Hep B Blog

Category Archives: About Hepatitis B

Pregnancy and Hepatitis B

 

The hepatitis B virus can cause an acute (lasting less than 6 months) or chronic (lifetime) infection. Chronic infection occurs in 90% of infants infected through mother-to-child transmission at birth; and about 50% of children will develop a chronic infection if exposed to the virus between 1 and 5 years of age. Those infected as adults are much less likely (<5%) to develop a chronic infection. Left untreated, hepatitis B can progress to cirrhosis and other serious liver diseases like liver cancer. This blog will talk about mother-to-child (perinatal) transmission and commonly asked questions about perinatal transmission.

Transmission of Hepatitis B from Mother to Child

Globally, the most common route of transmission is mother-to-child. Some people might think the hepatitis B virus is transmitted genetically, but this is NOT true. Hepatitis B is a virus that can be transmitted from a mother to her child because of the blood exchange that happens during childbirth. The great news is that we can prevent mother-to-child transmission! If a pregnant woman tests positive for hepatitis B infection, then her newborn must be given proper prevention immediately after birth in the delivery room, clinic or bedside:

  • first dose (called “birth dose”) of the hepatitis B vaccine
  • one dose of the Hepatitis B Immune Globulin (HBIG).*

*HBIG is recommended by U.S. CDC. HBIG is not recommended by WHO and may not be available in all countries. What is most important is to make sure the hepatitis B vaccine birth dose is given as soon as possible!

If these two medications are given correctly, a newborn born to a mother with hepatitis B has a 95% chance of being protected from a hepatitis B infection. You must make sure your baby receives the remaining shots of the vaccine series according to schedule to ensure complete protection.

And there is more good news – if a pregnant woman with hepatitis B has a high viral load during pregnancy, it is recommended that she take antiviral therapy during her third trimester, which will further reduce the risk of mother-to-child transmission. If you are pregnant and have hepatitis B, talk to your doctor about testing your HBV DNA level, and starting antiviral treatment if it is elevated. There are WHO guidelines for managing hepatitis B infection among pregnant women, which your doctor can use to guide your care.

Commonly Asked Questions About Perinatal Transmission

I am pregnant, should I be tested for hepatitis B?

ALL pregnant women should be tested for hepatitis B. Testing is especially important for women who fall into high-risk groups such as health care workers, women from ethnic communities or countries where hepatitis B is common, spouses or partners living with an infected person, etc. If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born, ideally as early as possible during the first trimester.

I have hepatitis B and I am pregnant, what should I do?

You already know your hepatitis B status – this is a great first step! The next thing you should do is tell your medical provider who should perform additional laboratory testing, including HBV DNA level (viral load), and should check to see if there is evidence of cirrhosis.

All pregnant women who are diagnosed with hepatitis B should be referred to care with a knowledgeable doctor. Some may require continued treatment with an antiviral, many will not. All women with hepatitis B need regular monitoring throughout their life since hepatitis B infection and the health of the liver can change over time.

Can I transmit hepatitis B to my baby when I am breastfeeding?

The U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) recommend that all women with hepatitis B should be encouraged to breastfeed their newborns.  

*Especially if your baby has received the hepatitis B vaccine birth dose, the benefits of breastfeeding outweigh any potential risk.*

Can I prevent my baby from contracting hepatitis B?

Yes! In all cases, it is very important that your obstetrician (or provider who will be delivering your baby), and your newborn’s pediatrician, are aware of your hepatitis B status to ensure that your newborn receives the proper vaccines at birth to prevent a lifelong hepatitis B infection and that you receive appropriate follow-up care.

Should I continue to see a doctor after I give birth?

Yes! Women who have hepatitis B should be closely monitored for 6 months after delivery whether they have been prescribed antivirals are not. This will ensure there are no dangerous elevations in liver enzymes, which can indicate liver damage (ALT flares). For most women whose follow-up testing shows no signs of active disease or cirrhosis, your physician will recommend regular monitoring with a liver specialist (hepatologist) or doctor with experience managing the care of people with hepatitis B. 

World Health Organization Recommendations

In 2020, The World Health Organization released two new recommendations for the prevention of mother-to-child transmission of hepatitis B.

  1. In addition to the series of hepatitis B vaccinations (including the first dose within 24 hours of birth), WHO now recommends that pregnant women testing positive for HBV infection (HBsAg positive) with an HBV DNA viral load threshold of ≥5.3 log10 IU/mL (≥200,000 IU/mL) receive tenofovir prophylaxis; the preventive therapy should be provided from the 28th week of pregnancy until at least birth.
  2. In settings where HBV DNA testing is not available, WHO now recommends the use of HBeAg testing as an alternative to determine eligibility for tenofovir prophylaxis for the prevention of mother-to-child transmission of HBV  This is because some settings have poor access to tests that quantify an individual’s HBV viral load and determine whether a pregnant woman would be eligible for preventive treatment or prophylaxis. This is especially the case in low-income settings or rural areas where many antenatal care visits take place.

Author: Evangeline Wang

Contact Information: info@hep.org

Hepatitis B and Liver Cancer

Tomorrow, February 4th, marks World Cancer Day! This day harnesses the international community to “raise awareness, improving education and catalysing personal, collective and government action, we’re working together to reimagine a world where millions of preventable cancer deaths are saved and access to life-saving cancer treatment and care is equal for all – no matter who you are or where you live.”

Hepatitis B and Liver Cancer

Cancer is a disease in which normal cells change and grow uncontrollably, that can form a lump called a tumor or mass. A tumor can be benign (not cancerous) or malignant (cancerous). The name of the cancer depends on the part of the body where the cancer first started. The term “primary liver cancer” refers to hepatocellular carcinoma (HCC), the most common type of liver cancer, which starts in liver cells called “hepatocytes.”

In the United States, primary liver cancer has become the fastest growing cancer in terms of incidence (new cases), in both men and women. From 2012-2016, the incidence of liver cancer increased by 2.5%, the largest increase of any cancer during the time period. In 2018, an estimated 42,220 new cases of liver cancer were diagnosed and an estimated 30,200 people died.

Liver cancer mortality also continues to increase, especially among Caucasian, Alaskan Native, American Indian and Hispanic males. Liver cancer disproportionately impacts certain communities more than others: in the U.S., it is now the 5th most common cause of cancer death for men overall, but the 2nd most common cause of cancer death among Asian American and Pacific Islander men, and the 4th most common cause of cancer death among Alaskan Native, American Indian and Hispanic males. The five-year survival rate is about 18%.

Worldwide, the most common risk factor for liver cancer is chronic infection with the hepatitis B virus. Chronic viral hepatitis infections (hepatitis B and hepatitis C) cause at least 80% of all liver cancers. In the United States, the leading cause is chronic hepatitis C virus infections because of the greater number of Americans infected with this virus. Chronic infections with hepatitis B or C are responsible for making liver cancer the most common cancer in many parts of the world. Take a look at other factors which might put you at a higher risk for developing liver cancer.

Prevention

The hepatitis B vaccine was named the first “anti-cancer” vaccine by the U.S. Food and Drug Administration because it prevents chronic hepatitis B infections, thereby preventing liver cancer caused by the hepatitis B virus. In the United States, the hepatitis B vaccine is recommended for all infants and children, and adults at high risk for infection. In many countries, including the United States, vaccinating newborns with the hepatitis B vaccine at birth has resulted in a dramatic reduction in the number of new cases of liver cancer caused by hepatitis B. For more information about the vaccine, visit here.

For more information about liver cancer please visit our Liver Cancer Connect page.

 References

https://www.worldcancerday.org/about-us

https://www.hepb.org/research-and-programs/liver/

 

 

 

Correctional Facilities and Hepatitis B

 

People experiencing incarceration in correctional facilities face a disproportionate burden of hepatitis B. This is due to potential increased exposure to high-risk individuals, including people who inject drugs or exchange sex for money or drugs.1 This blog will discuss the prevalence of hepatitis B in individuals experiencing incarceration in the United States and globally, risk factors for infection, and recommendations for policymakers, public health professionals, and correctional facilities.

Prevalence in The United States

The Centers for Disease Control and Prevention (CDC) estimates 850,000 to 2.2 million individuals are living with hepatitis B in the United States.2 Of those individuals, an estimated 0.9% to 11.4% for HBsAg (active, infectious HBV) and 6.5% to 42.6% for HBcAb (ever infected) of people experiencing incarceration are living with hepatitis B.2

Prevalence Internationally

Researchers have conducted various studies in different countries to determine hepatitis B prevalence. For example, a study in Iran found a prevalence of HBV DNA in incarcerated individuals at 2.1%.1  Another study in Mexico City tested over 15,500 men experiencing incarceration and almost 1,800 women experiencing incarceration and found the rate of HBcAb among men was 2.8% and among women, 3.0%. The rate of HBsAg was 0.1% among men and 0.3% among women.1

Risk Factors

Hepatitis B is transmitted through blood, semen, and other bodily fluids.1  Routes of transmission among incarcerated individuals include sharing needles and cookers or other injection drug paraphernalia, sharing tattoo paraphernalia, sharing razors, and having unprotected sex with someone living with hepatitis B.3  Because of policies in the United States criminalizing injection drug use and sex work, correctional facilities are more likely to have higher concentrations of individuals engaging in these risky behaviors. Additionally, sterile equipment is sometimes inaccessible and sharing drug injection equipment is common in correctional facilities which contributes to an increased risk of individuals contracting hepatitis B while experiencing incarceration.3

Recommendations

U.S. Preventive Services Task Force (USPSTF) recommends hepatitis B screening for all high-risk adult individuals which include people experiencing incarceration. However, The Hepatitis B Foundation urges a recommendation for universal screening because it would allow for individuals experiencing incarceration to lower their risk of contracting hepatitis B in correctional settings.

Opt-out vaccine programming is another strategy that can help to prevent the spread of hepatitis B in correctional facilities. However, it is also important for individuals at correctional facilities to be screened before they are vaccinated, to identify those who are already infected. Additionally, when public health professionals implement opt-out hepatitis B vaccination and/or screening programs in correctional facilities, they must ensure clear communication so that program recipients understand what they are being screened/vaccinated for, and that testing/vaccination is voluntary.4 Being diagnosed with a chronic infectious disease can be daunting, and some would rather not know their status, which is important to recognize and respect. Public health professionals also need to recognize the challenges associated with designing vaccination programs in correctional facilities. It is important to design a sustainable program which emphasizes continuous medical care for individuals who test positive for hepatitis B throughout incarceration, even with challenging situations like transfers, and reintegration back into their communities.1

Correctional facilities should consider providing treatment options for people experiencing addiction as well as utilizing a harm reduction approach to provide sterile injection and tattoo equipment to reduce the risk of hepatitis B transmission.1

References

  1. Smith JM, Uvin AZ, Macmadu A, Rich JD. Epidemiology and Treatment of Hepatitis B in Prisoners. Curr Hepatol Rep. 2017;16(3):178-183. doi:10.1007/s11901-017-0364-8
  2. https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm
  3. Gupta S, Altice FL. Hepatitis B virus infection in US correctional facilities: a review of diagnosis, management, and public health implications. J Urban Health. 2009;86(2):263-279. doi:10.1007/s11524-008-9338-z
  4. Rosen DL, Golin CE, Grodensky CA, et al. Opt-out HIV testing in prison: informed and voluntary?. AIDS Care. 2015;27(5):545-554. doi:10.1080/09540121.2014.989486

 

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

Humans Rights and Hepatitis B

Tomorrow, December 10th is Human Rights Day! Every December, this day “proclaims the inalienable rights which everyone is entitled to as a human being – regardless of race, colour, religion, sex, language, political or other opinion, national or social origin, property, birth or other status1” This year’s theme is: Recover Better- Stand up for Human Rights as it relates to the impacts of the COVID-19 pandemic. This day will emphasize the importance of human rights in recovery efforts to “create equal opportunities for all, address the failures exposed and exploited by COVID-19, and apply human rights standards to tackle entrenched, systematic, and intergenerational inequalities, exclusion and discrimination1”.

Impact of COVID-19, Hepatitis B, and Human Rights

The World Health Organization (WHO) states that people living with underlying health conditions such as hepatitis B can put them at a greater risk for a poorer COVID-19 prognosis2. COVID-19 has paused many organizations’ outreach and work which disproportionately affects already marginalized populations. Additionally, in the United States, COVID has raised unemployment rates to an estimated 25%3. Organizations are unable to provide viral hepatitis programs which can negatively affect people living with hepatitis B, like knowing their status, linkage to care, and management of their disease. Additionally, if people are experiencing unemployment and living with hepatitis B, their healthcare costs could significantly increase. This might make it difficult for people living with hepatitis B to effectively manage their disease. These situations directly violate the fundamental human right to healthcare – people should have access to healthcare services without financial hardship. With COVID-19 impacting organizations like the Hepatitis B Foundation, what are we doing to address these situations?

 How Are We Addressing Inequalities?

 The Hepatitis B Foundation is committed to human rights and the rights of people living with hepatitis B prior to COVID-19, during COVID-19, and will continue to do so after. The Foundation has advocated for persons living with hepatitis B and experiencing discrimination. We are proud to have had a part in a landmark settlement by the U.S. Department of Justice in 2013, which ruled that a medical school had violated the Americans with Disabilities Act (ADA) when they denied applicants because they had hepatitis B. Take a look at our Know Your Rights Section if you are experiencing discrimination while living with hepatitis B. The Hepatitis B Foundation also launched a new tool to assist people living with hepatitis B in making decisions on health insurance. The report provides health insurance shoppers living with hepatitis B with key information – including a checklist of questions to consider and a list of insurance companies in the analyzed states that exhibited discriminatory practices. Health insurance shoppers can take a closer look at the specific pricing tiers into which companies and plans place their hepatitis B treatments, and what additional costs may be included.

Currently, Hep B United Philadelphia, a coalition member of Hep B United, a national coalition founded under the Hepatitis B Foundation, is committed to serving the Greater Philadelphia Community during the pandemic. Hep B United Philadelphia rolled out a “contactless screening” program which allows individuals to get free hepatitis B testing. They have also hosted hepatitis B educational sessions over Zoom in multiple languages. Recordings and resources are available for use here.

 

References

  1. The United Nations
  2. The World Health Organization
  3. The Pew Research Trust

 

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

Holidays and Hepatitis B: Treat Your Liver Right

 

 

The holiday season is here! November and December are full with holidays like Diwali, Canadian Thanksgiving, American Thanksgiving, Hanukkah, Kwanzaa, Christmas, and the New Year just to name a few. This time is often filled with love, happiness, and delicious food. If you or a family member is living with hepatitis B, it is important to eat mindfully during this festive time. Eating healthy is not always a possible option – not with delicious smells filling your kitchen, but you can make healthier choices! Here is a list of action items you can do to help maintain a healthy liver during the holidays:

  1. You can contribute a healthy dish – something filled with lean meats, hearty vegetables,  and is low in sodium.
  2. Try your best to avoid alcohol and go for drinks with lower amounts of added sugar.
    • Coffee has been associated with improvement in liver enzymes!
    • You can bring your own non-alcoholic beverage like a sparkling flavored drink.
  3. Choose fiber-rich foods like beets, Brussels sprouts, broccoli, and beans – your plate should look colorful!
    • Click on the veggies for some delicious and healthy recipes!
  4. Stay active – take a walk with your family/someone in your COVID social circle or do a free online exercise video.

Most importantly, do not feel guilty. Try your best to make healthy choices and not over-indulge, but do not beat yourself up if you do – your next meal can be healthier!

Remember that everything you consume is filtered through your liver; your liver never gets a break! The lifestyle tips listed above may seem simple, but they can have a large, positive impact on your health. Sticking to a regular healthy routine even during the holiday season will make it easier to continue those habits all year long! You can also check out our healthy liver tips to see what other actions can be taken to protect your liver.

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

Adoption and Hepatitis B

 

November is National Adoption Month! National Adoption Month’s ultimate goal is to increase national awareness of the need for permanent families for children and youth in the U.S. foster care system. Most importantly, this month acknowledges the birth families who make the difficult decision to give up their children for adoption, the foster families who care for children from various backgrounds, and the adoptive families who love and care for their adoptive children.

Adoption and Hepatitis B

 Many people wish to adopt children from countries where hepatitis B infections are common: Asia, South America, Eastern Europe, and some parts of Africa. Children from these regions are often infected with the virus from their birth mothers who have hepatitis B and unknowingly pass the disease on to their children during delivery. In addition, many of these countries re-use needles for medications or blood tests, a practice that places children at risk if they have not already been infected at birth. It is advised that you do not request your child to be tested for hepatitis B in their birth country, since the blood test itself could be a source of infection.

Domestic adoptions also present some risk to potential adoptees. Children born to women in high-risk groups could have been infected with hepatitis B at birth. In addition, children from group homes are at increased risk for hepatitis B infection.

Many children who have hepatitis B do not have symptoms of the viral infection. This makes it difficult for adoptive parents to know their child is sick without a blood test! This simple 3-part blood panel will inform you if your child has an active infection, had a previous infection and recovered, has “immunity”, or needs a vaccine. The good news is that your adoption agency should be able to tell you if a child has been tested for hepatitis B. If you have questions or concerns about the test results please contact us to speak with our knowledgeable staff. We can also refer you to a parent who has adopted a child with hepatitis B.

Finding out that the child you wish to adopt has chronic hepatitis B can be upsetting, but should not be cause for alarm or stopping an adoption. We hope that a hepatitis B diagnosis will not change your decision to adopt a child. You can be reassured that most children with hepatitis B will enjoy a long and healthy life. Hepatitis B does not usually affect a child’s normal growth and development, and there are generally no physical disabilities or restrictions associated with this diagnosis.

Reference

https://www.hepb.org/treatment-and-management/children-with-hepatitis-b/adoption/

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

National Family Caregivers Month and Hepatitis B

November is National Family Caregivers Month! There are over 40 million Americans who are unpaid caregivers to their families, friends, and neighbors1. This month we celebrate and support all the caregivers who work tirelessly to keep our family and communities strong.

Caregivers and Hepatitis B

 Caregiving can be a tough, but noble job. It is often unpaid, long hours, and can cause burnout. However, caregivers selflessly work to provide their friends or family with the best care possible. Hepatitis B just does not affect the person living with the virus; it affects their family, friends, coworkers, and community members. Someone who lives with an individual who has hepatitis B might be put in a caregiver position.

Caring for an individual living with hepatitis B might be difficult if the person has advanced liver disease or is experiencing side effects from medication. While it may not always be physically demanding, caring for a person with hepatitis B can be emotionally overwhelming. Caring for an individual living with hepatitis B and other related complications can stir up heavy emotions which can take a toll on a caregiver’s mental health. Managing medications, diet, and healthy lifestyle for people living with hepatitis B during the COVID-19 pandemic can especially feel stressful. Luckily, there are resources available to help reduce feelings of stress and being overwhelmed.

Resources for Caregivers

Feeling stressed or overwhelmed with taking care of your friend or family member? It is also important to look after your own physical and mental health. Check out these resources from the How Right Now Initiative to help you manage your stress especially during COVID-19. Some suggestions include:

  1. Go for a quick walk or stretch
  2. Call, text, or video chat with friends or family
  3. Take several deep breaths

Does someone in your close circle have hepatitis B? Check out the Centers For Disease Control and Prevention’s Know Hepatitis B Campaign’s fact sheet, When Someone in the Family has Hepatitis B”. This fact sheet has basic information about hepatitis B and the importance of testing and vaccinating family members. The fact sheet is available in 13 Asian and African languages as well as three English versions focused on Asian American, Native Hawaiian and Pacific Islander, and African Immigrant communities. Download the fact sheet here.

For more information about the Know Hepatitis B Campaign, visit the campaign website.

References

  1. https://www.whitehouse.gov/presidential-actions/proclamation-national-family-caregivers-month-2020/
  2. How Right Now Initiative
  3. CDC’s Know Hepatitis B Campaign

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

Announcing the New Current Patient Opportunities Page on the HBF Website

A new page has been created on the Hepatitis B Foundation’s website that contains a compilation of various opportunities available for people living with hepatitis B. These opportunities can be for clinical trials, other types of research, or toolkits with information and resources for those living with hepatitis B and their loved ones and community members. All of these postings are produced or organized by entities external to HBF, but all are related to improved quality of life and liver health. The first two of these opportunities are listed below.

New Tool from CME Outfitters

A new HBV Patient Education Hub has been compiled by continuing medical education company CME Outfitters. The hub includes a great deal of valuable information, such as an overview of hepatitis B, a list of questions to ask your healthcare provider, a patient guide, information about hepatitis B co-infection, doctors’ advice on what to expect from treatment, and many other resources. All information is in an engaging and accessible format. Check it out today!

New Study Opportunity Available for People Living with Itching (Cholestatic Pruritus) Due to Liver Disease or Injury

A new paid opportunity has become available for those experiencing itching caused by hepatitis B, hepatitis C, drug-induced liver injury, auto-immune hepatitis, or primary sclerosing cholangitis (PSC). If you live in Canada or the US and have this condition, you may be eligible to participate in an interview to help researchers better understand your lived experience. The new research study is seeking participants ages 12-80 living in the US and Canada who are living with this itch. This is an opportunity to be involved in research and help advance scientific understanding! Contact the research coordinator for more information and to check if you are eligible. 

Please note that this study does not include treatment and pruritus must be at an intensity level of 4 on a scale of 1-10 for at least the past 8 weeks in order to participate. Patients cannot be pregnant or breastfeeding or have a diagnosis of primary biliary cholangitis. 

We are very excited to unveil this new section of our website and hope it will be a useful resource for many going forward! Please check back often, as more opportunities will be posted as they arise.

SHEA Updated Guidelines: Health Care Personnel Living Hepatitis B, Hepatitis C, and HIV

SHEA Updated Guidelines on Health Care Workers Living With Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus

 Many health care students and professionals in the U.S. are living with hepatitis B, hepatitis C or HIV. Living with these conditions should not interfere with a person’s health care education or professional career. It is important that health care students and professionals are aware of their rights and responsibilities – and equally important that health care schools and institutions are aware of their responsibilities, as well. There are now new guidelines to help institutions understand how to manage health care professionals living with hepatitis B, hepatitis C or HIV.

The Society of Healthcare Epidemiology of America (SHEA) recently updated their guidelines on health care workers who are living with hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). These updates reflect the advances in medical technologies and the low transmission risk health care workers living with HBV, HCV, and HIV pose. It is important to note, there have been very few cases of health care personnel (HCP) transmitting HBV,  HCV, or HIV to patients. These new guidelines, which align with the CDC’s Recommendations for the Management of Hepatitis B Virus-Infected Health-Care Providers and Students, can help reduce discrimination of health care students and personnel.

Some of the important updated recommendations for health care workers living with hepatitis B include:

  • Pre-vaccination testing does not need to be done unless the individual has an increased risk of infection
  • Health care workers should have a complete vaccination series for hepatitis B. Learn more about the vaccination series
  • Health care professionals living with HBV who do not perform exposure-prone procedures should not be prohibited from participating in patient-care activities solely on the basis of their HBV infection
  • Health care personnel living with HBV should seek optimal medical management, including, when appropriate, treatment with effective antiviral agents
  • Consistent with CDC guidelines, there is no justification for, nor benefit gained from, notifying patients with regard to health care professionals living with HBV who are being managed through an institution’s oversight panel

Some of the important updated recommendations for health care workers living with hepatitis C includes:

  • Because of the opioid epidemic in the United States, consideration should always be given to the possibility of substance use disorder when health care professional-to-patient transmission of a bloodborne pathogen is detected
  • Health care professionals living with HCV should seek optimal medical management, including treatment with effective antiviral agents to achieve cure of the infection
  • Health care professionals living with HCV who received treatment resulting in ‘undetectable’ circulating HCV-RNA levels can perform exposure-prone procedures with some stipulations:
    • Has not been previously identified as having transmitted infection to patients following definitive therapy resulting in a sustained virologic response (SVR)
    • Provides the oversight panel with records and laboratory results (or permits the HCP’s personal physician to provide records and laboratory results) confirming receipt of treatment and SVR
    • Has achieved SVR by remaining HCV RNA negative for 12 weeks following the completion of therapy

Some of the important updated recommendations for health care workers living with HIV:

  • Health care professionals living with HIV and who, despite appropriate antiretroviral treatment, have a confirmed viral load >200 copies/mL should not perform exposure-prone procedures until they have achieved virologic suppression
  • Scientists acknowledge that when the viral load is undetectable = untransmittable
  • Health care professionals living with HIV whose confirmed viral load is below 200 copies/mL can perform exposure-prone procedures with some stipulations:
    • Has not been previously identified as having transmitted infection to patients while receiving appropriate suppressive therapy
    • Obtains advice from an oversight panel about recommended practices to minimize the risk of exposure events
    • Is followed by a physician who has expertise in the management of HIV infection and who is allowed by the individual to participate in or communicate with the oversight panel about the individual’s clinical status
    • Is monitored on a periodic basis (eg, every 6 months) to assure that the HIV RNA remains below the level of detection, with results provided to the oversight panel.
    • Is followed closely by their physician and the oversight panel instances in which fluctuations in HIV viremia occur, including appropriate retesting as discussed above to reevaluate the HCP’s viral load
    • Agrees, in writing, to follow the recommendations of the oversight panel

Read more about the guidance and information on how hospitals, professional schools, and institutions should proceed for healthcare workers living with HBV, HCV, and HIV. You can also read more about the rights and protections for health care students and professionals living with hepatitis B in the U.S.

 

Reference

Henderson, D., Dembry, L., Sifri, C., Palmore, T., Dellinger, E., Yokoe, D., . . . Babcock, H. (2020). Management of healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus in US healthcare institutions. Infection Control & Hospital Epidemiology, 1-9. doi:10.1017/ice.2020.458

Author: Evangeline Wang, Program Coordinator, Hepatitis B Foundation

Contact Information: info@hepb.org

Your Liver and Hepatitis B

 

Your Liver and Hepatitis B

 Happy Liver Cancer Awareness Month! Your liver is an important organ for digesting food and breaking down toxins. Its main functions include: filtering blood from the digestive tract and transporting it back to the rest of the body, removing toxins from the blood, and storing important nutrients that keep the body healthy.

Hepatitis B is a viral infection of your liver that can cause serious damage over time. Chronic infection with the hepatitis B virus (HBV) can ultimately lead to scarring, cirrhosis, liver cancer, and liver failure. Liver cancer is the 3rd deadliest cancer worldwide, with 5-year survival rates of only 19%. There are few effective treatments for liver cancer, and we, therefore, must rely on prevention and early detection in order to save lives. Chronic hepatitis B infection causes approximately 78% of hepatocellular carcinoma (HCC), or primary liver cancer. The key to saving lives is ensuring that individuals infected with HBV are diagnosed and linked with appropriate care, including regular screening for liver cancer.

In the U.S., liver cancer incidence and death rates are increasing at a faster rate than any other cancer and are projected to continue to rise through at least 2030. Up to 2.2 million people are chronically infected by HBV in the U.S. and the majority is unaware of their infection. Identifying, managing and treating those with HBV infection can help prevent liver cancer in many people. Additionally, regularly screening people with chronic hepatitis B  for liver cancer can aid with early detection and treatment of liver cancer. If diagnosed early, liver cancer can be treated and even cured.

Below are some practices you can easily incorporate into your daily life and routine to keep your liver healthy while living with hepatitis B.

Healthy Liver Tips

  1. Reduce alcohol intake: Alcoholic beverages can damage or destroy liver cells and create additional health problems.
  2. Eat a healthy diet: Increase the amount of whole foods in your diet like fruits and vegetables while decreasing the amount of refined carbohydrates (pastas, white rice, white bread), processed sugar, and saturated fats which can create a healthy environment for your liver.
  3. Daily exercise: It is recommended for adults to exercise at least 60 minutes per day. Not only does this have many other health benefits, but it can reduce the fat surrounding your liver which can decrease your risk of liver cancer.
  4. Avoid the use of illicit drugs: Drugs like marijuana, cocaine, heroin, inhalants, or hallucinogens put stress on your liver and reduce its functioning capability.
  5. Wash produce and read labels on household chemicals: Pesticides and other chemicals can contain toxins which are harmful to your liver.

Incorporating these healthy practices does not have to be difficult. Choose one of the five tips that is most convenient with your current lifestyle and use it as a starting point for a healthier routine. By gradually incorporating each healthy liver tip into your lifestyle, you can reduce your risk of a negative liver outcome creating a healthier you!

Resources for Liver Cancer and Hepatitis B

Please join Hepatitis B Foundation, Hep B United and Hep B United Philadelphia’s webinar on October 20th at 3PM ET to learn more about hepatitis B and liver cancer. Dr. Kenneth Rothestein, Director of Regional Outreach and Regional Hepatology from Penn Medicine will be highlighting the importance of liver cancer screening for prevention. Register here!

To promote and ultimately prevent liver cancer this October we are pleased to share the Centers for Disease Control and Prevention’s Know Hepatitis B (KHB) Campaign Product of the Month – the Infographic: “Get Tested for Hepatitis B.”

The CDC’s Know Hepatitis B Campaign’s infographic, “Get Tested for Hepatitis B” encourages Asian Americans and Pacific Islanders to get tested for hepatitis B. This 2-page downloadable document is available in English, Traditional Chinese, Vietnamese and Korean languages and answers commonly asked questions about hepatitis B.

For more information about the Know Hepatitis B Campaign, visit the campaign website.

 

Author: Evangeline Wang, Program Coordinator, Hepatitis B Foundation

Contact Information: info@hepb.org