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Category Archives: Living with Hepatitis B

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Protein Myths and Your Liver

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Liver-friendly diets are a common concern for those with chronic hepatitis B wishing to make healthy lifestyle choices. Protein is essential to all, but there are healthier ways to consume necessary proteins.  Please enjoy this informative blog from the Al D. Rodriguez Liver Foundation – ADRLF, on Protein Myths and Your Liver written by ToniMarie Bacala.

We all love need protein – whether it be from animals or plants—protein gives us essential amino acids we need to keep our bodies strong and healthy. But how much do we really understand about protein and its effects on our organs, especially the liver? Is there such as thing as too much protein, even if its from vegetables and grains? Let’s delve into two popular protein myths and how we can ensure our protein intake is safe for our liver.

Love meat? Learn more about healthy proteins to protect you liver.
Love meat? Learn more about healthy non-animal meat proteins to protect you liver and keep your body healthy.

Protein is made of 20 different amino acids, but only 11 of which can be naturally synthesized by our body. The other types of protein come from the food we eat. Essentially, it’s safe to say that while protein helps in building the cell wall, strengthening muscle tissues and supporting cell functions, our body actually just needs certain types of amino acids.

So myth or truth? The best source of protein is animal meat. MYTH

Eating red meat requires our digestive system, as well as our liver to do a lot of work processing the heavy bulk of protein. Experts suggest limiting the amount of red meat we eat to at most one serving a day.

There are other good sources of proteins like whole grains, green vegetables, nuts, peas and beans. Fruits also contain small amounts of protein. Compared to animal meat, vegetables and beans have phytochemicals, antioxidants and other nutrients. Nuts and beans containing antioxidants help the liver process the food and beverage that we take in, making it a healthier source of protein.

Myth or truth? People desiring to build lean muscle mass can eat as much protein-rich food as they want.

MYTH.

There is such a thing as too much protein. While protein is an essential nutrient, the overall health of our body lies in having a balanced diet. People building up muscles such as athletes and bodybuilders are no different.

The advisable amount of protein intake for men also differs from women. Consult your doctor or a nutritionist who can give you the appropriate amount of protein you should include in your diet, as based on your weight, age and daily activities. There are also vegan bodybuilders who get much of their protein requirements from vegetables and grains.

Eating too much protein can cause several health conditions such as ketosis, organ failure, and heart diseases. Too much protein can also be dangerous and stressful to the liver. So look out for other protein myths with the basic truth in mind: Keep protein intake in moderation and explore the benefits of non-animal sources of healthy proteins.

Liver Cancer, Living with Hepatitis B

Inexpensive Test Could Reveal Liver Cancer Risk

Could an inexpensive test, used in conjunction with current, traditional HCC testing help reveal one’s liver cancer risk? Research for the V-chip is described in an article published in this week’s  Health Canal. 

Scientists from the Houston Methodist Research Institute and the University of Texas M.D. Anderson Cancer Center will receive about $2.1 million from the National Cancer Institute to learn whether a small, low-cost device can help assess a person’s risk of developing a common form of liver cancer.

The four-year project is based on technology previously developed by Houston Methodist nanomedicine faculty member Lidong Qin, Ph.D., who is the new project’s principal investigator. Qin’s “V-Chip,” or volumetric bar-chart chip, will be used to detect biomarkers for hepatocellular carcinoma (HCC), the most common cause of liver cancer. The device only requires a drop of blood from a finger prick.


The V-Chip allows the testing of up to 50 different molecules in a blood or urine sample.

“Most of the burden of HCC is borne by people who have low income, with the highest incidence rates reported in regions of the world where infection with hepatitis B virus is endemic,” Qin said. “Developing an accurate and low-cost technology that assesses the risk of cancer could make a big difference to people who ordinarily can’t afford expensive tests.”

M.D. Anderson Department of Epidemiology Chair Xifeng Wu is the project’s co-principal investigator.

Qin and Wu will see whether the V-Chip accurately detects HCC biomarkers. The researchers will also determine which combination of these biomarkers proves most predictive of disease.

Among the biomarkers the researchers will look at are antigens of hepatitis viruses B and C, aflatoxin (a fungal toxin that at high doses is associated with cancer risk), and metabolic indicators of alcohol consumption, obesity, diabetes, and iron overdose.

Tests of the V-chip will not replace traditional testing methods, but rather be carried out in tandem so that patients’ care cannot be adversely affected.

Hepatocellular carcinoma is believed to be the third-highest cause of cancer death worldwide and the ninth leading cause of cancer death in the U.S. It is most commonly caused by a past infection of hepatitis viruses B or C (HBV or HCV) and cirrhosis of the liver caused by alcohol abuse or other toxic damage.

Please visit Health News, Health Canal for more information 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Living with Hepatitis B

Diagnosed With Chronic Hepatitis B? What Phase – HBeAg-Positive Chronic Hepatitis / Immune Reactive / Immune Clearance?

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In the last chronic hepatitis B stages blog, we looked at the HBeAg-Positive Chronic Infection (also known as immune tolerant).

At some point the immune system recognizes the hepatitis B virus and the chronically infected person will enter a phase referred to as the  HBeAg–positive chronic hepatitis- (also  known as immune reactive/immune clearance). During this phase blood work will show that you are HBeAg positive, with lower levels of HBV DNA when compared to the HBeAg-positive chronic infection/immune tolerant stage, and increased ALT (SGPT) levels. (Remember, it is not at all unusual for kids to have viral loads in the millions or even billions.) During this “clearance” phase the immune system is actively attacking infected liver cells. This is both good and bad. On the good side, if the immune system is able to “beat” the virus, the person will go through HBeAg seroconversion and lose the HBeAg antigen. This means that HBeAg will go from positive to negative and the HBeAb antibody, or anti-HBe will go from negative to positive.  This results in significant decrease in the hepatitis B virus level, often to an undetectable level, and normalization of ALT/AST liver enzymes and other liver function blood test results. Successful HBe serconversion moves you into the HBeAg-negative chronic infection/inactive carrier phase.

When the immune system activates and starts attacking infected liver cells, it not only kills the virus, but also the host liver-cells. You may not feel any of this, but your ALT (SGPT) and AST (SGOT) lab values will be elevated. These enzymes are released when there is inflammation caused by liver cells that are injured or killed.  Your doctor may see a mild, moderate or high levels of ALT elevation reflecting inflammation in the liver. Ultimately the problem is how much inflammation and liver damage occurs during the process of HBeAg seroconversion. Your doctor will need to carefully monitor liver enzymes, liver function and use non-invasive calculations and diagnostic imaging to get a clearer picture of what is happening with your liver.

It is possible a person will quickly and spontaneously move into and out of the HBeAg-positive chronic hepatitis/immune reactive phase, and with a limited amount of inflammation and liver damage. However, some people may cycle up and down for years with intermittent flares, which are evidenced by ALT elevations which may be as high as 10 times above the upper limits of normal (normal is 35 IU/mL for men and 25 IU/mL for women) when in the immune reactive phase.  While the immune system attacks infected liver cells, viral replication will decrease and ALT levels will elevate as infected liver cells die in the battle.  If successful, the immune system response will result in HBe seroconversion –  losing HBeAg, gaining the HBe antibody, and a decline of the viral load  (HBV DNA) to very low or undetectable levels, and the normalization of ALT/AST and other liver enzyme levels.

Unfortunately, that might not be enough, and the immune system may not be able to put up a big enough fight permitting HBe seroconversion to a less active or HBeAg negative chronic infection /inactive carrier phase. Evidence of this is ALT levels that go back down, and viral replication that goes back up. (Note the above diagram.) This cycling up and down over time will be reflected in lab work if a liver specialist monitors you regularly over time. If you are not having your ALT levels regularly monitored (every few months), then you may miss these cycles of intermittent elevations or flares over time. It is during these elevations that liver damage occurs, and you will likely be completely unaware, unless you have lab work done while liver enzymes are elevated, or you wait until there are symptoms and significant liver damage.

It is during the immune clearance phase when treatment is sometimes recommended. It is true that a chronically infected person will eventually serconvert HBe spontaneously – without treatment, but most liver specialists choose to treat in order to prevent years of ALT elevations and flares and subsequent damage to the liver.

If you appear to be in the HBeAg-Positive Chronic Hepatitis / Immune Reactive phase, be sure to ask your doctor about treatment with first line antivirals such as tenofovir (TAF or TDF) and entecavir.  Don’t be afraid to ask questions about your hep B infection and the health of your liver. Treatment with antivirals greatly reduce liver disease progression and can be lifesaving.

 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Living with Hepatitis B

Kudos to HBF’s Blog Voted as a “Sexual Health Top 10, Must Read Blog”

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The team at Health Express has voted HBF’s blog as one of the “Must Read Blogs of 2013 – Sexual Health Top 10!”  HealthExpress.co.uk is an online clinic that provides support, advice and treatment for common medical conditions that patients do not always feel comfortable talking about. You can take a look at their recommended Top 10 blogs and learn more about them at healthexpress.co.uk.

The accolades from the HealthExpress team are a great opportunity to review transmission of the hepatitis B virus. HBV is transmitted through infected blood and body fluids. This includes direct blood-to-blood contact, unprotected sex, unsterile needles, and from an infected woman to her newborn baby at birth.  Sharing sharp, personal items that may have trace amounts of blood on them such a razors, toothbrushes, nail clippers and body jewelry including earrings, can also spread the virus.  Remember that the HBV virus may live up to a week on a surface resulting in possible transmission through direct blood-to-blood contact. This is why close, household contacts or family members are at greater risk of infection if one or more members are living with HBV. Don’t forget to be sure your tattoo or piercing experience is safe and that the parlor carefully follows infection control practices. Hepatitis B is also 50-100 times more infectious than the HIV virus.

Hepatitis B is also a sexually transmitted disease and is spread through infected semen, vaginal fluids and any blood that may be exchanged as part of a sexual practice – most often through sexual intercourse. In the United States, sexual transmission is the most common mode of HBV transmission and is responsible for 2/3 of acute HBV infections. A common question is “what about oral sex?” In general, oral sex would be considered less risky, but any kind of intimate sharing that may result in the exchange of bodily fluids will present some degree of risk.

So how can you prevent hepatitis B transmission between sexual partners? Fortunately there is a safe and effective hepatitis B vaccine to protect against the spread of HBV.  Get screened for HBV and vaccinate to protect – especially if you or your partner has more than one sexual partner, or if one or more partners is at greater risk.  When in doubt, get screened. Keep in mind that HBV is referred to as a “silent infection” since it may take decades for symptoms to occur. People with chronic HBV may be completely unaware of their infection and inadvertently spread HBV to their partner(s) if precautions are not taken.

Other precautions include practicing safe sex by using a latex or polyurethane condom. A lambskin condom will not prevent the spread of hepatitis B or other viral STDs. Looking for condom details?

A general comment to those with multiple sex partners– We are very fortunate to have a vaccine to protect against the hepatitis B virus. However, practicing safe sex with an effective condom is always advised to prevent the transmission of other infectious diseases that are not vaccine preventable, such as HCV and HIV, along with condom use to prevent the spread of other sexually transmitted diseases. Use common sense. No one wants a sexually transmitted disease, and if you have HBV, you really don’t want a coinfection. It can really complicate your life.

Hepatitis B Treatment, Living with Hepatitis B

HBV Journal Review – August 2013

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HBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:

*First Clinical Trial Using “RNA Interference” for Hepatitis B Begins
*Why Do Some People Clear HBsAg After Years of Chronic Infection?
*Longer Antiviral Treatment Urged after Seroconversion to Prevent Relapse
*Federal Officials Dramatically Undercount Liver Disease Deaths in the U.S.
*More Women Than Men Retain Protection Against Hepatitis B After
*Immunization Hepatitis B Cirrhosis Declines in China, But Alcohol-related
*Cirrhosis Rises Hepatitis E Vaccine Development Shows Promise
*Tenofovir Most Effective Antiviral Treatment in HIV-HBV Coinfected Patients
*Study Confirms Coffee Protects the Liver in European Populations
*Hepatitis C Is Also a Risk for Southeast Asians, Including Women
*In Small Trial, Chinese Herbal Medicine Reduces ALT Levels

HBV Journal Review
August 1, 2013
Volume 10, Issue 8
by Christine M. Kukka

First Clinical Trial Using “RNA Interference” for Hepatitis B Begins

A ground-breaking approach to hepatitis B treatment, which manipulates RNA messengers to halt viral replication, has begun its first human clinical trial. If successful, this approach would be a paradigm shift in treatment, possibly re- placing interferon and antivirals.

In animal trials, reported in the May 2013 journal Molecular Therapy, RNA interference (RNAi) treatment reduced hepatitis B surface antigen (HBsAg) levels to undetectable within 24 hours in mice and the antigen remained undetectable for nearly a month.

RNAi treatment works by destroying or “silencing” the molecular messengers that carry im- portant genetic information to the hepatitis B virus (HBV) antigen/ protein factories. Without the critical information that messenger RNA molecules carry, these antigen factories shut down and HBV reproduction de- clines dramatically.

Early RNAi research found that RNA silencing worked extremely well in the liver, but the challenge has been to create a formula and delivery system to target hepatitis B antigens in liver cells without affecting other important cells.

Arrowhead Research Corp. found that when the small RNA interrupters are linked to cholesterol, they target liver cells extremely well, and the addition of special polymers helps the gene silencing process. Arrowhead designed an intravenous formula, called ARC-520, that is utilized in its Phase 1 trial.

The hope is that when the viral load is dramatically reduced, the body’s immune system can gain the upper hand and eradicate the infection on its own.

In addition to its mouse trial, a similar trial involving an HBV infected chimp with an extremely high viral load also led to rapid reduction in HBV DNA and a 90% reduction in another hepatitis B antigen—the hepatitis B “e” antigen (HBeAg).

The clinical trial of ARC-520 (which uses a Dynamic Polyconju- gate delivery platform and includes two distinct RNA silencing agents that should shut down hepatitis B anti- gen reproduction) in humans is taking place in Melbourne, Australia. It is a randomized, double-blind, placebo- controlled trial. Each group of six healthy volunteers will receive either a placebo intra- venous injection or a single dose of ARC- 520…
Continue reading about this and additional studies…

 

Living with Hepatitis B

Hepatitis B and Social Security Disability Benefits

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Please welcome guest blogger, Ram Meyyappan, senior editor of Social Security Disability Help as he provides advice on applying for Social Security Disability Insurance or Supplemental Security  Income should your HBV prevent you from working.

Hepatitis B (HBV)  is often referred to as a “silent infection” because those chronically infected may have few or no symptoms, or may not be unaware of their infection for decades. However, over time, the risk of serious liver disease is certainly possible and symptoms can range from mild to severe.  Severe symptoms rarely occur with an acute HBV infection, but can have very serious outcomes.  If your condition is severe to the point that you can no longer continue to work, you may qualify for SSDI (Social Security Disability Insurance) or Supplemental Security Income (SSI) benefits from the Social Security Administration (SSA).

You can learn more about SSDI and SSI here

Hepatitis B and Qualifying for Benefits

When you submit an application for Social Security Disability benefits an adjudicator will review your file and compare your condition with a listing of conditions known as the SSA Blue Book (http://www.ssa.gov/disability/professionals/bluebook/). This Blue Book contains a listing of conditions and qualifying criteria that may qualify an individual for Social Security Disability benefits. Unfortunately Hepatitis B does not have its own listing in the Blue Book. You may still be able to qualify for disability benefits, however, if you are able to prove that you suffer from an associated condition (such as depression) that is included in the Blue Book. Some of the conditions that may qualify an individual for Social Security Disability benefits that are listed in the Blue Book and that may be associated with Hepatitis B include:

  • 5.05 Chronic liver disease
  • 5.08 Unexplained weight loss
  • 5.09 Liver transplant
  • 12.04 Affective disorders

If you are applying for disability benefits based on an associated condition that is listed in the Blue Book, you must provide medical documentation proving that your condition is severe enough to meet the criteria of that specific listing. For example, in the case of chronic liver disease, you must be able to prove that:

  • You are hemorrhaging from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy and it has resulted in hemodynamic instability and required hospitalization for transfusion of at least 2 units of blood; or
  • You suffer from ascites or hydrothorax that is not attributable to other causes, despite continuing treatment, as prescribed, and that the condition was present during at least 2 evaluations that were at least 60 days apart within a consecutive 6-month period; or
  • You suffer from spontaneous bacterial peritonitis with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3; or
  • You are suffering from end-stage liver disease with SSA CLD scores of 22 or greater.

If you are not suffering from a condition that is listed in the SSA’s Blue Book, you may still be able to qualify for disability benefits under what is known as a vocation allowance. In order to do this, however, you will have to prove that you are unable to perform any type of work activity whatsoever. This can be done through medical findings, laboratory reports and a residual functional capacity form. In the case of Hepatitis B, your condition must be very advanced and severe in order to qualify. Unless you are suffering from end-stage liver disease, you may have a hard time qualifying for benefits based on this condition.

Applying for Social Security Disability Benefits with Hepatitis B

To apply for Social Security Disability benefits, you can apply online at the SSA’s website (http://www.socialsecurity.gov/pgm/disability.htm) or apply in person at your local Social Security office. You will want to make sure that you have all of your medical evidence ready when you go to submit your application for benefits.

It can be very hard to prove that you qualify for Social Security Disability benefits when you are applying based on a condition that is not included in the SSA’s Blue Book. Because of this, you may want to consider retaining the services of a disability attorney prior to submitting your application. A disability lawyer can help you gather the evidence that you will need to prove your case. These attorneys will know which condition, if any, may qualify you under the SSA’s Blue Book or how to prove that you qualify based on a vocational allowance.

Article written by Ram Meyyappan, senior editor of Social Security Disability Help. Please refer to the Social Security Disability Benefits Help website for additional information. (www.disability-benefits-help.org)

 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Living with Hepatitis B

High HBV Viral Load Tied to Low Serum Vitamin D Levels

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An interesting study published in Healio Hepatology:  “High HBV viral load tied to low serum vitamin D levels” discusses the relationship between the HBV viral load and vitamin D levels. In fact is shows seasonal fluctuations of HBV viral load associated with vitamin D levels. Vitamin D has been on the radar for years, but this interesting correlation between HBV virus flucuations and vitamin D levels warrants additional research to investigate how adequate vitamin D levels can positively impact treatment for those living with chronic HBV. Please refer to earlier blogs, Hepatitis B and Vitamin D and Got HBV? Adding Vitamin D to Your Diet for additional information.  As always, please talk to your doctor and have your serum vitamin D levels checked before making any drastic changes to your diet or supplements you may be taking. Don’t forget that vitamin D is the sunshine vitamin, so be sure to keep in mind the impact of the seasons on your levels. 

Patients with chronic hepatitis B who also were vitamin D deficient had significantly higher HBV DNA levels than patients with adequate vitamin D concentrations in a recent study.

In a retrospective study, researchers measured the serum levels of 25-hydroxyvitamin D (25OHD) in 203 treatment-naive patients with chronic hepatitis B seen between January 2009 and December 2012. Patients with 25OHD levels less than10 ng/mL were considered severely deficient, levels below 20 ng/mL were considered deficient, and levels of 20 ng/mL or greater were considered adequate. Patients’ samples were collected upon initial presentation, except 29 participants whose samples were taken at antiviral therapy initiation.

The mean 25OHD concentration for the cohort was 14.4 ng/mL. Forty-seven percent of participants were considered 25OHD deficient; 34% were severely deficient. 25OHD levels were similar between Caucasians (14.38 ng/mL) and non-Caucasians (14.59 ng/mL) (P=.7).

An inverse correlation was observed between levels of HBV DNA and 25OHD (P=.0003). Multivariate analysis indicated that HBV DNA was strongly predictive of low 25OHD levels (P=.000048), and vice versa (P=.0013). Patients with HBV DNA levels less than 2,000 IU/mL had 25OHD concentrations of 17 ng/mL; those with 2,000 IU/mL or higher had concentrations of 11 ng/mL (P<.00001 for difference). Participants who tested positive for hepatitis B e antigen (HBeAg; n=26) had significantly lower 25OHD levels than HBeAg-negative participants (P=.0013); this association was significant only under univariate analysis.

Investigators also noted fluctuations in HBV DNA and 25OHD levels according to season. Significantly lower HBV DNA levels were observed among samples taken during spring or summer than in autumn or winter (P=.01).

“The present study demonstrates a profound association between higher levels of HBV replication and low [25OHD] serum levels in chronic hepatitis B patients,” the researchers wrote. “At least in patients without advanced liver disease … HBV DNA viral load appears to be the strongest determinant of low [25OHD] serum levels. … Future studies to evaluate a therapeutic value of vitamin D and its analogs in HBV infection may be justified.”

Hepatitis B Advocacy, Living with Hepatitis B

Viral Hepatitis Action Alert!

*ACTION ALERT*

HAP – Hepatitis Appropriations Partnership

 Urge Your Members of Congress to Support Viral Hepatitis Funding

In Their Appropriations Programmatic Requests

 

 

With the passage of the continuing resolution (CR) for FY2013 at the FY2012 levels (before the sequester) and no Prevention and Public Health Fund allocations, we do not know the total, final funding level for FY2013 at the Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis (DVH) or the future of the $10 million they received in FY2012 for a testing initiative. The President’s FY2014 budget has not yet been released. We need your help in raising awareness among Members of Congress about the viral hepatitis epidemics and asking their support for increased funding for viral hepatitis activities at the federal level.  Viral hepatitis advocates are urging for a total funding at the Division of Viral Hepatitis of $35 million, an increase of $5.3 above the total FY2012 level.

In the next week and a half, all Senators and Representatives will write their “programmatic appropriations request letters,” which ask members of the Appropriations Subcommittees (who put together the federal funding legislation) to include funding for their priorities. The more Members of Congress that include a request for hepatitis funding in their letters, the greater the likelihood the Appropriators will include additional funding in FY2014.

As you know, viral hepatitis impacts over 5.3 million people nationwide. With a lack of a comprehensive surveillance system, these estimates are likely only the tip of the iceberg and 75% of those infected do not know their status. Even with these daunting figures, there are only $19.7 million in federal funding dedicated to fund viral hepatitis activities nationwide at the CDC in the CR for FY2013, before sequester.  Members of Congress need to know that viral hepatitis is a concern in their district, that their constituents are being affected and that this is an issue they need to care about. We need you to tell your story and ask your elected representatives to take action by April 12.

Additionally, the CDC released FY2012 Grant Funding Profiles by state, here. When you click on your state and “Generate Report,” your state’s viral hepatitis funding is included in the report.

Step-by-step instructions on what to do are below:

1.   Determine what Members of Congress to contact.  You should contact your personal Member of the House of Representatives and two Senators.  You should also contact other House Members in areas where your organization is located or provides services.  To determine who your Representative is please go to www.house.gov and type in your zip code(s); to determine who your Senators are go to www.senate.gov and select your state from the drop down menu.

2.   Call the Members’ Offices to get the name and correct spelling of their health staff person.  Email the staff using the draft email text below.  House staff emails are First.Last@mail.house.gov (john.smith@mail.house.gov) Senate staff emails are First_Last@Last name of Senator.Senate.gov (john_smith@doe.senate.gov)

Sample email:
Your Name
State and Zip code

Dear (Name of Health Staffer):

My name is ____________ and I live in City/State. I am writing to urge Representative/Senator________________ to include funding for viral hepatitis in his/her Fiscal Year 2012 programmatic appropriations request letter.  [Include brief details on the impact of viral hepatitis on yourself or describe your organization].

There are over 5.3 million Americans impacted by viral hepatitis but, in FY2012, the only dedicated federal funding stream provided a mere $29.7 million through CDC.  This is insufficient to provide the most basic public health services such as education, counseling, testing, or medical management for people living with or at risk of viral hepatitis.

I urge Representative/Senator ___________ to support a total funding level of $35 million for the Division of Viral Hepatitis in FY2014 to effectively combat these epidemics.  I will be following up with you in the near future to discuss this request.  In the meantime, feel free to contact me with questions.

Thank you again for consideration of my request.

Your Name

3.   Follow-up with the staff you have emailed with a phone call to confirm they received the request and to determine when they may have an answer from their bosses as to whether or not they will include a hepatitis funding request in their Appropriation programmatic request letter.  If asked, make it clear to the staff that this is a program request and NOT a project request (i.e. money for a district specific project like a bridge, hospital or university).  You may need to follow-up again around the time the staff says they will have an answer from their chain of command.

4.   If you need assistance or want to talk through the process please email or call Oscar Mairena at (202) 434-8058 or omairena@NASTAD.org. If the staff member requests “report language” or “program language,” please contact Oscar and he will provide that for you. Please also share positive responses with the Hepatitis Appropriations Partnership by contacting Oscar.

Oscar Mairena
Manager, Viral Hepatitis/Policy and Legislative Affairs
National Alliance of State & Territorial AIDS Directors (NASTAD)
444 North Capitol Street NW, Suite 339
Washington, DC  20001
Phone: (202) 434.8058      Fax: (202) 434.8092
omairena@NASTAD.org     www.NASTAD.org
“Bridging Science, Policy and Public Health”

 

 

 

 

Liver Cancer, Living with Hepatitis B

What You Need to Know About Hepatitis C and Liver Cancer

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The Hepatitis B Foundation’s Liver Cancer Webinar Series continues Wednesday, April 3rd.  HBF’s first webinar was overwhelmingly successful, so we hope you’ll join us next week for “Liver Cancer and Hepatitis C: What You Need to Know”, presented by leading hepatitis C expert, Douglas LaBrecque, MD.

Dr. LaBrecque is the Professor of Medicine and Director of the Liver Service at the University of Iowa. He also served as Chief of GI and Hepatology at the Iowa City VA Hospital for 19 years. He has conducted extensive research on the development and treatment of hepatitis C, hepatitis B, and other liver diseases, including liver transplantation with more than 100 peer-reviewed manuscripts, three books, 22 book chapters and over 150 abstracts.

Liver cancer is the third leading cause of cancer-related deaths and the seventh most common cancer worldwide. But the major causes of liver cancer— such as chronic hepatitis B or hepatitis C, and cirrhosis— are largely preventable. And treatments for liver cancer are available.

Join The Hepatitis B Foundation’s webinar series to learn about the risk factors for liver cancer and the importance of liver cancer screening and surveillance. The expert presenters will describe currently available treatment options and clinical trials. These webinars are provided free of charge to help educate and raise liver cancer awareness.

Liver Cancer and Hepatitis C: What You Need to Know webinar details:

Presented by: Dr. Douglas LaBrecque
Date: Wednesday, April 3, 2013
Time: 3 pmEST; 12 pmPST
Click here to register

Download the March 6th Webinar and listen to Hepatitis B and Liver Cancer: What You Need to Know, by Dr. Robert Gish. 

For additional accurate, easy-to-understand information on liver cancer, visit the Hepatitis B Foundation’s dedicated website, www.LiverCancerConnect.org.

Hepatitis B Advocacy, Hepatitis B Prevention, Liver Cancer, Living with Hepatitis B

The Hepatitis B Foundation Participates in Liver Capitol Hill Day, 2013 – A Personal Reflection

Yesterday the Hepatitis B Foundation participated in the American Association for the Study of Liver Diseases (AASLD) annual “Liver Capitol Hill Day” visits. This is a great opportunity to get in front of state Senators and Congressmen in order to make requests known to them. It is also an opportunity to educate. As a constituent, your state representatives are interested in what you have to say. The “Asks” for the day were to support funding for liver related research, prevention strategies, and support of liver patient access to quality medical care.  Specifically, we were asking for NIH funding growth, rather than the 20% cut over the last decade, along with support of government agencies such as the CDC Division of Viral Hepatitis, and the delivery of health care systems and payment policies for patients living with liver diseases.  Prevention is also critical with specific asks for new, one-time hepatitis C testing and screening for hepatitis B for at-risk patients. As we are all aware, budgets are tight and we will all soon feel the effects of the Sequester. Research programs may no longer be funded, or severely cut, public health agencies and programs will be cut, and patients who are currently receiving medical assistance will suffer. For treated patients with HBV, it is essential nothing interrupts the daily antiviral use, and of course HBV and liver cancer prevention through screening, vaccination and surveillance is both necessary and cost effective in the long run.

Due to the Sequester, the day started in a panic for many Hill visitors. I was fortunate to arrive early – a good thing since I waited in a long security line for 45 minutes that wrapped around the building. As Maryland residents, Dave Li and I met with staff from both Senator Ben Cardin’s (D) and Senator Barbara Mikulski’s (D) offices.  Senator Mikulski was recently appointed the Chairperson of the U.S. Senate Appropriations Committee. This means she will have a great deal of influence on budget and spending decisions. We were told that due to the Sequester, the Continuing Resolution (CR) will remain in place for the remainder of the 2013, but Senator Mikulski is optimistic that the FY14 and future funding for the NIH, specifically, will be maintained. As a Maryland Senator, this is extremely important to Sen. Mikulski on many fronts. Senator Cardin has been making visits to agencies in MD, including the NIH, and researchers are frustrated they are unable to do their work.  Both Senator Cardin and Senator Mikulski support federal agencies (such as the CDC, Division of Viral Hepatitis, Public Health Agency etc.) and initiatives that provide care and services to meet the health care needs of Marylanders.  Fortunately this supports the Health and U.S. Health and Human Services (HHS) Viral Hepatitis Action Plan initiatives, since both Senators are supportive of prevention and surveillance initiatives.  Dave and I walked out of our Senate meeting feeling pretty good.

Unfortunately, the outlook was not so optimistic on the House side. We visited staffers from Congressman Chris Van Hollen and Congressman Elijah Cummings offices. Although they are working on budgets, they are meeting with opposition and resigned to deep cuts in their supported programs.  Congressman Cumming’s staffer was pleased to hear an optimistic viewpoint from Mikulski’s office.  Although clearly mixed signals from our House and Senate meetings, we can only hope that Congress will eventually work together and move forward with continued funding of agencies and programs that support those living with liver disease.

Please remember that your state Senators and Representatives have been voted to serve YOU. It is imperative that your voice be heard. If you don’t let them know what is important to you, important programs and agencies will be drastically cut.  You do not need to be a political machine to participate. Don’t know your Representative?   Find your Rep. on-line by putting in your zip code or state to learn who you need to contact. Find your Senator, Governor and Congressmen here. Call the Capitol switchboard’s toll free number at 1-888-876-6242 , or send an email  or letter with your asks, and your personal stories. Be sure your message is clear and concise, and personalize it if you can. You can visit your Representative or Senator when you are visiting Washington, D. C., or in the local, state office. Let your voice be heard – especially during this very difficult time.

Baruch S. Blumberg Institute