitis B. He spent sleepless nights wondering how he contracted the virus and whether it was a death sentence. After wading through dense layers of information online, he went in for more tests and was reassured by a caring provider that with monitoring, dietary changes and an active lifestyle, he would live a long life.

He realized that knowing where hepatitis B came from isn’t as important as focusing on staying healthy.

The CDC offers short video clips that feature a conversation between a daughter and her parents, with the daughter explaining why Asian-Americans should be tested for hepatitis B in English, Cantonese, Mandarin, Vietnamese and Korean. A high percentage of Asian and African immigrants have hepatitis B, but most don’t know they are infected. To view these clips, visit: http://www.cdc.gov/knowhepatitisb/materials.htm

Join a Twitter Chat: National Organizations Share Highlights From Hepatitis Awareness Month and Strategies for Successful Events

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Join Hep B United, the National Viral Hepatitis Roundtable, NASTAD and CDC’s Division of Viral Hepatitis for a Twitter #HepChat at 2 p.m. (EST) Thursday, June 8. The chat will highlight Hepatitis Awareness Month outreach events and allow hepatitis B and C partner organizations to share their successes, challenges and lessons learned from their efforts.

Continue reading "Join a Twitter Chat: National Organizations Share Highlights From Hepatitis Awareness Month and Strategies for Successful Events"

Hepatitis B Foundation Executive Director Joan Block Steps Down, But First Shares Her Love Story

Tim and Joan Block
Tim and Joan Block

By Joan Block, RN, BSN, Executive Director and Co-Founder

The story of the Hepatitis B Foundation is a love story that’s never been told. In June, I will retire after 25 years of service, so now feels like the right time to share my personal story.

In 1987, I was diagnosed with hepatitis B. I had just married Tim (co-founder and president of the foundation and its research affiliate, the Baruch S. Blumberg Institute) when my doctor suggested I get tested for hepatitis B because I was born in Korea.

We were devastated by the diagnosis. As a young nurse in the 1980s, the only hepatitis B patients I knew were dying of liver failure or liver cancer. They were kept in isolation rooms where I had to wear a gown, gloves, and mask to even provide them with basic care.

This was a dark and scary time for us. There was nowhere to turn for information or support, and no available treatment. The prospect of our life together was overshadowed by fear and uncertainty.

My husband Tim, a research scientist, took immediate action by changing his focus to hepatitis B and began the quest to find a cure. We reached out to our close friends, Paul and Jan Witte, and together we decided to create a nonprofit organization dedicated to finding a cure for hepatitis B and helping those affected.

In 1991, the Hepatitis B Foundation was officially established. A quarter of a century later, the foundation has grown from a grassroots effort into the world’s leading nonprofit research and disease advocacy organization solely dedicated to hepatitis B.

Joan M. Block, Co-Founder and Executive Director
Joan M. Block, RN, BSN, Co-Founder and Executive Director

There are many reasons why I waited so long to share my personal story. At first, it was fear and shame. The stigma of having an infectious disease was strong, even though I had acquired hepatitis B at birth. Later, I wanted to keep the focus on the mission of the foundation, not on my personal story.

Today, however, I realize that there is a compelling need for people like myself to publicly share their stories. We need to break the silence around hepatitis B. Personal stories are a powerful tool to increase awareness, decrease stigma and end discrimination.

Although I am stepping down as executive director, I will continue to be passionately involved in advancing the foundation’s mission to find a cure. I will also use every opportunity to personally give voice to the more than 257 million people affected by hepatitis B worldwide.

If more of us can stand up and say without fear or hesitation, “I have hepatitis B,” then we will indeed contribute significantly to making hepatitis B history!

Thank you.

In recognition of Joan’s dedicated service, the Board of Directors has created the Joan Block Improving Lives Fund of the Hepatitis B Foundation. This fund will enable the foundation to advocate powerfully to increase research funds for a cure, end discrimination against those affected, and increase screening, prevention and care to save more lives from hepatitis B.

To honor Joan’s valuable legacy, please make a donation at our secure website by clicking here.

Ten Things Women and Mothers Can Do to Combat Hepatitis B

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net.
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net.

By Christine Kukka

Don’t know your hepatitis B status? Get tested. An estimated 75 percent of people with chronic hepatitis B don’t know they’re infected. Unfortunately, many doctors won’t test you for hepatitis B unless you request the test. If you or your parents come from a country with high rates of hepatitis B, or if you’ve been sexually active or have other risk factors , get tested. It could save your life.

Get tested for sexually-transmitted infections (STIs). More than half of us will have an STI in our lifetime, and in the U.S. about half of new hepatitis B infections are sexually-transmitted. Many doctors don’t test for STIs. In a national survey of U.S. physicians, fewer than one-third routinely screened patients for STIs. To make matters worse, many women are afraid to talk to doctors about their sexual history and STI risk. Be brave, ask your doctor to test you for STIs and hepatitis B if you think you are at risk.

Photo by Amanda Mills of CDC.
Photo by Amanda Mills of CDC.

Get immunized against hepatitis B. Not sure if you’ve been immunized during childhood? Tell your healthcare provider and get tested and immunized. Even you were vaccinated in the past, getting a second vaccine series won’t harm you. If your partner has hepatitis B, getting vaccinated is critical to protect your health. Practice safe sex until you have received all three shots. About one to two months after your third shot, get tested for the hepatitis B surface antibody (called titers). If you have at least 10 mIU/mL of surface antibodies, you are permanently protected against this serious liver disease.

Infected? In Love? Disclose. When you disclose your hepatitis B status before sex – even if it’s safe sex with a condom – you don’t jeopardize your partner’s health or his/her trust in you. Talking about hepatitis B helps reduce the stigma surrounding this infection and may prompt the person to get vaccinated. How do you tell a potential partner that you have hepatitis B? Calmly and carefully. Do some research so you have a thorough understanding about hepatitis B, which will make it easier for you to calmly explain it. The more you know, the less you fear, and the more comfortable you will be in dispelling their fears and conveying a sense of truth and integrity.

Insist on sterile medical and tattoo equipment. Hepatitis B can live for several days on hard surfaces, including improperly-sterilized and re-used syringes and other medical devices. Whether you’re going for a tattoo or to a dentist or doctor’s office, it is your right to insist that all equipment is brand new (ask to see it removed from protective packaging) and properly sterilized. Visit a licensed, professional tattoo parlor and make sure all tattoo equipment has been sterilized and that needles come out of new packages.

Image courtesy of patrisyu at FreeDigitalPhotos.net
Image courtesy of patrisyu at FreeDigitalPhotos.net

Infected and pregnant? Protect your baby from hepatitis B.

  • Make sure your newborn gets the hepatitis B vaccine within 12 hours of birth. Nearly all hepatitis B-infected women will pass the infection onto their children during delivery, but you can stop that infection cycle. In about 90 percent of cases, immediate immunization will prevent infection. In some countries, it may be difficult to get just the single hepatitis B vaccine dose, but if you are able to immunize your baby at birth, you will have protected your child against a potentially dangerous liver disease. If you live in an area where HBIG (hepatitis B antibodies) is available, make sure your newborn is also given a dose of HBIG at birth, this adds another layer of protection against infection.
  • Get your viral load (HBV DNA) tested early in your pregnancy. Some women with high viral loads (exceeding 200,000 IU/mL or 1 million copies/mL) are at high risk of infecting their newborns, even if the baby receives the first vaccine dose within 12 hours of birth. Ask your doctor to test your viral load, if it’s high, medical guidelines recommend treatment with the antiviral tenofovir during the last three months of your pregnancy to lower your viral load. If you doctor doesn’t test your viral load, be assertive and ask for the test.
  • Breastfeeding is OK, even if you have hepatitis B. If you’re infected with hepatitis B, you can safely breastfeed your baby, as long as the baby was vaccinated against hepatitis B at birth.
Maureen and her two daughters
Maureen and her two daughters

Your children infected? Don’t wait to start talking to them about hepatitis B. You need to start talking to them about germs and how to keep themselves and others safe when they’re young. (Listen to Jin’s Story #justB You about growing up with hepatitis B.) This conversation will be one of the hardest discussions you will ever have with your child, and you’ll be talking about it often in the years ahead, but you can do it!

To hear how other mothers handled talking about hepatitis B with their children, visit our Storytelling page and click on Maureen’s Story #justB Brave  and Maureen K’s Story #just B Assertive  to hear how these mothers navigated issues of disclosure and stigma with their daughters.

 Talk to your children about sex and safe sex practices. It’s critical to educate young people about sexual health and STIs. If we want our sons and daughters to feel empowered to take care of their sexual health, we have to change the culture that dictates the way we talk – or don’t talk – about sex. That means removing denial, uncertainty and shame so we have better conversations about sexual health, sexual assault prevention and STIs. It’s also important to encourage our children to have frank sexual health discussions with one another.

Take care of your health, get monitored regularly: It is important to get your hepatitis B monitored regularly – at least every year and more often if you have liver damage. Women living with hepatitis B tend to have lower rates of liver damage than men because estrogen appears to help protect the liver. But even if we lead a healthy lifestyle and avoid alcohol and cigarettes, as we age our immune system weakens and our viral load (HBV DNA) can start to rise. There is no cure yet for hepatitis B, but there are effective drugs that lower viral load and reduce the risk of liver damage.

Renseley and her husband.
Renseley and her husband.

Be happy. A mother or woman who is well rested, enjoys a healthy diet, gets plenty of exercise, has good relationships with friends and family members and knows how to ask for help when she needs it, is far better equipped to be happy and be the best mother she can be. It isn’t selfish to take care of yourself. Tough times happen, and sometimes a friend or family member may need us, and we will need to be strong during difficult times. If we take care of ourselves and ask for help, in the long run happiness will prevail. For a profile in joy and courage while fighting hepatitis B in her family, watch Renseley’s Story #justB Strong.

The Hepatitis B Foundation recently launched its storytelling campaign, sharing the stories of people affected by hepatitis B. Join a Twitter interview including Maureen K, parent of a daughter with hepatitis B, at 2 p.m. (EST), Tuesday, May 16, hosted by the Hepatitis B Foundation and StoryCenter. Click here for more information.