Hep B Blog

Category Archives: Hepatitis B Awareness

About Hepatitis B, Hepatitis B Awareness, Hepatitis B Prevention

Happy Human Rights Day: Hepatitis B and Human Rights

Human Rights and Hepatitis B  

Every year on December 10th, we celebrate Human Rights Day! This year’s theme is “Equality – Reducing inequalities, advancing human rights.” This theme emphasizes equality, inclusion, and non-discrimination to further the Sustainable Development Goals by 2030.   

So how does this year’s theme relate to hepatitis B? 

Hepatitis B is the most common liver infection in the world. Almost 300 million people worldwide are living with chronic hepatitis B, yet there are a lot of misconceptions and myths surrounding the disease which perpetuates stigma, discrimination, inequality, and exclusion.  

More commonly, misconceptions surround the transmission of hepatitis B. Sometimes people think that hepatitis B can be spread through casual contact, through sharing food, through dirty environments – others feel that people with hepatitis B must have done something “bad” to get the virus. These perceptions can be damaging to an individual who is living with hepatitis B because it can create not only social stigma but self-stigma.  

A person living with hepatitis B might feel like they cannot disclose their status or live freely because of the way people or institutions will treat them. This fear of exclusivity also might create hesitation for people to get tested which could potentially delay treatment for people who might need it to prevent hepatitis B from progressing to something more serious like cirrhosis, fibrosis, or liver cancer.  

In some cultures, hepatitis B is viewed as a punishment from a supernatural force. People living with hepatitis B who believe this might feel a burden and shame and will not share their status. This belief also perpetuates hesitation for people to access testing and treatment. 

However, hepatitis B is NOT transmitted casually, 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.  

Are You Feeling Isolated? 

If you are feeling isolated from your community, family, other individuals, etc., there are support groups you can join! Hep B Community is a global online support group dedicated to connecting people affected by hepatitis B with one another and with verified experts in the field, who provide trustworthy and accurate advice. 

On this day let’s celebrate Human Rights Day and take action to improve equality, inclusivity, and non-discrimination. Here are some resources: 

Did you know the Hepatitis B Foundation has a Discrimination Registry? 

The Hepatitis B Foundation is working to document discrimination related to hepatitis B through its Hepatitis B Discrimination Registry. If you experienced hepatitis B discrimination, you can take action and report it through the Registry Survey.  

The Hepatitis B Foundation also has a page dedicated for people experiencing discrimination in the United States. Check out what to do if you are experiencing discrimination in the workplace, military, and schools and institutions 

If you are experiencing discrimination and would like some advice email discrimination@hepb.org  

 

Author: Evangeline Wang

Questions: info@hepb.org

About Hepatitis B, HBV, Hepatitis B Awareness

Happy National Family History Day!

It’s National Family History Day on November 25th! Today is the perfect time to sit down and talk to your family about health; it gives your loved ones an opportunity to provide the gift of a healthy future! As hepatitis B rarely has any symptoms, many people do not discover that they are infected until a family member is diagnosed or they develop liver damage or liver cancer.  

Approaching the topic and starting the conversation can help to break this cycle of transmission within families and allow your loved ones to protect themselves. If you need some tips on how to start the discussion on family health, you can check out our blog post here! 

Your family’s health history tells a powerful story. It guides us on what behaviors to avoid and actions that we can take to prevent developing certain illnesses or diseases. It can also help inform us on how to best navigate the health system. Do I need to be tested for liver cancer? Is the medication that I’m taking actually dangerous to my health?  

When a family member is living with or has lived with hepatitis B, family health history can become even more critical to creating a healthy future. Hepatitis B is one of the world’s leading causes of liver cancer, so it is extremely important to be aware of your risk! Although hepatitis B is not genetic or hereditary – it is only spread through direct contact with infected blood or through sexual contact – multiple family members can be infected without knowing. This is because hepatitis B often does not have any symptoms and can be spread from mother to child during childbirth or by sharing sharp objects such as razors, toothbrushes, or body jewelry that may contain small amounts of infected blood. Knowing about a family members’ current or past infection is a signal to get tested for hepatitis B using the 3-panel hepatitis B blood test (HBsAg, HBsAb, HBcAb). Testing is the only way to be sure of your hepatitis B status. The test will let you know if you have a current infection, have recovered for a past infection, or need to be vaccinated.  

Why does this matter if myself or a family member has recovered from a past infection?  

If someone has recovered from a past infection (either acute or chronic), this is great news! Loss of the hepatitis B surface antigen may be exciting, but it does not mean that you don’t need to proceed with caution! Recovery from a past infection means that while the virus is no longer in your blood, it is still living in the liver in an inactive state. You cannot infect anyone else at this stage, but family members, and sexual partners should still get tested for the 3-panel hepatitis B blood test (HBsAg, anti-HBc, anti-HBs) because they may have been exposed in the past. Check out this helpful fact sheet on what it means to have recovered from an acute or chronic infection! 

A past infection should be a part of all medical records as well. Various medications and treatments for other conditions, such as cancer or Rheumatoid arthritis have the potential to reactivate the virus that is sleeping in your liver.  Some medications can suppress the immune system, which gives hepatitis B a chance to reawaken and attack the liver. Healthcare providers need to be aware if you had a past infection so that they can monitor you and potentially prescribe medications to prevent the virus from reactivating in your body.  

Not every treatment will cause hepatitis B to reactivate, so it is important to be aware of the ones that carry a risk! Any treatment that suppresses the immune system such as chemotherapy and other cancer therapies, and certain arthritis, Crohn’s disease, Ulcerative colitis, asthma, and psoriasis drugs may pose a risk of hepatitis B reactivation. You can find a list of specific drug names and their risk levels on our website, but you should always consult your doctor or provider for the most accurate information.  

Every medication also comes with a warning label that you should read carefully. This section will let you know if there is a risk of reactivation. You can also use the National Institute of Health’s LiverTox website to search the name of the treatment and see if there is a risk! 

Talking to Your Family  

Hepatitis B may increase a person’s risk of liver disease and liver cancer but with knowledge of an infection, you can take measures to help manage it. For family members who have not been infected, they can take action to prevent future infection by getting vaccinated! Many people assume that they have already been vaccinated, but this is not always the case. Globally, adult completion rates of all 3 doses of the vaccine are low, meaning that most adults are vulnerable to infection. The vaccine is highly effective and is the best form of protection against the virus. Don’t assume you have been vaccinated; check your immunization records or ask your doctor!  

Spending your holiday talking about health may not sound like fun, but it is extremely important – it may even change your life! Set 30 minutes aside to sit down with your loved ones and talk about any diseases or disease risk factors, that are in your family. Awareness is the key to prevention! 

 

About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Prevention, Liver, Liver Cancer, Liver Health

Liver Cancer Among Men

June is Men’s Health Month. This month we bring awareness to preventable health problems and encourage early detection and treatment of disease among men and boys. In 2020, The World Health Organization found that liver cancer is the third leading cause of cancer deaths with 830,000 deaths.1 Liver cancer occurs more often in men than in women with it being the 5th most commonly occurring cancer in men and the 9th most commonly occurring cancer in women.2

There are two main types of liver cancers, hepatocellular carcinoma (HCC) which accounts for about 75% of liver cancer cases, and intrahepatic cholangiocarcinoma which accounts for 12-15% of cases. Liver cancer especially impacts Asian countries like Mongolia, Vietnam, Laos, Cambodia, Thailand, and China. Hepatitis B is the leading cause of HCC globally. Of the 300 million individuals living with a chronic hepatitis B diagnosis, about 25% will develop HCC.3

Risk Factors

HCC affects men with an incidence 2x-4x higher than women due to differences in behavioral risk factors and biological factors.3 Research has found men were less likely to undergo HCC screening and more likely to smoke.  Additionally, studies have shown alcohol is a major risk factor for HCC. In the United States, HCC associated with alcohol is higher among men than in women at 27.8% and 15.4% respectively.3

Biologically, there is evidence estrogen (a female hormone) decreases IL-6 mediated hepatic inflammation and viral production.3 Studies have demonstrated IL-6 may promote virus survival and/or exacerbation of the disease.4 In the context of hepatitis B, men are at an increased risk for HCC as they do not produce estrogen which would help decrease the risk of IL-6, in turn, promoting viral survival.

Prevention

The great news is that HCC can be prevented by preventing hepatitis B. There is a safe and effective vaccine that can be completed in either 2 or 3 doses over a span of 3 months. Ask your healthcare provider for the hepatitis B vaccine series.

If you are unsure of your hepatitis B status, you can get tested! Ask your healthcare provider for the “Hepatitis B Panel” – it should include 3 parts. The panel is super simple and only requires one sample of blood.  If you are of Asian descent and male, it is especially important for you to get tested as liver cancer disproportionately impacts individuals from Asian countries and men.

If you have chronic hepatitis B, make sure your doctor screens you regularly for liver cancer. Typically done with a combination of blood tests and imaging, liver cancer screening can help detect HCC early when it is still curable.

As we wrap up June and Men’s Health Month, you are encouraged to get vaccinated and tested for hepatitis B. Take control of your health, and don’t wait!

References

  1. https://www.who.int/news-room/fact-sheets/detail/cancer
  2. https://www.wcrf.org/dietandcancer/liver-cancer-statistics/
  3. Wu EM, Wong LL, Hernandez BY, et al. Gender differences in hepatocellular cancer: disparities in nonalcoholic fatty liver disease/steatohepatitis and liver transplantation. Hepatoma Res. 2018;4:66. doi:10.20517/2394-5079.2018.87
  4. Velazquez-Salinas L, Verdugo-Rodriguez A, Rodriguez LL, Borca MV. The Role of Interleukin 6 During Viral Infections. Front Microbiol. 2019;10:1057. Published 2019 May 10. doi:10.3389/fmicb.2019.01057

 

Author: Evangeline Wang

Contact Information: info@hepb.org

 

About Hepatitis B, Hepatitis B Awareness

World Refugee Day!

June 20th is World Refugee Day! This day “celebrates the strength and courage of people who have been forced to flee their home country to escape conflict or persecution. World Refugee Day is an occasion to build empathy and understanding for their plight and to recognize their resilience in rebuilding their lives.”1

In 2020, the United Nations Refugee Agency estimates that 80 million people were forcibly displaced. A majority of refugees originate from Syria, Venezuela, Afghanistan, South Sudan, and Myanmar and are mostly resettling in countries like Turkey, Colombia, Pakistan, Uganda, and Germany.1

As individuals who are experiencing forcible displacement begin to resettle, it is important to encourage hepatitis B testing and vaccination, even though hepatitis B might be the last thing on their minds. It is important to keep health, and especially hepatitis B in mind because hepatitis B disproportionately affects people from the World Health Organization’s (WHO) African, Western Pacific, and Asian regions.

In South Sudan, hepatitis B accounts for 80% of the viral hepatitis cases. Moreover, Myanmar has a moderate to high burden, with 6.5% of the general population being infected with hepatitis B. It is imperative that testing and vaccination is encouraged in countries like South Sudan and Myanmar and in countries where people are resettling to not only prevent the spread of hepatitis B but also allow people living with hepatitis B who might not know it to live a long and healthy life. Additionally, it is important to note that the continuation of care for people experiencing forcible displacement is halted when resettling in different countries. This interruption can be damaging to individuals’ health, especially those living with hepatitis B as medication must be taken daily, and seeing a liver specialist should happen every 6 months.

However, some people who are in the process of resettling might be hesitant to get tested for hepatitis B. This can be due to a myriad of reasons like the cost of healthcare if they do test positive, access to quality healthcare, fear of stigma, and other cultural/language barriers.

So how can organizations encourage people experiencing displacement to get tested for hepatitis B? This answer is frankly too complicated and complex for a simple blog post, but here are a few suggestions for organizations.

  1. Utilize community health workers. Community health workers who are fluent in refugee languages and cultures can educate community members about preventative health measures. People might be more receptive to the information if someone familiar with the community is the educator.
  2. Reduce barriers to healthcare. Transportation sometimes is a barrier for individuals experiencing resettlement. Offering transportation to and from healthcare clinics can greatly increase access to quality healthcare. Furthermore, when the individual arrives at their healthcare facility, they must have an interpreter if they do not speak the local language or go to a provider who speaks their native language.
  3. Use culturally sensitive educational materials. Using materials in languages other than English is so important to effectively communicate health information about hepatitis B! The Centers for Disease Control and Prevention (CDC), has their Know Hepatitis B Campaign where you can access FREE multi-lingual hepatitis B educational materials.

Reference:

  1. https://www.unhcr.org/en-us/world-refugee-day.html

About Hepatitis B, advocacy, HBV, Hepatitis Awareness Month, Hepatitis B Awareness

Happy Hepatitis Testing Day

May 19th is national Hepatitis Testing Day! Today we raise awareness about viral hepatitis and encourage people to know their status. More than half of the people living with viral hepatitis in the U.S. do not know their status, so if you do not know your status, get tested!

Since 2013, the United States has officially observed May 19th as Hepatitis Testing Day. With over 2.4 million people living with chronic hepatitis B in the United States and 300 million people living with it globally, it is so important to know your status! Additionally, hepatitis B is known as a “silent infection” which means that you do not know you have the disease until it has done major damage to your liver. Luckily, with hepatitis B testing, you can find out your status and take control of your health!

Hepatitis B Testing

The hepatitis B test is a simple blood test that can be done at your doctor’s office or local care clinic. The hepatitis B blood test requires only one sample of blood and your health care provider should order the “Hepatitis B Panel,” which includes three parts. You and your health care provider will need to know all three test results in order to fully understand whether you are infected, protected or still at risk for a hepatitis B infection. Remember to ask for a copy of your hepatitis B blood test results so that you fully understand which tests are positive or negative.

Interpreting Results

Your results should include HBsAg (hepatitis B surface antigen), HBsAb (hepatitis B surface antibody), and HBcAb (hepatitis B core antibody). Below is a chart to help you interpret your results!

Newly Diagnosed

Here are some next steps if you have received your test results and tested positive for hepatitis B. The first thing you should know is that you can live a long and healthy life.

Next Steps:

  1. Understand your diagnosis. Do you have an acute or chronic infection? When someone is first infected with hepatitis B, it is considered an acute infection. Most healthy adults who are acutely infected are able to get rid of the virus on their own. If you continue to test positive for hepatitis B after 6 months, it is considered a chronic infection. Knowing whether your hepatitis B is acute or chronic will help you and your doctor determine your next steps. If you are unsure of what your blood test results mean, you may find Understanding Your Blood Tests helpful.
  2. Prevent the Spread to Others. Hepatitis B can be transmitted to others through blood and bodily fluids, but there is a safe and effective vaccine that can protect your loved ones from hepatitis B. You should also be aware of how to protect your loved ones to avoid passing the infection to family and household members and sexual partners.
  3. Find a Physician. If you have been diagnosed with chronic hepatitis B, it is important to find a doctor that has expertise in treating liver disease. We maintain a searchable physician directory database to help you find a liver specialist near you.
  4. Educate Yourself. Get the facts about hepatitis B, including what it is, who gets it, and possible symptoms, starting with What is Hepatitis B.
  5. Seek Support. It might be helpful to you if you seek community support. You can join Hep B Community, an online global forum dedicated to supporting people affected by hepatitis B. The Hepatitis B Foundation also lists more support groups you can check out here .

 

Author: Evangeline Wang

Contact Information: info@hepb.org

About Hepatitis B, Hepatitis Awareness Month, Hepatitis B Awareness

May is Hepatitis Awareness Month!

May is Hepatitis Awareness Month! This month, we bring awareness to the public health impact of viral hepatitis in the U.S., and the health consequences of hepatitis B and C infections if left untreated.

Globally, hepatitis B virus (HBV) affects 2 billion people and in the U.S. an estimated 2.4 million people are living with a chronic hepatitis B infection. Hepatitis B is often called the “silent killer”, as people often do not realize they are infected with hepatitis B until their liver is severely damaged, which makes it vital that the month of May is dedicated to raising awareness of hepatitis B. Because chronic hepatitis B infection is the most common risk factor for liver cancer, it is critical that we improve awareness on how to prevent, diagnose and treat hepatitis B. Individuals chronically infected with hepatitis B have a 25% to 40% lifetime risk of developing liver cancer. However, it is important to note that with proper testing and treatment, people living with hepatitis B can reduce that risk and live a long and happy life.

This month we look forward to encouraging all adults in the U.S. to get tested for hepatitis B with a simple blood test, and get vaccinated with a safe and effective vaccine if they are not yet protected or infected.  Thank you for helping us bring awareness to hepatitis B this May!

Resources For Patients

The Hepatitis B Foundation has multiple resources for patients you might not be aware of. Below is a small list you should check out!

  • Hep B Community
    • A new global online support group.
  • Physician Directory
    • Find knowledgeable doctors! The Hepatitis B Foundation has created a directory of liver specialists to help those seeking qualified medical care. The specialists have agreed to be included in this directory and treat chronic hepatitis B and/or liver cancer and are willing to be contacted for further information.
  • B Heppy
    • A podcast discussing all things hepatitis B-related. Our first episode discusses the COVID-19 vaccine and people living with hepatitis B.
  • Liver Q’s Video Series on Hepatitis B
    • These short video clips answer some frequently asked questions about hepatitis B.
  • Clinical Trial Locator
    • Volunteering for a clinical trial program can be very valuable. Expensive blood work, treatment medications, and doctor’s visits are usually provided free of charge for those accepted into a study. Clinical trials also provide the opportunity to potentially benefit from the latest advances in medical science.

Check out our website for more!

Resources For Providers

  • CDC’s Hepatitis Awareness Month Social Media Toolkit
  • Hep B United’s and CDC’s Know Hepatitis B Social Media Templates
    • The Know Hepatitis B campaign provides translations in multiple languages like Arabic, Amharic, French, and Swahili, Chinese, and Vietnamese.
  • Hep B United Philadelphia’s Provider ECHO
    • The goal of the Hepatitis B ECHO is to expand provider capacity at the primary care level to diagnose, treat and manage hepatitis B. Each ECHO session will include one case discussion and a 15-minute didactic aimed to empower providers to manage hepatitis B.
  • Webinar: Educational Resources for African Communities
    • Panelists from the Centers for Disease Control and Prevention (CDC) and the African Services Committee will discuss Know Hepatitis B campaign resources for community health workers working within African communities and community-based hepatitis B prevention initiatives. Additionally, hepatitis B activist and storyteller Bright Ansah will share his personal experiences with hepatitis B and highlight the need for greater awareness, education, and resources about hepatitis B in African communities.

About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Prevention

April 30 is National Adult Hepatitis B Vaccination Awareness Day

The Need for an Adult Hepatitis B Vaccination Awareness Day

 In 2019, the hepatitis B community successfully advocated for the introduction of U.S. House and Senate resolutions to designate April 30th as National Adult Hepatitis B Vaccination Awareness Day for the first time! Two years later, the Hepatitis B Foundation is proud to support this day and continue adult vaccination efforts as we gear up for May, Hepatitis Awareness Month.

On April 30th we bring awareness to adult hepatitis B vaccination efforts. Despite a safe and effective hepatitis B vaccine, only 25% of the U.S. adult population has been vaccinated, primarily due to people being born before the vaccine was universally recommended.1 New hepatitis B infections are highest among people aged 30-49 years because many people at risk in this group have not been vaccinated in spite of federal recommendations.

Acute hepatitis B cases are rising partially due to the opioid epidemic with the increase in injection drug use. Hepatitis B can be spread through needle sharing or unsterile drug injection equipment. Additionally, hepatitis B can be transmitted from mother-to-child, and about 1,000 newborns become infected   each year in the U.S..2 This statistic is concerning because mother to child transmission can be prevented in most cases with appropriate use of the vaccine. When exposed to the hepatitis B virus at birth, 90% of newborns will develop chronic life-long infection, putting them at much greater risk for cirrhosis and liver cancer.

Immunization rates also remain low among vulnerable populations including those living with other chronic conditions such as hepatitis C, HIV, kidney disease, or diabetes. In fact, just 12% of diabetic adults 60 years old or older are fully vaccinated, and 26% of diabetic adults ages 19-59 have received the complete vaccine series. Healthcare workers are an under-vaccinated vulnerable population as well. According to the Centers for Disease Control and Prevention, just 60% of healthcare personnel have completed their vaccine series. Get yourself vaccinated for yourself and your loved ones!

How to Become Vaccinated for Hepatitis B

In the era of COVID, we are reminded how important vaccines are. Make sure you and your loved ones are vaccinated for hepatitis B. If you are not vaccinated, ask your doctor or healthcare provider for the hepatitis B vaccine. This safe and effective vaccine is given in 2 or 3 doses depending on the vaccine:

The three-dose vaccine (scheduled at 0, 1 and 6 months):

  1. The first dose is administered at any time (newborns should receive their first dose in the delivery room).
  2. The second dose is administered one month after the first dose.
  3. The third dose is administered 6 months after the first dose.

Sometimes committing to a 3-dose shot is hard. Luckily, there is an approved 2-dose hepatitis vaccine, Heplisav-B, for adults in theU.S..

The two-dose vaccine:

  1. The first dose is administered at any time.
  2. The second and final dose is administered one month after the first dose.

More information on the dosing schedule can be found here.

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You can show your support for National Adult Hepatitis B Vaccine Day by using the social media toolkit and hashtag #AdultHepBVaxDay on April 30th and when discussing the hepatitis B vaccine on social media! Graphics are also available to share throughout your networks.

Join the Hepatitis B Foundation and other leading hepatitis organizations for a Congressional Briefing on Thursday, April 29th at 3pm ET where a group of panelists will discuss how we can work towards achieving health equity by increasing adult hepatitis B vaccination rates.

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References

  1. https://www.cdc.gov/hepatitis/populations/idu.htm
  2. https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html

Author: Evangeline Wang

Contact Information: info@hepb.org

About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Hep B Community – A New Global Online Support Group

The Hepatitis B Foundation is excited to announce our support of a new global online community support group called Hep B Community. Thomas Tu, PhD, a researcher at Westmead Institute for Medical Research founded this online community to reach a global audience who might need support if they are affected by hepatitis B. 

Dr Tu stated that “While hepatitis B remains incurable, it can be managed and treated. But, people with hepatitis B face social stigma and discrimination, discouraging them from seeking medical help that could prevent progression of their illness to serious disease like liver cancer,”. He further explained that this online forum is important for people affected by hepatitis B to feel supported and empowered to take control of their diagnosis. 

Westmead Hospital’s Storr Liver Centre and the Hepatitis B Foundation have provided start-up funding and help coordinate the forum with support from the World Hepatitis Alliance. The site is peer-led, volunteer-run and is free to join. Already, more than 200 members from all over the world have joined.

Chari Cohen, DrPH, MPH, senior vice president, Hepatitis B Foundation, believes, “The new forum is critically important because people can anonymously seek advice about how to live with hepatitis B, and what they can do to protect their liver and long-term health.” If you are considering joining Hep B Community – do not hesitate! In fact, research has shown that people participating in hepatitis support groups can increase their knowledge, coping, and compliance.1 

How Does it Work?

The online forum has multiple sections like learning resources, media about hepatitis B, and general discussion. 

You can post completely anonymously and a hepatitis B expert or a person living with hepatitis B will respond to your questions. You can also choose your own username and the platform will never show your email, ensuring privacy and confidentiality. 

The hepatitis B experts responding to your questions go through a verification process to identify that they are trustworthy sources of information. These providers are clinicians, nurses, scientists or patient experts,  there to provide reliable answers and give information about health guidelines and treatment options. The forum also has researchers and scientists giving explanations and updates about technical information related to hepatitis B virus and treatment. 

The site is completely free! You can access the site even without making an account if you want to browse. However, in order to ask questions or post content, you will need to create an account. Empower yourself and join the other 200 users and immerse yourself in the supportive hepatitis B community!

Reference

  1. Jessop, Amy B. PhD, MPH; Cohen, Chari MPH; Burke, Monika M. RN; Conti, Molli BS; Black, Martin MD Hepatitis Support Groups, Gastroenterology Nursing: July 2004 – Volume 27 – Issue 4 – p 163-169 

Author: Evangeline Wang

Contact Information: info@hepb.org

HBV, HDV, Hepatitis B Awareness, Hepatitis Delta (HDV)

Hepatitis B and Hepatitis Delta

 

What is Hepatitis Delta

Hepatitis delta is a liver infection that results from the hepatitis delta virus (also known as HDV) that causes the most severe form of viral hepatitis known to human beings. It is also the smallest virus known to infect humans. Hepatitis delta is unique because it is dependent on the hepatitis B virus (HBV) to infect and reproduce in liver cells, so those already infected with hepatitis B are at a greatly increased risk of developing hepatitis delta.

Since testing for hepatitis delta is not as widespread as it should be (everyone who is diagnosed with hepatitis B should also be tested for hepatitis delta), the exact number of people living with hepatitis delta is unknown. Some reports point to 15-20 million people living with hepatitis delta worldwide, but other studies have estimated that as many as 60-70 million people could be living with hepatitis delta around the world.

Co-Infection with Hepatitis B

Co-infection with hepatitis B and hepatitis delta can cause more serious liver disease than hepatitis B infection alone. This includes faster progression to liver fibrosis (or scarring), higher risk of liver cancer, and earlier onset of cirrhosis or liver failure.

There are two ways in which someone living with hepatitis B can become infected with hepatitis delta. One is through co-infection, which occurs when an individual acquires hepatitis B and hepatitis delta infections at the same time, and the other is through super-infection, which occurs when someone who is already living with hepatitis B acquires hepatitis delta.

A co-infection is less common and will often clear up on its own within six months, but sometimes it can cause very dangerous or fatal liver failure. A superinfection is more common and is the culprit of severe liver disease. As many as 90% of people with a superinfection will develop chronic (life-long) hepatitis B and hepatitis delta infections, 70% of which will progress to cirrhosis. This compares to only 15-20% of chronic hepatitis B infections alone.

Transmission and Prevention

Hepatitis delta can be transmitted in the same ways as hepatitis B, through exposure to infected blood or bodily fluids. This occurs most often through the sharing of hygiene equipment; practices of bodily alterations, such as tattoos, piercings or scarification; unsterile healthcare practices; sharing needles, syringes, or other paraphernalia during injection drug use; or having unprotected sex. Although hepatitis B virus is most commonly transmitted from mothers to their babies during childbirth, it is believed that hepatitis delta transmission through this route is uncommon. Since hepatitis delta cannot be contracted on its own, only people who are already infected with hepatitis B or who are at high risk of contracting both viruses simultaneously can contract hepatitis delta.

A vaccine for hepatitis delta does not exist, but fortunately, the vaccine for hepatitis B protects against hepatitis delta as well! Just as with hepatitis B, family members and sexual partners of people living with hepatitis delta should also receive the hepatitis B vaccine to significantly lower their risk of contracting hepatitis B and hepatitis delta. For those who are already infected with chronic hepatitis B, the best way to protect yourself from hepatitis delta is to practice protected sex (with a condom) and avoid potential blood exposure.

All individuals who have been diagnosed with hepatitis B should also get tested for hepatitis delta. The test is a simple blood test. Hepatitis delta can be managed by a doctor – it is most dangerous when a person does not know they have it, making it that much more important to get tested!

 Who is at Risk

If you are living with chronic hepatitis B, you are at risk for hepatitis Delta. Groups at risk for hepatitis delta include:

  • People chronically infected with hepatitis B are at risk for infection with HDV.
  • People who are not vaccinated for hepatitis B
  • People who inject drugs
  • Indigenous people and people with hepatitis C virus or HIV infection
  • Recipients of hemodialysis
  • Men who have sex with men
  • Commercial sex workers
  • Individuals from countries or regions where hepatitis delta prevalence is high

Several geographical hotspots have a high prevalence of hepatitis delta infection, including Mongolia, the Republic of Moldova, and countries in Western and Middle Africa.

For Patients

If you are living with hepatitis B, it is recommended you get tested for hepatitis delta. Please ask your healthcare providers to be tested for hepatitis delta.

The Hepatitis B Foundation has resources for patients living with hepatitis delta.

Drug Watch – Drugs and Medications in Development for Hepatitis Delta

Clinical Trials – Clinical trials are research studies that test new potential treatments for a disease. Talk to your doctor about possible clinical trials that could be helpful to you.

Find a Doctor – Visit our Physician Directory to locate a doctor near you! It now includes a specific search tool to locate doctors that also manage hepatitis delta patients. For additional assistance locating a doctor, email connect@hepdconnect.org.

Other educational resources include webinar recordings, multilingual fact sheets, and frequently asked questions.

For Providers

Providers in the United States can request hepatitis Delta tests from Quest Diagnostics. It is recommended that you first call your local Quest representative to confirm that the location does this specialty testing.

Below is the coding list for hepatitis delta testing as well as quantitative HBsAg and hepatitis B genotyping.

  • Quest Test Code for HDV Antibody Total—4990 Set up 2 times/week
  • Quest Test Code for HDV Antibody IgM—35664 Set up 2 times/week
  • Quest Test Code for HDV RNA Quantitative PCR—37889 Set up 6 times/week

Quest does not currently offer a national test code for hepatitis delta antibody reflex to HDV RNA quantitative, but you can coordinate with the Quest commercial person that covers your account to possibly set up a custom reflex.

 

Authors: Beatrice Zovich and Evangeline Wang

Contact Information: info@hepb.org

 

 

About Hepatitis B, advocacy, HBV, Hepatitis B Awareness

B Heppy- A Podcast

We are so excited to announce the launch of our podcast: B Heppy! This podcast is part of our 300 Million Reasons campaign, a movement to improve awareness about hepatitis B and liver cancer worldwide, to promote engagement of key stakeholders, and to empower people impacted by hepatitis B to become vocal advocates. There are almost 300 million people around the world living with chronic hepatitis B infection, and we want to make sure each and every voice is heard.

B Heppy addresses various topics about hepatitis B to help inform providers, persons living with hepatitis B and the general public about hepatitis B. The first episode covers the covid-19 vaccine in the context of individuals living with hepatitis B. The Foundation interviewed Robert Gish M.D., Hepatitis B Foundation Medical Director to answer questions like what is an mRNA vaccine, the side effects of the COVID-19 vaccine, and if it is safe for people living with hepatitis B to receive the COVID-19 vaccine.

Our next episode will discuss the history of the Hepatitis B Foundation as well as giving an overview of hepatitis B. We will be joined with co-founders, Joan Block, RN, BSN and Jan Witte and Senior Vice President Chari Cohen, DrPH, MPH.

We hope this podcast reminds you that you are not alone in your diagnosis! Together, we can foster a collaborative and connected global community united around all things hepatitis B.

B Heppy is available on Spotify Podcasts, Apple Podcasts, and Overcast, you can also access it here.

Author: Evangeline Wang

Contact Information: info@hepb.org

Baruch S. Blumberg Institute