Hep B Blog

Category Archives: Living with Hepatitis B

Recently Diagnosed with Hepatitis B? Getting Through the Next Months Waiting to Confirm if Your Infection is Acute or Chronic

Have you recently been told you have hepatitis B?  Dealing with the diagnosis and waiting out the next six months to determine if your infection will resolve itself or learning that it is a chronic infection can be nerve-wracking.

Fortunately, greater than 90 percent of healthy adults who are newly infected will clear or resolve an acute hepatitis B infection.  On the hand, greater than 90% of babies and up to 50% of children infected with hepatitis B will have lifelong, chronic infection. Sometimes people are surprised to learn they have a chronic infection. It can be confusing since there are typically few or no symptoms for decades. If a person continues to test hepatitis B positive for longer than 6 months, then it is considered a chronic infection. Repeat testing is the only way to know for sure.

Acute hepatitis B patients rarely require hospitalization, or even medication.  If you are symptomatic, (some symptoms include jaundice, dark urine, abdominal pain, fever, general malaise)  you may be anxiously conferring with your doctor, but if you are asymptomatic, you might not feel compelled to take the diagnosis seriously.  Ignoring your diagnosis can be very serious. If you have concerning symptoms like jaundice (yellow eyes and skin), a bloated abdomen or severe nausea and vomiting, please see your doctor immediately. Your doctor will be monitoring your blood work over the next few months to see if you clear the virus, or monitoring your liver if there are concerning symptoms.

Your job is to start loving your liver …today.  STOP drinking alcoholic beverages.  Refrain from smoking cigarettes.  Your liver is a non-complaining organ, but you cannot live without it.  Make your diet liver-friendly and healthy filled with a rainbow of vegetables and fruits, whole grains, fish and lean meats. Minimize processed foods, saturated fats and sugar.  Drink plenty of water.

Talk to your doctor before taking prescription medications, herbal remedies, supplements or over-the-counter drugs.  Some can be dangerous to a liver that is battling hepatitis B.  Get plenty of rest, and exercise if you are able.

Don’t forget that you are infectious during this time, and that loved ones, sexual partners and household contacts should be tested to see if they need to be vaccinated to protect against hepatitis B.  Sometimes family members or close household contacts may find that they have a current infection or have recovered from a past HBV infection.  If anyone fears exposure ensure them that hepatitis B is not transmitted casually. They should get tested, and vaccinated if needed, and take simple precautions. Remind them that 1/3 of the world’s population will be infected with the hepatitis B virus during their lifetime.

On the flip-side… Do not let this new hepatitis B diagnosis consume you.  As the weeks and months pass, you might find that the infection is not resolving, and you might worry that you have a chronic infection.  The associated stress and anxiety can be challenging, even overwhelming.  It can contribute to physical symptoms you may be experiencing.  Find a family member, friend, or health care professional with whom you can share your concerns.

If you are told you have recovered from an acute HBV infection (you are now HBsAg negative, HBcAb positive and HBsAb positive) be sure to get copies of your lab reports to ensure there are no mistakes. Compare them with our easy to use blood tests chart.   If something looks wrong, or if you’re confused, speak up and ask your doctor. Once confirmed be sure to include hepatitis B as part of your personal health history. This is important in case you have conditions later in life that warrant monitoring.

No one wants to learn they have chronic hepatitis B but it is a manageable disease. You’ll want to see a doctor with experience treating chronic HBV so they can run additional tests. There are very effective treatments available, though not everyone with chronic HBV needs treatment. All people living with chronic HBV benefit from regular monitoring since things can change with time. Please do not panic or ignore a chronic hepatitis B diagnosis. Take a deep breath and get started today learning more about your HBV infection and the health of your liver.  Things are going to be okay!

If you are confused about your diagnosis, please feel free to contact the Hepatitis B Foundation at info@hepb.org.

If Hepatitis B Is Sexually Transmitted, How Come My Partner Isn’t Infected?

Image courtesy of Canva

I thought hepatitis B was sexually transmitted? I just tested positive, but my partner tested negative, we’ve been together for years, what gives?

This question is a common one. Hepatitis B is indeed easily transmitted sexually, so why do some people — who were not vaccinated — never get hepatitis B from their sexual partners?

It comes down to variables, such as the type of sexual activity you engage in, the viral load (HBV DNA) of the infected partner, and who is on the receiving end of infectious body fluids, especially blood that contains the most virus, and semen.

Having one partner infected, and other not, can add more stress to an already traumatic hepatitis B diagnosis. “It was very confusing and made me question how was it possible I was the only one infected,” said a woman who tested positive while her husband tested negative.  “I thought it was possibly a mistake, maybe I was a biological anomaly, which of course I was not.”

Let’s look at the factors that affect who gets infected and who doesn’t when two people have sex.

Viral load: Semen, vaginal fluids and blood all contain the hepatitis B virus (HBV), and the higher the viral load, the more infectious one’s blood and body fluids are. However, having an undetectable viral load doesn’t mean you won’t infect someone during unsafe sex. Even if a man has an undetectable viral load, studies show his semen still contains some HBV and can spread infection, though the risk is lower.

So, the rule here is if a man tests positive for the hepatitis B surface antigen (HBsAg), he must consider himself infectious.

The role of gender: In heterosexual relationships, uninfected women are at higher risk of getting infected by a male partner infected with hepatitis B, than the reverse. Women are on the receiving end of semen, which greatly increases their risk of becoming infected unless a condom is used.

When a woman is infected with hepatitis B, an uninfected man is at risk through direct contact with her vaginal secretions, but that contact is lower-risk than a woman’s direct exposure to infectious semen during intercourse.

However, an infected woman who is menstruating is more likely to spread hepatitis B because blood can contain higher levels of HBV than vaginal secretions. That is why gloves and dental dams are recommended to provide a barrier against exposure.

The type of sexual activity: Certain sexual activities are far more efficient at spreading hepatitis B than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a very high risk of transmission because of tears in the skin that can occur during penetration, which improves transmission of HBV.

Fingering carries a lesser risk, unless the infected woman is menstruating or a person has bruises or cuts on their hands that allow entry of hepatitis B virus in semen or vaginal fluids, then gloves are recommended.

The “uninfected” partner could already have been infected and cleared hepatitis B: When a person is first diagnosed with hepatitis B, doctors often test his or her partner for only the hepatitis B surface antigen (HBsAg), which indicates a current hepatitis B infection. If they are negative for HBsAg, they are immediately vaccinated.

If the partner isn’t also tested for the hepatitis B surface antibody (anti-HBs or HBsAb), then no one knows if the individual was already protected, either due to recovery from a past hepatitis B infection, or because they had already been vaccinated.

Hepatitis B is not called the “silent” infection for nothing — many people who get hepatitis B never have any symptoms and never realize they were infected. As a result, a wife, husband, partner or lover who tested negative for HBsAg, may actually have been infected in the past and cleared the infection and now has protective hepatitis B surface antibodies to forever safeguard them from infection. If they’re immediately vaccinated and retested after the three-dose vaccination, they will test positive for surface antibodies, without ever knowing that their antibodies resulted from a past infection, not immunization.

Bottom line, if one of you have been diagnosed and the other is not infected, it is unusual but not uncommon. Get tested and immediately vaccinated if the uninfected partner tests negative for the hepatitis B surface antibody.

Take a quiz to find out how much you know about hepatitis B transmission: click here.

Find an earlier version of this post here

World Hepatitis Day 2018: Why is Hepatitis B testing Important?

 You can help raise awareness and save lives…

Tell us why you think hepatitis B testing is important?

Globally, 292 million people are living with chronic hepatitis B. Only 10 percent are aware of their diagnosis. The theme for this year’s World Hepatitis Day is “Find the Missing Millions.” Help us raise awareness for World Hepatitis Day (July 28th, 2018) by telling the world why it is important to get tested for hepatitis B!

Create an awareness message about hepatitis B by answering the prompt below.The Hepatitis B Foundation will compile video entries for a larger video that will be released on World Hepatitis Day, July 28, 2018.

Who Can Enter? Anyone across the world!

Here’s how to Enter:

  1. Record a short video or an audio clip of yourself (15 seconds or less) answering the prompt, “People should be tested for hepatitis B because ….”

2. Note: You may choose the audio option if you wish to remain anonymous. Film yourself answering the above question. Your face and/or your picture does not have to be in the video; however, we must be able to hear you. If you choose to record an audio clip you are welcome to send a picture from your country or something that represents you. 

Keep your video no longer than 15 seconds!

  1. Send your video to us:
  1. When you send your video, please mention that you wish to participate in the World Hepatitis Day 2018 Campaign.

Video Tips/Guidelines

  1. Your video must be 15 seconds or less
  2. Your video should be in English

Note: If your video is recorded in a language other than English, please provide the English translation. If possible, provide a timed script with timings of phrases.

  1. Videos must be recorded in Landscape/horizontal mode. Videos recorded in a Vertical format cannot be used.
  2. Record your video in a quiet area or with a microphone.
  3. Record your video in good lighting.

Disclaimer

By submitting a video to this campaign, participants give the Hepatitis B Foundation permission to use their videos (audio and video), in the World Hepatitis Day campaign and promotion, as well as in future hepatitis B awareness efforts. The participant will waive any claims to royalty, right, or remuneration for such use. The Hepatitis B Foundation will not disclose any personal information obtained from participants (i.e., full names, email addresses, etc.) in the campaign to third parties or use the information for marketing or other purposes.

For inspiration, visit our website, World Hepatitis Alliance’sFind the Missing Millionscampaign, and CDC’s and Hep B United’s Know Hepatitis Bcampaign.

Submission Period: You must submit your video by July 20, 2018 (Submission closes at 11:59 PM EST on 7/20/18)

Have Questions? Please contact Kristine Alarcon at kristine.alarcon@hepb.org

Additional  information can be found at hepb.org/worldhepatitisday2018.

May is Hepatitis Awareness Month

Hepatitis Awareness Month is dedicated to increasing awareness of hepatitis in the United States and to encourage high risk populations to get tested. If you’re not sure how you can get involved in the hepatitis B community this month, here are some ways you can!

  • Share and spread hepatitis B knowledge. CDC’s Know Hepatitis B Campaign is a great resource to learn more about hepatitis B and to promote testing in your area! They also have great posters, handouts, and videos available in different languages including Spanish, Mandarin, Vietnamese, Korean, French, and more! You can also look for some of the Hepatitis B Foundation’s fact sheets and #justB storytelling campaign videos.
  • Join or organize a screening event. May 19th is National Hepatitis Testing Day! Organizations around the country will provide viral hepatitis screenings – both hep B and C! Be sure to look for some Hep B United partners’ websites for screenings in your local area, especially if you’re interested in volunteering.
  • Organize or join a flash mob to increase awareness! With our local hepatitis B campaign in Philadelphia, Hep B United Philadelphia, we held a “B A Hero Flash Mob” in the past. It is a great way to open the discussion about hepatitis B in an engaging and fun way!
  • Become an HBV advocate! You can join our Hep B United Action Center to get all the updates on our advocacy efforts. You can also share your hepatitis B knowledge on social media too!
  • Check out and share Hepatitis Victoria’s Little Hep B Hero book and animation. Hepatitis Victoria created an engaging book to explain hepatitis B to six to twelve-year-old children. Their book is available to order and in English, Simplified Chinese, and Vietnamese.
  • Join the #HepAware Thunderclap. You can easily share and show your support for CDC Hepatitis’s efforts by joining their Thunderclap by May 19th, Hepatitis Testing Day. You can use Facebook, a Facebook page you manage, Twitter, and Tumblr.
  • Join our international #HepBeLIeVER Social Media Contest. Not only will you be spreading hepatitis B awareness, but you can also get a chance to WIN a $50 AMAZON GIFTCARD and other Hepatitis B Foundation swag. All you have to do is take a picture loving your liver and upload it to Twitter, Instagram, or Facebook with #HepBeLIeVER. More information here.

There are endless possibilities to celebrate this month! If you need even more ideas, CDC has a plethora of resources available dedicated to Viral Hepatitis Awareness month. You can also check out our Hepatitis Awareness Month webinar from Hep B United, NASTAD, and CDC or Hep B United and NOHep’s webinar: The NOHep Fight for Elimination!

A Day in the Life of Program Managers: #justB Workshop

Welcome to a Day in the Life of Program Managers! Join Catherine Freeland, MPH, and Rhea Racho, MPAff for a day in their work life and the justB workshop.

#justB: Real People Sharing Real Stories of Hepatitis B” is collaboration between the Hepatitis B Foundation, Story Center, and Association of Asian Pacific Health Organizations (AAPCHO) to share the stories of people affected by hepatitis B. The episode highlights the workshop and process our storytellers go through to develop their impactful stories.

Music
Clouds – Joakim Karud

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SNAPCHAT: @hepbfoundation

Hepatitis B Precautions for People Living with Diabetes

 

March 27th is Diabetes Alert Day!

Diabetes is a chronic condition that is characterized by high glucose (or sugar) levels in the blood. It usually occurs when a person cannot produce enough insulin, a hormone that controls blood sugar levels. According to the World Health Organization (WHO), global prevalence of diabetes is on the rise! In 1980, diabetes prevalence in adults over the age of 18 was 4.7%. The number rose to 8.5% in 2014 and continues to increase. In 2015, there was an estimated 1.6 million deaths that were attributed to diabetes.

Like hepatitis B, there have been several studies that show a strong link between type II diabetes and liver cancer. Diabetes and hepatitis B can be a dangerous combination and can work together to increase someone’s risk of developing liver cancer.

Since the hepatitis B virus can be transmitted via blood or other bodily fluids, people living with diabetes are at an increased risk of contracting hepatitis B. In fact, one study found that people living with diabetes between the ages of 23-59 have an approximately two-fold increased risk of hep B infection compared to those without diabetes. According to the Centers for Disease Control and Prevention (CDC), there have been hepatitis B outbreaks in nursing homes, assisted living, and long-term care facilities among people living with diabetes. Some risks for transmission include:

  • Sharing glucose meters between residents without cleaning and disinfecting between uses
  • Lack of proper hand hygiene and failure to wear gloves between fingerstick procedures
  • Using the same fingerstick devices for more than one resident
  • Cross-contamination of clean supplies with contaminated blood glucose monitoring equipment used by home health agencies
  • Sharing injection equipment such as an insulin pen or syringe for more than one person
  • Failure to perform proper sterilization and separating contaminated and clean podiatry equipment
  • Failure to perform proper disinfection between podiatry patients

So, what can you do if you are living with diabetes to prevent hepatitis B transmission?

  • Get tested! A simple three-part blood test will tell you if you have hepatitis B, were exposed, or are protected.
  • Get vaccinated – If you find that you are not protected or if you have not finished your hepatitis B vaccine series. The CDC and Advisory Committee on Immunization Practices (ACIP) recommend that adults between 19-59 years of age living with diabetes get vaccinated to protect against hepatitis B. Those 60-years-old or older should ask their doctor about the vaccine before getting it.
  • Do not share your diabetes care equipment to prevent exposure!

For more information about hepatitis B and diabetes, WHO, CDC, and/or American Diabetes Association. For a personal account of hepatitis B and diabetes, visit Martha Zimmer’s blog post. You can also visit our website for information about diabetes and liver cancer

What to do about hepatitis B when you’re pregnant?

Around the world, the most common mode of hepatitis B transmission is from mother to child. Unfortunately, pregnant mothers who have hepatitis B can transmit the virus to their newborn during the delivery process. 90% of these HBV infected babies will progress to chronic infection  putting them at increased risk of serious liver disease or liver cancer later in life.

It is important that ALL pregnant women get tested for hepatitis B to prevent the transmission of the virus to newborns at birth.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all newborns born to hepatitis B positive women be given two shots in the delivery room – the first dose of hepatitis B vaccine (5 mcg dose) and one dose of hepatitis B immune globulin (HBIG, 0.5 mL dose). If a woman knows that she is infected, it is important that she tell her doctor to have these two drugs available when she is ready to deliver. These two shots must be given at separate injection sites, i.e. different limbs. When administered correctly within the first 12 hours of life, a newborn has a 95% chance of being protected against a lifelong hepatitis B infection. The infant will need to complete the hepatitis B vaccine according to schedule as part of a 3 or 4 dose series. CDC recommends follow up testing to confirm immunity or protection against HBV at 9 months or at the baby’s 1 year checkup.

The World Health Organization (WHO) recommends the birth dose of the hepatitis B vaccine for ALL babies, though it is especially important for a baby born to a woman with hepatitis B to receive the first dose of the vaccine as soon as possible, within 24 hours. HBIG may not be available in all countries or may be cost prohibitive. The hepatitis B vaccine series may be completed with the remaining monovalent  (single) injections of the HBV vaccine, or may be completed as part of a combination vaccine series.

In developing countries combination vaccines such as the pentavalent vaccine are often given to babies. The first dose of the pentavalent vaccine (which includes hepatitis B vaccine) is given at 6 weeks of age, and the 2nd and 3rd doses are given at 10 and 14 weeks of age. Waiting for the first dose at 6 weeks is too late for babies born to mothers living with chronic hepatitis, though the pentavalent vaccine should never be used as the birth dose or before 6 weeks. Women who know they have hepatitis B should talk to their doctor about ensuring that a birth dose of the hepatitis B vaccine is available for their baby at birth.

There is no second chance!  It is vitally important that we protect all newborns from hepatitis B!

Also, all infected pregnant women need to learn more about their hepatitis B infection from a liver specialist or a doctor with experience treating patients with chronic hepatitis B. It is recommended that pregnant women have their hepatitis B monitored throughout their pregnancy, to check the health of their liver and to see if they need treatment. For HBeAg positive women with high hepatitis B viral loads, taking FDA-approved antivirals during the last trimester can reduce the amount of virus in the blood and help prevent the chance of transmission to the newborn. Once an infected woman gives birth, it is important that she routinely see her doctor to keep monitoring her hepatitis B infection. Keeping mothers healthy allows them to better take care of their families!

For more information, or if you live in the U.S. and need help with hepatitis B infection during pregnancy, please visit the Perinatal Hepatitis B Prevention Program to find a coordinator near you. If you are outside of the U.S., you may consider visiting the World Hepatitis Alliance to find if there are organizations in your country that can ensure your baby starts with a birth dose of the hepatitis B vaccine.

Visit our website for additional information!

#StigmaStops: Can We End Hepatitis B Discrimination

Around the world, millions of people with chronic hepatitis B face wrenching discrimination that limits their dreams, education, careers, income and personal relationships.

Discrimination is unethical, unnecessary and a violation of human rights. Hepatitis B is simply not transmitted through casual contact. The stigma that persists is based on ignorance and it impacts millions around the world daily. The United Nations created Zero Discrimination Day to highlight the negative impact of discrimination and promote tolerance, compassion and peace. Many hepatitis activist organizations, including the Hepatitis B Foundation, used this commemorative day to draw attention to global hepatitis B discrimination. Even though Zero Discrimination Day was on March 1, we still need to recognize the importance of stopping hepatitis B discrimination.

Every day is zero discrimination day, and ending discrimination starts with each of us working in any way we can in our communities to end this stigma.

No one is to blame for hepatitis B, and people who have hepatitis B deserve the same opportunities to live fulfilling lives – at work, at home and in the community.  . There is a safe and effective vaccine that prevents hepatitis B infection. When people are protected, there is no reason to fear that healthcare workers or hotel maids will spread this infection. Even without vaccination hepatitis B transmission can be avoided with simple prevention measures. Hepatitis B is not transmitted casually.

People who have hepatitis B are part of our global community. They are our mothers, brothers, doctors, teachers, spouses and friends. To learn about how the fear of discrimination affects people who have hepatitis B, check out some of our #justB patient stories. Jin’s story tells us how a vibrant young woman handles her fear, and Carolyn’s story shows us the devastating consequences of hiding a hepatitis B diagnosis.

It is morally reprehensible that given the tools and knowledge we have that discrimination against people who have hepatitis B should continue today. So we ask you to help us end this discrimination.

One way you can fight hepatitis B discrimination is by joining the World Health Alliance in their #StigmaStops awareness campaign. It is a year-long campaign that highlights the stigma and discrimination associated with hepatitis around the world. #StigmaStops provides people living with hepatitis a platform to strengthen their voice and speak about the stigma and its impact as well as dispel myths and misconceptions of hepatitis B. Another way to help is to talk about hepatitis B – with your colleagues, friends and family members. The more we talk openly about hepatitis B, the less it will be stigmatized. And feel free to share our #justB videos – they can be a great conversation starter!

Read our previous blogs about employment discrimination and more stories about hepatitis B discrimination.

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.