Hep B Blog

Category Archives: Hepatitis B Prevention

Vlog: What Do We Do at a Hep B Screening?

Join Kristine Alarcon, MPH for A Day in the Life of a Public Health Coordinator to learn about some of the activities we at the Hepatitis B Foundation take part in!

This episode highlights our events for our local program, Hep B United Philadelphia, during January 2018. We show you the “behind-the-scenes” of a hepatitis B screening event.

Raising Awareness about Hepatitis B in African Immigrant Communities in the US

Hepatitis B Foundation Health Outreach Coordinator and Guest Blogger Sierra Pellechio, B.S., CHES discusses her work with the African Immigrant community.   

Hepatitis B affects over 2 million people in the United States, disproportionately affecting Asian, Pacific Islander and African Immigrant (AI) communities in the U.S. Although partners around the U.S. have been trying to increase awareness and improve screening and linkage to care rates among high risk communities, there have been few programs designed to address the urgent need for intervention among U.S. AI communities. An estimated 5% to 18% of African immigrants in the U.S. are affected by hepatitis B, with less than 20% aware of their infection. However, since research and prevalence data specific to AIs are lacking, it has been difficult to understand the true burden of this disease. One thing we do know is that there are significant knowledge gaps and low screening and linkage to care rates in AI communities. If left undiagnosed, people with hepatitis B are at risk of developing liver complications, including cirrhosis and liver cancer, which can lead to premature death, making it vital to identify those affected. This is complicated by the fact that hepatitis B is a silent disease with few or no symptoms for decades.

Last year, the Hepatitis B Foundation, in collaboration with the Centers for Disease Control and Prevention (CDC) and CHIPO (Coalition Against Hepatitis for People of African Origin) launched a pioneering project to create a broad scale educational initiative to promote hepatitis B awareness and testing for AIs across the United States.  The project aims to increase awareness, testing, linkage to care and vaccination among AI’s to align with the goals of the March 2017 A National Strategy for the Elimination of Hepatitis B and C by the U.S. National Academies of Sciences, Engineering, and Medicine (NASEM). This strategy set the goal of eliminating hepatitis B as a public health threat in the U.S. by 2030.

Working with a diverse sixteen-member expert advisory committee comprised of African community leaders, providers, and public health experts from across the U.S., the first phase of this project assessed the individual, community, and society-level barriers that affect hepatitis B screening, vaccination, and linkage to care. Findings revealed that a potentially effective strategy for improving awareness and testing could involve first educating community health workers, who would then serve as trusted educators and advocates to promote education and testing in their communities. In collaboration with the advisory committee, the Hepatitis B Foundation is developing two training modules tailored to community health workers. The modules focus on providing basic hepatitis B information, addressing myths and stigma, and suggesting strategies for incorporating health messages into their work that are culturally and religiously relevant. These educational modules will have an accompanying audio recording, a comprehensive resource guide, and a flipchart for direct community education on hepatitis B. To ensure relevance and effectiveness, these materials will be pilot tested and revised prior to nationwide dissemination. Once the project concludes, resources and materials will be available on the Hepatitis B Foundation and CDC resource pages in early 2019.

If you are a community health worker working in the African Immigrant community and would like to connect, share resources, or learn more, please contact the manager of this project, Sierra Pellechio at sierra.pellechio@hepb.org.

Adoption and Hepatitis B

Have you been thinking about adoption for a long time or have been inspired by NBC’s show, This is Us, to adopt? Adoption is exciting! However, it can be nerve wracking and feel overwhelming. We at the Hepatitis B Foundation can help with one aspect of the adoption process – making sure you have accurate information about hepatitis B.

It is important to be armed with accurate information about hepatitis B when preparing for adoption for both international and domestic adoptions. This can help protect your future child, family members and yourself when you welcome your future child with open arms.

Many people wish to adopt children from countries where hepatitis B infections are common: Asia, South America, Eastern Europe, and some parts of Africa. Children from these regions could be infected with the virus since it can be unknowingly passed from birth mothers who have hepatitis B and transmit the disease to their children during delivery. In addition, many of these countries struggle with proper infection control practices that place babies and young children at risk with unsafe medical procedures. Unfortunately, many infants still do not have access to the birth dose of the hepatitis B vaccine to help prevent transmission.

Domestic adoptions also present some risk. Children born to women in high-risk groups (e.g. illicit drug users, multiple sexual partners, etc.) could be exposed to hepatitis B at birth. In addition, children from group homes are at increased risk for hepatitis B infection. The good news is that there are procedures in place that can prevent a baby from getting infected if born to an infected mother – and the success rate is up to 95%! This includes providing the first dose of the hepatitis B vaccine along with a dose of hepatitis B immune globulin (HBIG) within 12 hours of birth. If you are planning a U.S. adoption, and know that the birth mother is infected, you can ensure that the birth hospital knows about these procedures and can administer the shots on time.

During the adoption process, the adoption agency should tell you if your child has been tested for hepatitis B, but there can be errors if the child was tested only as an infant. With an international adoption, it is advised that you do not request that your child be tested since the blood test itself could be a source of infection. If you are concerned about the results of these tests, please contact us to speak with our knowledgeable staff. We can also refer you to a parent who has adopted a child with hepatitis B. Whether your child has been diagnosed with hepatitis B or not, testing for HBV should be repeated once you’re home. If needed, you can refer to our physician directory to find a pediatric specialist who knows about hepatitis B.

If you do find out that your child does have hepatitis B, you can handle it!Hepatitis B is a manageable disease. Many families seeking a “special needs adoption” choose to adopt a child with chronic hepatitis B because it is manageable and treatable. Hepatitis B is a vaccine preventable disease, so newly adopted children can be safely integrated into vaccinated families. Children with chronic HBV can expect to live a long and healthy life if they are monitored by a pediatric liver specialist. Some may need treatment during childhood, most probably won’t. Hepatitis B does not affect a child’s growth and development, and there are generally no restrictions associated with chronic hepatitis B. It is recommended that those with chronic hepatitis B see a pediatric liver specialist every six months for hepatitis B management. Often this entails only blood work to monitor the child’s HBV and liver health. Also make sure household members are vaccinated and that you talk to talk to all of your children about the importance of handwashing and “never touching anyone’s blood”. When your children get older, help them acclimate to dating and disclosure. The hepatitis B vaccine is required for school in all but four states.

For some tips, you can visit our website on adoption, children with hepatitis B, and one of our previous blogs. You can also watch some adoption stories from our #justB storytelling campaign. Be sure to watch Maureen’s, Maureen K’s, and Jin’s stories about the international adoption process with hepatitis B. You can also watch Janet and Kurt’s domestic adoption process. Please consider opening your home to an adopted child. It will change your life.

Journey to the Cure: What is Hepatitis B? ft. Timothy Block, PhD

Welcome to Journey to the Cure. This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.

In the first episode (part 1), Kristine Alarcon, MPH sits down with Timothy Block, PhD, President and Co-Founder of the Hepatitis B Foundation, to talk about the basics of hepatitis B.

For any questions about hepatitis B, please email info@hepb.org

The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure and improving the lives of those affected by hepatitis B worldwide through research, education and patient advocacy. Visit us at www.hepb.org, on Facebook at www.facebook.com/hepbfoundation, on Twitter at twitter@hepbfoundation, and our Blog at www.hepb.org/blog

Disclaimer: The information provided in this video is not intended to serve as medical advice or endorsement of any product. The Hepatitis B Foundation strongly recommends each person discuss this information and their questions with a qualified health care provider.

Edited by:
Samantha Young

Music:
Modern – iMovie Library Collection

Checking In on Your New Years’ Resolutions for Hepatitis B

How are your New Years’ Resolutions going?  When you were making your resolutions, did you consider hepatitis B specific New Year’s resolutions?  Here are a few ideas…

  • Make an appointment to see your liver specialist.  If you have hepatitis B, and you are not being seen regularly by a liver specialist, or a doctor knowledgeable about hepatitis B every six months, then make the commitment to do so this year. It is important to know and keep track of your HBV status and your liver health. Check out HBF’s Directory of Liver Specialists. We do not have names and contact information for all countries, so please feel free to share your favorite liver specialist with the HBV community. Make an appointment today!

 

  • Organize your hepatitis B lab dataand make a table with the date of the blood draw and the associated blood test results. You’ll want to start by requesting copies of all of your labs from your doctor. Then you can generate data tables using Excel, Word or a pencil and paper table for your charted data.  It will help you visualize your HBV over time, and you may find your doctor likes to see both the lab results and your table of results.

 

  • Generate a list of questionsfor your next appointment with your liver specialist.  People get nervous anticipating what their doctor might say about their health. It is very easy to forget those important questions, so be sure to write them down, or add them to a note app on your phone or tablet. If the option is available, have a family member or friend attend the appointment with you. That will allow you to pay closer attention while your friend or family member takes notes for you.

 

 

  • Avoid the use of alcohol. Hepatitis B and alcohol is a dangerous combination. An annual toast to the New Year? Sure. Drinking daily, weekly or even monthly? Not a good idea.  Binge drinking? Dangerous. A studyshows an increased risk for liver cancer among cirrhotic patients with HBV. Don’t let it get that far. If you have HBV and you are still drinking alcohol, seek the help you need to stop.

 

 

  • Exercise. Many people think that having a chronic illness precludes them from exercise. This is rarely the case, but if you have concerns, talk to your doctor. If you consistently exercise, keep up the good work. If you don’t, please start slowly and work your way up to a more strenuous routine, and follow general physical activity guidelines for adults. Join a gym or find an exercise buddy. Don’t compare yourself to others and work at your own pace. Set realistic workout goals. You don’t need to run a marathon. Brisk, daily walking is great, too. You may find that you experience both physical and emotional benefits, and if you exercise with friends, you’ll also benefit socially. Clinical and experimental studiesshow that physical exercise helps prevent the progression of liver cancer and improves quality of life. It also helps prevent the development of non-alcoholic fatty liver disease (NAFLD or “fatty liver”. Get moving. It’s good for your overall health and specifically your liver!

 

  • Maintain a healthy weight by eating a well-balanced diet.This is a favorite on the New Year’s Resolution list for just about everyone with or without HBV. You can’t prevent or cure HBV with a healthy diet, but it does help by preventing additional problems like the onset of fatty liver disease or diabetes. If you’ve been following trending health problems, then you are well aware that fatty liver disease and type 2 diabetes are huge problems both in the U.S. and around the globe. Fatty liver disease and type 2 diabetes can often be prevented with a healthy diet and regular exercise. Start by avoiding fast foods, and processed foods. Cut down on fatty foods and sweets. Sugar (fructose) is not your friend. Avoid sugary treats and drinks with sugar, including sodas and fruit juices. Reduce the amount of saturated fats, trans fats and hydrogenated fats in your diet. Saturated fats are found in deep-fried foods, red and fatty cuts of meats and dairy products. Trans and hydrogenated fats are found in processed foods. With fatty liver disease, fat accumulates in the liver and increases inflammation. If you have hepatitis B, you want to avoid any additional complications that may arise with fatty liver disease. Diabetes and HBV together can also be very complicated.  So what should you eat? Eat plenty of fresh vegetables, fresh fruits, whole grains, fish and lean meats, and whole grains. Eat brown rice, whole wheat breads and pastas, instead of white rice, bread and pasta.  Go back to the basics! If you have specific questions about your diet, be sure to talk to your doctor.

 

  • Don’t worry, be happy… Easy to say, but not so easy to accomplish. Anxietyand depression associated with a chronic illness are challenging problems that may be short term, or can worm their way into nearly every aspect of your life. They can even create physical symptoms that may be confusing and may result in even more worry. Please talk to your doctor if you believe your anxiety or depression is something you are unable to manage on your own. Consider joining a support group where you can talk to others facing the same challenges. Personally, I found the Hepatitis B Information and Support List a wonderful source of information and support. Chronic illness can feel very lonely – especially with a disease like HBV that has a stigma associated with it. Find a trusted confident with whom you can share your story.

Check out our previous post about New Year’s resolutions to get more ideas and tips!

New Year’s Resolutions

Image courtesy of Wikimedia Commons

The holidays are over and it’s time for a fresh new year- a fresh new start! Have you made your New Year’s resolutions yet? Do you need some suggestions or help creating your list? Here are some ideas!

  • Be healthier.
    • One of the most popular New Year’s resolutions in the US is to be healthier, whether it is to eat healthier, get more exercise, and/or to head over to the gym more often. There are studies that continue to show the importance of exercise, which favorably impacts the health of your liver as well. Although there is no specific diet for chronic hepatitis B, studies show that eating cruciferous vegetables such as cabbage, broccoli, and cauliflower is good for the liver.  Green, leafy vegetables are also good for the liver. All of these veggies tend to naturally protect the liver against chemicals from the environment.  The American Cancer Society’s diet, which includes low fat, low cholesterol, and high fiber foods is a good, general diet to follow.  It is also good to avoid processed foods and foods from “fast food restaurants”. These foods along with too many foods high in saturated fats, and foods or sugary drinks with refined sugars and flours may result in fatty liver disease, which can also harm the liver. When possible, eat whole grains and brown rice. For more suggestions, check out the World Health Organization’s healthy diet and CDC’s tips for staying healthy.
  • See your doctor more often.
    • We encourage those chronically infected to be regularly monitored by a liver specialist, treated when necessary, and to make lifestyle changes that help keep the liver healthy. The most important thing is to find a doctor who is knowledgeable about hepatitis B, who can help manage your infection and check the health of your liver on a regular basis. The doctor will take blood tests, along with a physical examination of the abdominal area and perhaps an ultrasound, to determine the health of the liver. Talk to the doctor and see what he or she recommends. Don’t forget to get copies of test results for personal files to see how test results change over time
  • Stop drinking/limit alcohol.
    • Chronic hepatitis B and alcohol is a dangerous mixture.  Studies have shown that even small amounts of alcohol can cause damage to an already weakened liver.  Avoiding alcohol is one decision someone can make that will greatly reduce the risk of further liver disease. It is also important to avoid smoking and other environmental toxins.  For example, avoid inhaling fumes from paint, paint thinners, glue and household cleaning products, which may contain chemicals that could damage the liver.  Keep in mind that everything that you eat, drink, breathe in or absorb through the skin is eventually filtered by your liver and toxins are removed. If you can limit the toxins in your body, your liver will benefit.
  • Pursue your dreams.
    • Don’t let your hepatitis B status stop you!! Find friends, family members, colleagues, and/or doctors who can support and encourage you to learn about your hep B status. Become an advocate for yourself, just like our #justB storytellers!

Start off your resolutions with attainable goals! You don’t have to quit cold turkey and completely eliminate certain foods. Take it step by step! Keeping a journal and tracking your progress will help you keep an eye on those resolutions this year. Even if you break your New Year’s resolutions, don’t be discouraged! Everyone goes through pitfalls and experiences lows. The important thing is to start over again when you break your resolutions!

Check out our previous post on New Year’s resolutions for more ideas for your resolution this year!

Vlog: “Hilleman: A Perilous Quest to Save the World’s Children” Screening

Join Kristine Alarcon, MPH for A Day in the Life of a Public Health Coordinator to learn about some of the activities we at the Hepatitis B Foundation take part in!

This episode highlights our special film screening of “Hilleman: A Perilous Quest to Save the World’s Children.”

Check out our previous blog post for more information about the event here and our last vlog here.

It’s Flu Season! Did you get your shot?

Flu season is upon us! It usually ranges from the winter into early spring. It’s important that you get your flu shot, especially if you or a family member has a chronic disease such as hepatitis B.

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get the flu vaccine every year. Flu viruses change constantly from season to season and can even mutate during a single flu season. It takes 2 weeks for antibodies to develop, so get your flu shot today!

There are some people who cannot get the flu shot, including certain age groups, those with health complications, and those with allergies. However, there are still ways people can protect against getting sick. Be sure to wash your hands to prevent the spread of germs. If you feel you are sick, stay home from work or school.

While we all know antiviral drugs are effective against the hepatitis B virus, researchers have also developed antivirals that can help us fight the flu once it is confirmed someone are infected. People at high risk of serious flu complications (such as children younger than 2 years, adults 65 and older, pregnant women, and people with chronic hepatitis B) and people who simply get very sick with the flu should talk to their doctor about getting one of three available flu antiviral drugs–oseltamivir, zanamivir, or peramivir.

According to CDC, prompt treatment with a flu antiviral can mean the difference between having a mild case versus a very serious one that can potentially land you in the hospital.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still help if administered later during your illness. Antivirals are effective in all age and risk groups. Studies show some doctors do not prescribe antiviral drugs to people at high risk of complications from the flu, so be assertive and ask your doctor for them if you have the flu!

It’s time to get your flu shot! It will help you, your family, and friends get protected against the flu. To find out where you can get a flu shot, click here.

For more information about hepatitis B and the flu vaccine, check out our previous posts on the flu here, here, and here.

HIV/HBV Co-Infection

World AIDS Day was last Friday, December 1st. It is a day dedicated to raising awareness about HIV and AIDS. However, it is also a great opportunity to discuss the possibility of coinfection with hepatitis B virus, HBV.

 Dr. John Ward, MD, Director, Division of Viral Hepatitis, CDC talks about hepatitis B, hepatitis C, and HIV epidemics in the United States.

Hepatitis B (HBV) and HIV/AIDs have similar modes of transmission. They can be transmitted through direct contact with blood, or sexual transmission (both heterosexual and MSM). Unfortunately, people who are high risk for HIV are also at risk for HBV, though hepatitis B is 50-100 times more infectious than HIV. Fortunately hepatitis B is a vaccine preventable disease and the vaccine is recommended for individuals living with chronic HIV.

Nearly one third of people who are infected with HIV are also infected with hepatitis B or hepatitis C (HCV).2 To break down the numbers further, about 10% of people with HIV also have hepatitis B, and about  25% of people with HIV also have hepatitis C.2 Liver complications due to HBV and HCV infections have become the most common non-AIDS-related cause of death for people who are HIV-positive.3

Who is at risk of HIV and HBV co-infection? Because both infections have similar transmission routes, injection drug use and unprotected sex (sex without condoms) are risk factors for both infections.4 However, there are additional risk factors for HIV and  for HBV that put people at risk4

It is important that people who are at risk of both diseases are tested! HIV-positive people who are exposed to HBV are more likely to develop a chronic HBV infection and other liver associated complications, such as liver-related morbidity and mortality if they are infected with HBV.1

If a person is co-infected with both HBV and HIV, management of both diseases can be complicated, so a visit to the appropriate specialists is vital.3 Some anti-retrovirals, which are usually prescribed to treat HIV, can eventually lead to antiviral resistance or liver-associated problems.3 One or both infections will require treatment and must be carefully managed.  Treatment differs from person to person .4

It is also important to hear about the perspectives of those who are living with co-infections. As a part of our #justB: Real People Sharing their Stories of Hepatitis B storytelling campaign, Jason shares his experience of living with both hepatitis B and HIV/AIDs.

To learn more about HIV and viral hepatitis coinfection, go here. For more #justB videos, go here.

References:

  1. Centers for Disease Control and Prevention (CDC). (2017, Sept). HIV/AIDS and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hepatitis/populations/hiv.htm
  2. Centers for Disease Control and Prevention (CDC). (2017, June). HIV and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hiv/pdf/library/factsheets/hiv-viral-hepatitis.pdf
  3. Weibaum, C.M., Williams, I., Mast, E.E., Wang, S.A., Finelli, L., Wasley, A., Neitzel, S.M, & Ward, J.W. (2008). Recommendations forMorbidity and Mortality Weekly Report (MMWR), 57(RR08), 1-20. Retrieved from: Identification and Public Health Management of Persons with Chronic Hepatitis B Infection. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

Special Film Screening: “Hilleman: A Perilous Quest to Save the World’s Children”

The Hepatitis B Foundation was excited to share a special film screening of Hilleman: A Perilous Quest to Save the World’s Children.

Packed house at the film screening with opening remarks by Chari Cohen, DrPH, MPH

The documentary film, produced by The Vaccine Makers Project, follows the unknown story of a man who “had more of an impact on [people’s] lives compared to Einstein.” The film tells the story of a courageous and gutsy scientist, Dr. Maurice R. Hilleman, and the elimination of diseases of children. With his unwavering determination, Dr. Hilleman invented the first-ever vaccine against a human cancer (the hepatitis B vaccine), developed the measles-mumps-rubella (MMR) combination vaccine, and prevented pandemic flu. During World War II he developed an urgently needed vaccine for Japanese B encephalitis in 30 days.

 

The hepatitis B virus was also featured in the documentary.

He is responsible for more than half of the vaccines children receive today and is credited with saving more than eight million lives every year. Now through exclusive interviews with Dr. Hilleman and his peers, rare archival footage, and 3-D animation, this new documentary puts a human face to vaccine science, revealing the character that drove this bold, complex, and heroic man.

When parents began choosing not to vaccinate their children in the 1990s, a cruel irony became clear; Hilleman’s unprecedented successes have allowed us to forget just how devastating childhood diseases can be. The documentary reminds us by allowing us to see these diseases as part of the film.

Chari Cohen, DrPH, MPH introducing the panelists. L-R: Timothy Block, PhD (Moderator), Donald Rayne Mitchell, David Oshinsky, PhD, Walter Tsou , MD, MPH, Paul Offit, MD

Community members from Philadelphia and Bucks County came for the film screening as they enjoyed fun movie snacks. They also enjoyed a panel discussion moderated by Timothy Block, PhD, with the documentary director and esteemed representatives from scientific community. Expert panelists included Donald Rayne Mitchell, Paul Offit, MD, David Oshinsky, PhD, and Walter Tsou, MD, MPH. They shared their thoughts on the documentary, Dr. Hilleman’s life, and the future of vaccines. Mitchell and Dr. Offit expressed that the documentary film was created to “inspire a kid or to get into [scientific] work someday,” and to “put a human face on vaccines.”

For more information about the film, click here. If you are interested in learning more about the hepatitis B vaccine, click here.

Be on the look out for a special “preview” vlog of the film screening at the end of December 2017.