Hep B Blog

Category Archives: Liver Cancer

Fighting the Doom and Gloom: Screening Saves Lives!

blood tubes

By Anu Hosangadi

Liver Cancer Connect’s “Fighting the Doom and Gloom” series is highlighting some of the advances in prevention, screening, and treatment that are helping to increase survival among people with liver cancer. Previously, we talked about how prevention works. Now we’ll explain how screening and surveillance save lives.
Continue reading "Fighting the Doom and Gloom: Screening Saves Lives!"

Fighting the Doom and Gloom: It Takes a Team

universal-health-care-medical-team

By Anu Hosangadi

People generally think liver cancer is non-treatable and non-curable. But that perception needs to change. Diagnosis and treatment of liver cancer have improved so much in the past 20 years that it can be cured if caught early and managed by an experienced health care team. Liver Cancer Connects “Fighting the Doom and Gloom” series explains how the right treatment plan  and teamwork offer the best chances for a cure.  Continue reading "Fighting the Doom and Gloom: It Takes a Team"

Join us for a Twitter Chat for Liver Cancer Awareness Month!

October is Liver Cancer Awareness Month. Often we neglect to think about the link between hepatitis and liver cancer. Tuesday, Oct. 16, representatives from Hepatitis B Foundation, CDC’s Division of Viral Hepatitis, and NASTAD will co-host a twitter chat at 3 p.m. EST to discuss this important link.

Featured guests include Prevent Cancer Foundation, Hep B United Philadelphia (HBUP) and Iowa Harm Reduction Coalition. Prevent Cancer Foundation is a national nonprofit dedicated to cancer prevention and early detection. HBUP is a Hep B United partner committed to testing and vaccination to fight hepatitis B and liver cancer in Philadelphia. Iowa Harm Reduction Coalition is a non-profit organization providing non-judgmental and compassionate services that empower people to care for themselves and one another.

Below are the questions to be discussed during the chat. How can you contribute?  Join the conversation that day and throughout the month with the hashtag #Liverchat. Share any resources or strategies you have that raise awareness about the link between liver cancer and hepatitis.

  • Q1:What are things everyone should know about liver cancer, and also the link between hepatitis and liver cancer?
  • Q2: What can people do to prevent hepatitis, or for those living with hepatitis, what can be done to protect the liver and prevent liver cancer?
  • Q3: What are the barriers that keep people from getting screened for hepatitis and liver cancer and how can they be addressed?
  • Q4: Why are some populations more vulnerable to hepatitis and liver cancer, and how do we address the disparities?
  • Q5: What resources are available to educate others about hepatitis B & C and liver cancer? What resources are needed?
  • Q6: Who are your key partners in addressing liver cancer? Who would you like to engage more in your work? (Tag them here!)
  • Q7: What is one lesson learned or piece of advice for others who want to expand their work on the link between viral hepatitis and liver cancer?

Co-hosts and featured partners of the chat include:

  • Hepatitis B Foundation – @hepbfoundation
  • NASTAD – @NASTAD
  • CDC Division of Viral Hepatitis – @cdchep
  • Prevent Cancer Foundation – @preventcancer
  • Hep B United Philadelphia – @hepbunitedphila
  • Iowa Harm Reduction Coalition – @IAHarmReduction
  • CDCNPIN will be moderating the chat – @cdcnpin

Confirmed participants and their handles include:

  • Hep B United  – @hepbunited
  • Coalition Against Hepatitis For People of African Origin – @CHIPO_HBV
  • Liver Cancer Connect – @livercancerconn
  • CDC’s Division of Cancer Prevention and Control – @CDC_Cancer
  • Hep Free Hawaii – @HepFreeHawaii
  • HBI-DC – @HBIDC
  • HepFreeNYC – @hepfreenyc
  • NAIRHHA Day – @NAIRHHADAY
  • Minnesota Department of Health – @mnhealth
  • Philly Hep C Coalition – @hep_CAP

Just getting started with Twitter? Do you wish to join the conversation but you don’t know how?  Type #Liverchat in the search box of the Twitter application to follow the chat, and click on “Latest”.

 

You can prepare your tweets in response to the topics listed above in advance, or you can also tweet on the fly, re-tweet, or Like a tweet during the chat.

The questions are labeled Q1, Q2, etc. so please respond/answer specific question by using A1, A2, etc. in front of your tweets. Remember to include the #Liverchat hashtag, which is not case sensitive, in all of your tweets.

If you plan to participate, please contact us at info@hepb.org and we’ll add you to the list of confirmed participants. Let us know if you have any other questions about joining the chat. We’re here to help!

 

 

 

Where is Hepatitis D? High Prevalence of Hepatitis B/D Coinfection in Central Africa

ResearchWhile hepatitis B is known to be highly endemic to sub-Saharan Africa and is estimated to affect 5-20% of the general population, the burden of hepatitis D, a dangerous coinfection of hepatitis B, has largely been left undescribed. Since the virus’s discovery 40 years ago, Africa has faced structural barriers that have contributed to the ongoing prevalence of the virus in this region. Widespread instability, under-resourced health systems, and poor surveillance have contributed to inadequate research and a lack of understanding about the health burden of hepatitis D on hepatitis B patients, particularly in Central Africa.

New data, however, reveals pockets of hepatitis B/D coinfection in this region, particularly in countries such as Cameroon, Central African Republic and Gabon. In a recently published study of nearly 2,000 hepatitis B infected blood samples from 2010-2016 in Cameroon, 46.7% tested positive for hepatitis D antibodies, a marker of past or current hepatitis D coinfection. Another study of 233 chronic hepatitis B carriers from 2008-2009 found a 17.6% positivity for hepatitis D antibodies. Other small studies from the Central African Republic have revealed 68.2% prevalence in hepatitis B patients, 50% coinfection in liver cancer patients and an 18.8% coinfection in hepatitis B infected pregnant women. Not only are new studies revealing evidence that there are groups at higher risk for hepatitis D, but a 2008 study on 124 community members in Gabon found 66% of them had markers for hepatitis D, proving this virus can also be circulating in the general population. Globally, hepatitis D is thought to affect about 5-10% of hepatitis B patients, making Central Africa an area of extremely high prevalence.

A diagnosis with hepatitis B and D can increase the risk for cirrhosis and liver cancer by nearly three times, and with only one available treatment, the future for coinfected patients if often uncertain. Although hepatitis B and D can be safely prevented by completing the hepatitis B vaccine series, which is available in many countries throughout Africa, the birth dose of the hepatitis B vaccine is often not given within the recommended 24 hours of birth. Lack of awareness, availability, and high cost mean many infants will not begin the vaccine series until 6 weeks of age, creating a window for exposure to hepatitis B. Greater than 95% of babies infected with hepatitis B will go on to develop chronic hepatitis B infections, leaving them susceptible to a future hepatitis D infection. Spread the same way as hepatitis B, through direct contact with infected blood and sexual fluids, hepatitis D can be contracted through unsterile medical and dental equipment and procedures, blood transfusions, shared razors and unprotected sex. Although the severity of disease varies greatly by hepatitis D genotype, coinfection always requires expert management by a knowledgeable liver specialist, which are often difficult to find.

As an increasing number of studies continue to describe the widespread endemicity of hepatitis B/D coinfection and its public health burden, researchers and the Hepatitis Delta International Network are calling on the World Health Organization (WHO) to declare hepatitis D a “threat” in this region in order to promote increased priority and awareness. Addressing hepatitis B/D coinfection prevention and management will be complex and require a multi-pronged approach through methods such as government prioritization, increased funding for health systems, hepatitis B vaccination awareness programs, birth dose prioritization, better sterilization techniques in hospitals, clinics, and barbers, and public awareness of the disease.

For more information about hepatitis B/D coinfection and the Hepatitis Delta Connect program, please visit www.hepdconnect.org or email us at connect@hepdconnect.org. Hepatitis Delta Connect seeks to provide information, resources and support for hepatitis B/D patients and their families through its website, social media, fact sheets, webinars and hepatitis D liver specialist directory.

Journey to the Cure: What Does Liver Cancer Research Look Like? ft. Aejaz Sayeed, 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 fourth episode (part 2), Kristine Alarcon, MPH sits down with Aejaz Sayeed, PhD, Assistant Professor at the Baruch S. Blumberg Institute, to talk about his research in liver cancer. For any questions about hepatitis B, please email info@hepb.org.

Disclaimer: The information provided in this audio post is not intended to serve as medical advice of 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:
Kristine Alarcon, MPH

Special thanks:
Samantha Young

Music:
Modern – iMovie Library Collection

Script:

Welcome to “Journey to the Cure!” Every month, we’ll sit down with scientists from the Hepatitis B Foundationand the Baruch S. Blumberg Instituteto talk to you about hepatitis B and efforts to find a cure for hepatitis B. There’s still a long way to go, but we’re here to walk you through our journey.

Kristine Alarcon, MPH:
Can you tell me about your research?

Aejaz Sayeed, PhD:
That’s an interesting question. I’vespent a lot of time pursuing breast cancer and prostate cancer. I just started working on the liver cancer. There are millions of people who are pursuing cancer research, but the challenge is that we have done a lot of progress in some cancers, but some cancers, still, we do not have a handle on. For example, we have done a lot of progress in breast and prostate cancer. We have not done much in pancreatic and liver cancer. And, the five-year survival rates of breast and prostate and other cancers have drastically increased, but we have not done much of a progress in pancreatic or a specific form of brain cancer or pancreatic cancer or liver cancer. The problem, again, is that we’re not able to detect the disease at an early stage, and if we had a good set of biomarkers available, there’s a good opportunity, there’s a good chance that we should be able to control these diseases as well.

Kristine Alarcon, MPH:
What attracted you to studying liver cancer?

Aejaz Sayeed, PhD:
I’ve been working on breast cancer and prostate cancer, so in liver cancer, I want to use the tools and techniques, which I used in breast and prostate cancer. That’s why there’s that desire to use the similar strategies, which I used in breast and prostate cancer to discover and characterize markers. That’s why I’m still setting up collaborations with transplant surgeons because liver cancer is treated generally by either resecting the tumor or transplanting the liver. The liver is such an important organ that you cannot really take the liver away. You need the liver. Transplanting the liver is another strategy of treating these patients, so, yes, it is basically that desire that we have more biomarkers, and I can use the knowledge that I gained in breast and prostate to recapitulate the same kind of events, so that we can make a dent.

Kristine Alarcon, MPH:
Yeah; that’s so cool.

Aejaz Sayeed, PhD:
Thank you.

Kristine Alarcon, MPH:
Well, thank you for joining us on this episode of “Journey to the Cure.” Please join us next time for our next episode. Thank you for joining us!

Aejaz Sayeed, PhD:
Thank you!

The Woodchuck Colony Legacy

Bud Christopher Tennant, DVM (1922-2016)

Did you know that the hepatitis B virus doesn’t just infect humans? It also infects chimpanzees1, tree shrews1, Peking ducks1, horses2, and woodchucks2. The hepatitis B virus that infects woodchucks is closely related to the human hepatitis B virus.2 Because of this, woodchucks have now become a prominent animal model in studying the hepatitis B virus and testing drugs for the disease.2,3

Behind every legacy, there is a man who started it all. In the case of the woodchucks and hepatitis B, there was Bud Tennant, DVM. Dr. Tennant was a California native, born in the San Joaquin Valley.2 He studied veterinary medicine, earning his Doctor of Veterinary Medicine from the University of California at Davis in 1959. 2 As a veterinarian, Dr. Tennant conducted research in comparative medicine focusing on hepatocarcinogenesis (development of liver cancer), hepatic injury mechanisms, viral hepatitis, and gastrointestinal and liver diseases of domestic animals.2

His work in hepatitis started during his tenure as the James Law Professor of Comparative Medicine at Cornell University, where he studied the pathogenesis of serum hepatitis in horses.2 He would not work with woodchucks until Dr. Norman Javitt, Chief of Gastroenterology at Weill-Cornell Medical College at the time, approached him, urging the need for an animal model for studying hepatitis B virus to understand pathogenesis, treatment, and prevention of hepatitis B. Dr. Javitt introduced him to Drs. Jesse Summer and William Mason’s research on a new virus infecting woodchucks, its close relation to human hepatitis B virus, and its association with chronic hepatitis B and liver cancer.

Dr. Tennant spent over thirty years on the study of Woodchuck Hepatitis Virus infection,  working with a colony of woodchucks in Ithaca, New York. 2 He developed the woodchuck as a successful animal model to learn how hepatitis B effects the liver, including the development of liver cancer. His work with the woodchuck model ultimately enabled scientists to run clinical therapeutic trials for treating hepatitis B in humans. 2 In fact, preclinical studies for almost every hepatitis B therapeutic drug licensed by the FDA have been conducted using the woodchuck model! Today, the Woodchuck Hepatitis Virus infection study continues at the Roswell Park Cancer Institute in Buffalo, New York. 2

Dr. Baruch S. Blumberg would also contact him to work together on fighting the hepatitis B virus in humans.

Dr. Bud Tennant is famous in the scientific world for his game-changing work in hepatitis B, and won many awards. At the 2016 Hepatitis B Foundation Crystal Ball, Dr. Tennant was presented with the 2016 Baruch S. Blumberg Prize, the Foundation’s highest honor. 2 He was also beloved by those who worked with him. He was known as “a towering physical presence, yet soft spoken and humble, and he was greatly admired for his good nature and his ability to share a story on just about any topic.” 2 Though Dr. Tennant passed away a little over a year ago, he will always be remembered for his unwavering commitment, and thought of as a valued friend and mentor to many scientists. 2

References:

  1. Schinazi, R.F., Ilan, E., Black, P.L., Yao, X., & Dagan, S. (1999). Cell-based and animal models for hepatitis B and C viruses. Antiviral Chemistry & Chemotherapy, 10, 99-114.
  2. Ithaca Journal. (2016, Nov 29). Bud Christopher Tennant. Retrieved from: http://www.legacy.com/obituaries/theithacajournal/obituary-print.aspx?n=bud-christopher-tennant&pid=182819897
  3. Hepatitis B Foundation. (2016). HBF at the Forefront: Hepatitis B Foundation Hits Nearly $125,000 Monte Carlo Jackpot!, B Informed, 69, 5.

Celebrating the Holidays with Hepatitis B

Image courtesy of Pixabay

The holidays are a joyous time as family and friends gather for parties, dinners and get-togethers. However, they can also be a difficult, stressful time on so many levels, and especially for those who might not yet have disclosed their hepatitis B to loved ones.  You may have been recently diagnosed, or decided this is the year you’re going to let them know about your status. If you’re not there yet, that’s okay, but consider making this the year you choose to disclose.

Enjoy and celebrate the holiday cheer, but …alcoholic beverages may be an issue during this time, and it may be tempting to indulge. The most important thing to do is not pick up that drink no matter what! Hepatitis B and alcohol is a dangerous combination. Here are some tips that may help you politely refuse a drink:

  • Practice saying no
  • Prepare a reason for not drinking (i.e., “Sorry, I’m taking mediation and I can’t drink.” or “My stomach is upset and I want to enjoy all this food.”)
  • Leave the event early if you feel uncomfortable.
  • Find others who are not drinking.
  • Choose a non-alcoholic drink – sparkling water with fruit is a healthy option!
  • Volunteer to be the designated driver. You may suddenly find you have many friends!

You might want to think long and hard about disclosing your status to coworkers and acquaintances.  Only you know for sure, but family and close friends can become a new source of support for you moving forward. If the holidays inspire you to share your status, you may start with talking about your family’s health history. Even though hepatitis B is not genetic and does not run in families like some other chronic diseases, it is possible that you may have hepatitis B because you were exposed to it from an infected family member, possibly at birth or by accidental household exposure; 90% of babies and 50% of young children who were infected with hepatitis B become chronically infected. It is also important to talk about hepatitis B if there is a history of liver disease and cancer in your family. Having hepatitis B can put you at an increased risk of developing liver disease and liver cancer during your lifetime.

Here are some other considerations:

  • Choose a time when there will not be too many distractions.
  • Think about whether your loved ones will be open and accepting.
  • Bring up an interesting fact to open up the conversation.
  • Ask a relative about their health history.
  • Try to break stereotypes surrounding hepatitis B.
  • Encourage your family members to get tested, vaccinated, or treated.
  • Family members may mention that “an uncle had liver problems”, or “died of cancer”, but not know if it was related to hepatitis B.
  • Be prepared with a printed fact sheet or video from the Hepatitis B Foundation or material from the Know Hepatitis B campaign!

Disclosure can be scary and make you anxious! When you are disclosing to a loved one, their response is out of your control, but their response might surprise you. Be prepared with simple explanations about hepatitis B. A Google search may highlight frightening statistics, so be sure to reassure loved ones that HBV is controllable and manageable.

Take a look at the videos from our #justB storytellers about how HBV has impacted their lives, and share them with family members. We must all do what we can to break the silence about hepatitis B so we can get more people tested and into care, and reduce stigma and discrimination!

For more tips on how to navigate the holidays with hepatitis B, check out our previous post here.

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.

Sharing Your Story – Your Family’s Story

Sharing Your Story – Your Family’s Story

Image courtesy of Good Free Photos

Thanksgiving is not only a day to eat turkey or remind us to remember what we are thankful for; it is also National Family History Day!!1 This holiday can be used an opportunity for families to discuss and record health problems that run through the family, as this helps us live longer and healthier. 1

There are many chronic diseases that may run through multiple generations of a family. 1 Doctors can predict whether or not you could have a chronic disease just by knowing if your parents, grandparents, and other relatives have had it. 1 That is why knowing your family health history is an important and powerful screening tool.1 You can change unhealthy behaviors, reduce your risk of diseases, and know when you should be screened when you learn about what diseases run through your family. 2

Image courtesy of Wikimedia Commons

Hepatitis B is not like other chronic diseases, where if your parents have it, your genes make you more prone to it. Hepatitis B is not genetic. The hepatitis B virus is transmitted through blood and infected body fluids. This can happen through direct blood-to-blood contact, unprotected sex, body piercings or tattooing, intravenous drug use, and as a result of unsafe medical or dental procedures. It can also be transmitted from an hepatitis B positive mother to her baby at birth.

Even though hepatitis B is not genetic, you should still include it in your family health history discussion! The most common method of hepatitis B transmission worldwide is from mother-to-child due to the blood exchange that happens during child birth. Pregnant women who are infected with hepatitis B can transmit the virus to their newborns during delivery. 90% of babies exposed to hepatitis B at birth will become chronically infected with hepatitis B, which increases their risk of serious liver disease later in life. Knowing your family’s hepatitis B history can help you figure out if you and other loved ones should get screened for or vaccinated to protect against hepatitis B.

Image courtesy of Wikimedia Commons

Knowing if you have a family history of liver cancer can also be important, since hepatitis B is one of the leading causes of liver cancer. If your family has a history of hepatitis B related liver cancer, then you may have a greater risk of developing liver damage or liver cancer if you have hepatitis B. Be sure to discuss a family history of liver cancer with your liver specialist.

If you need some advice on how to start the conversation about your family health history, read more here. You can also use the US Department of Health & Human Services’s My Family Health Portrait Web tool to help start this dialogue and learn how to share family history information at a future doctor visit.

You don’t need to wait until this Thanksgiving to talk about your family health history. You can talk to your family about your family health history and hepatitis B status RIGHT NOW!

References:

  1. https://www.hhs.gov/programs/prevention-and-wellness/family-health-history/about-family-health-history/index.html
  2. https://www.cdc.gov/genomics/famhistory/famhist_basics.htm