Hep B Blog

Category Archives: Living with Hepatitis B

How to Find a Hepatitis B Provider

How to Find a Hepatitis B Provider

If you have chronic hepatitis B or are newly diagnosed, it’s important to see a medical provider who has experience managing and treating hepatitis B.

Having a medical provider with hepatitis B expertise on your team not only safeguards your health but also lessens the stress of having a chronic liver disease. “My specialist gave me all the possible scenarios, but most importantly, he gave me my life back,” one hepatitis B patient recalled.

When first diagnosed, it’s often a primary health provider (PCP) or for children a pediatrician who orders diagnostic tests for hepatitis B. Doctors may run additional blood tests and/or immediately refer you to a liver specialist. If your PCP has experience managing and treating hepatitis B, you may decide to continue your hepatitis B care with that provider. Or, they may recommend a specialist who accepts your insurance or practices in the same healthcare system. But,  you may have to do some research to find the best specialist to treat your hepatitis B.

There are two types of specialists who treat liver diseases:

  • A gastroenterologist is an internist who has trained in digestive disorders including the liver, but how much liver expertise a gastroenterologist (GI doctor) has varies based on their training. It’s important to find out if they specialize in liver diseases and if they have experience with hepatitis B.
  • A hepatologist is a physician who specializes in the liver. This doctor has the most expertise and should be up-to-date about new treatments and clinical trials. But not all hepatologists have treated hepatitis B. Many will have treated hepatitis C, but not hepatitis B, so you need to ask.

Tips for finding a specialist:

  • Are they in the Hepatitis B Foundation directory? The Foundation has a Physician Directory of medical providers who treat hepatitis B around the world. These doctors have voluntarily signed up to be included in the database. It is not an exhaustive list, there may be hepatitis B specialists in your area who have not yet joined the directory.
  • Call the practice ahead of time and ask questions. How many hepatitis B patients have they treated? Do they participate in any clinical trials?  Are they aware of current monitoring and treatment guidelines for hepatitis B?
  • What’s the doctor’s reputation? Does anyone in your community see a liver specialist for viral hepatitis? Whom do they recommend?
  • Will you actually see the specialist or an assistant? Do you see a specialist only if there is a need for treatment? If you go to a teaching hospital, do you see the doctor or an intern, fellow or resident?

You are entering into a long-term relationship with someone who may care for you for many years. You need their expertise, but you also need to feel comfortable working with them. Do they listen when you speak and make eye contact? Trust and rapport are very critical.

“It’s really important that they don’t judge me,” one hepatitis B patient explained.  Another patient said that finding a doctor who spoke his language, or had an assistant who was fluent in his language, helped immensely.

Once you identify a specialist, here are some questions to ask:

  • Is the specialist accepting new patients? How long do you have to wait to get an appointment?
  • What hospital or lab do they use, and are they convenient for you? It’s important for you to always use the same lab so you have consistent results that allow apples-to-apples comparisons.
  • Will the doctor call you with the results or will a nurse or other assistants communicate with you?
  • What would you like your care plan to be? Will you go for blood tests and then see the specialist? Typically, hepatitis B patients get blood tests once or twice a year to monitor their liver, unless they are undergoing treatment.

How to design a long-distance care plan if the specialist is far away:  Sometimes, the best hepatitis B specialist is a few hours drive from where you live, but distance doesn’t have to be a deal-breaker. Many people see a specialist for a first visit, and afterwards, simply have their PCPs or local labs email lab results to the specialist. For this remote healthcare relationship to work, your PCP needs to be willing to partner with the specialist. Also, your specialist needs to be open to telephone or video consultations with you as needed.

Technology matters. Sharing medical records and lab tests electronically make a remote relationship work smoothly. If there are firewalls between practices, find out how to ensure your PCP and specialist share your medical records. Be prepared, you may have to be the conduit if the two healthcare systems don’t talk to each other.

Insurance and cost: Ideally, the hepatitis B specialist closest to you accepts your insurance or is in your provider network. That doesn’t always happen so finding out the charges in advance is important.

  • Will the specialist bill your insurance or will you need to pay the fee upfront and manage the insurance reimbursement yourself?
  • How much do you have to pay out-of-pocket if the specialist is outside your network, or if you are not insured? Some specialists charge a lower fee to uninsured patients. You may be able to have an annual consultation with a specialist and bring your lab results.

One hepatitis B patient reported he was not entirely happy with the specialist his PCP referred him to. “At the time, I had great insurance so all the tests he ordered weren’t a lot of money out-of-pocket,” he said. “But then I changed jobs and I couldn’t afford all of his tests, and he wanted me to go on treatment though my lab reports didn’t justify it.

“I went looking for a new one and found one in the Hepatitis B Foundation’s website,” he said. “I had to drive farther to see him, but his knowledge and patience were very comforting and he spoke my primary language. He really helped me regain confidence in life.”

Prepare for your visit: Before you see your hepatitis B medical provider, put together a list of questions (see sample questions) and have your lab reports available — either bring hard copies or call ahead of time to make sure the doctor has access to your latest labs and medical records.

After you meet with your specialist, take some time to reflect. Are you happy with the doctor? Did he or she communicate well? Are you clear about what you need to do in the weeks and months ahead to take charge of your health? If the answer is yes, congratulations, you have assembled a good healthcare team.

Contact Information: info@hepb.org

Join #MoreThanB

The Hepatitis B Foundation is very excited to announce the launch of our new campaign: #MoreThanB.  The goal of the campaign is to celebrate the lives of those living with or impacted by hepatitis B worldwide. Hepatitis B might be a big part of our lives, but we want to highlight the other aspects of our lives – our hobbies and dreams, the way we spend our time, the things that make us who we are, outside of hepatitis B.

The Hepatitis B Foundation has been a long-time advocate and supporter of individuals living with hepatitis B who express that they are more than their diagnosis. In 2008, The Foundation supported 18-year old John Ellis throughout his “Believe in the Cure” cycling tour from Pensacola to Philadelphia to raise awareness about hepatitis B. When John was diagnosed with hepatitis B as a teenager, he wanted to be “bigger” than his diagnosis, so he undertook this physical challenge, which raised $50,000 for The Foundation’s mission to find a cure and improve the lives of those affected. John helped us all learn to express how we are bigger than a  hepatitis B diagnosis.

We want you to share who you are beyond hepatitis B. Share a few sentences about your life, hobbies, work, family, friends, and upload a photo. We will turn your submissions into social media posts to share on the Foundation’s social media pages. United States respondents, please submit your profile by April 2nd to be featured during Hepatitis Awareness Month in May and international respondents, please submit by June 30th to be featured in July for World Hepatitis Day.

Take a look at the examples below:

“I am constantly learning and finding new adventures. I love to read, attend the theatre (when safe 😊), spend time with my family and dog, and find new ways to incorporate sustainability into my lifestyle. You’re most likely to find me scrolling on social media, or playing a card game with friends!”

 

“I am a wife, dog mom, marathoner and avid traveler. I am passionate about food, hiking, being in nature, exploring, public health and eliminating hepatitis B.”

 

Submit Your More Than B Profile

 

Author: Evangeline Wang

Contact Information: info@hepb.org

 

Sexual Transmission and Hepatitis B Among Adults in China

As the birth-dose for hepatitis B (HBV) increases, sexual transmission is the most common mode of transmitting hepatitis B among unvaccinated adults. A research study, “Evaluating the independent influence of sexual transmission on HBV infection in China: a modeling study” evaluated the independent impact of sexual transmission on hepatitis B. This blog will give a summary of the results of the study, prevention tips, and future recommendations.

Summary of Research Study

 The researchers of this study developed an age- and sex-specific discrete model at the population level to evaluate the influence of sexual transmission on HBV infection in China. They found that in 2014, due to sexual transmission, the total number of chronic HBV infections in people aged 0–100 years increased by 292,581 people! That year, due to sexual transmission, there were  189,200 new chronic infections among men and 103,381 new chronic infections among women. In 2006, sexual transmission accounted for 24.76% (male: 31.33%, female: 17.94%) of acute HBV infections in China and in 2014, sexual transmission accounted for 34.59% (male: 42.93%, female: 25.73%) of acute HBV infections in China. These statistics demonstrate that acute HBV infections due to sexual transmission increased by 10% and 8% respectively from 2006-2014.

However, researchers found that if the condom usage rate increased by 10% annually starting in 2019, then compared with current practice, the total number of acute HBV infections from 2019 to 2035 would be reduced by 16.68% (male: 21.49%, female: 11.93%). The HBsAg prevalence in people aged 1–59 years in 2035 would be reduced to 2.01% (male: 2.40%, female: 1.58%).

Prevention and Harm Reduction Strategies During Sex

 Practicing safe sex is can be a great way to prevent the transmission of hepatitis B. Condoms are an effective way to prevent the transmission of hepatitis B during intercourse. Sometimes during sex, people like to use personal lubricants. When using condoms it is important to remember to only use silicone or water-based lubricant. Oil-based lubricants increase the chance of ripping or tearing the condom. It is highly recommended if someone is living with hepatitis B to have sex with a condom, however, if you are having sex without a condom, certain sexual activities are far more efficient at spreading hepatitis B than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a very high risk of transmission because tears in the skin can occur during penetration, allow more transmission routes for the virus.

Recommendations

If you have never been vaccinated for hepatitis B, it is recommended that you receive the vaccination. The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for lifetime protection against preventable chronic liver disease. The hepatitis B vaccine is also known as the first “anti-cancer” vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.

If you think you might be at increased risk for hepatitis B infection, is also recommended you get tested for hepatitis B. Hepatitis B is known as the” silent” infection, meaning you could be infected with the virus and not show symptoms that can cause long-term liver damage. If you have not been tested for hepatitis B and would like to know your status, you should get in contact with your primary care provider. Your physician should order a panel of three blood tests for the hepatitis B panel:

  1. HBsAg (hepatitis B surface antigen)
  2. Anti-HBs or HBsAb (hepatitis B surface antibody)
  3. anti-HBc or HBcAb (hepatitis B core antibody)

The results of all 3 blood test results are needed in order to make a diagnosis. Be sure to request a printed copy of your blood tests so that you fully understand which tests are positive or negative, and what your hepatitis B status is.

If you know you have had unprotected sexual intercourse with someone living with hepatitis B, there is something called post-exposure treatment. If an uninfected, unvaccinated person – or anyone who does not know their hepatitis B status – is exposed to the hepatitis B virus through contact with infected blood, a timely “postexposure prophylaxis” (PEP) can prevent infection and subsequent development of chronic infection or liver disease. This means a person should seek immediate medical attention (within 72 hours of exposure) to start the hepatitis B vaccine series. In some circumstances, a drug called “hepatitis B immune globulin” (HBIG) is recommended in addition to the hepatitis B vaccine for added protection.

 

Author: Evangeline Wang

Contact Information: info@hepb.org

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

New Year’s Resolutions and Hepatitis B

 

2020 was a difficult year for most of us. The coronavirus pandemic challenged us professionally, personally and could have led to financial hardship or strained relationships. 2021 ushers in a new year of resilience and resolutions. 

If you are living with chronic hepatitis B, you may feel as though you are not in control of your health, but that’s not true! Small changes to your daily life can go a long way towards improving your liver health and may even prevent liver damage from occurring. Here are four New Year’s resolutions to help you start 2021 off right!

Kick Your Old Habits to the Curb: Did you know that not only does smoking hurt your lungs, it also negatively impacts your liver? Old habits can be hard to break, but staying healthy is important. Smoking cessation can be hard! Instead of going cold turkey, maybe reduce your cigarette intake from smoking every day to every other day and work your way up to complete cessation. Did you know that insurance plans in the United States must cover smoking cessation programs through preventive care under the Affordable Care Act? This means that copayments and coinsurance can’t be applied to these programs. Taking the first step is better for your liver and your wallet!

Cook More: As you decrease your smoking intake, increase your cooking habits! Cooking can be a lot of work, but it can also be fun. Regularly eating fast-food and highly processed meals are bad for your liver and can leave you feeling lethargic, so try switching things up. Consider signing up for a virtual cooking class with your friends or family to learn some new tricks in the kitchen. You don’t have to make every meal from scratch; start by making one or two fresh meals a week and increase them as you feel more confident. Don’t know where to start? Try one of these recipes – desserts included!  There is no standard diet for chronic hepatitis B patients, but the American Cancer Society’s low fat, low cholesterol, and high fiber meal ideas are a good, general diet to follow.

Take Some Time For Yourself: Stress is bad for every part of your body – including the liver – so it is important to take some time for yourself. Set a few hours aside each week to do an activity that you enjoy. You can take up journaling, practice mindfulness, or go on a quick walk to help relieve stress – whatever relaxing activity feels right for you. If you have the resources, you may want to consider planning a vacation or taking a small weekend trip. Even if you can’t get away, set a goal to spend more time outdoors. Green spaces, such as an urban park or a forest, have been known to lower stress levels and can help manage weight, which is an important part of maintaining liver health.

Get Active: Exercising more might be one of the most common New Year’s resolutions, but it is also one of the most important ones! If you’re tired of going to the gym or bored with your old routine, try your hand at an exercise you hadn’t considered before. Yoga, pilates, running, and kickboxing are just a few examples of fun workouts that you can add to your exercise catalog and can be done outside of a typical gym setting. If you’re looking for affordable exercise options, be sure to check out some of the free exercise videos you can find on YouTube. You can also try hiking at your local park or joining a local community center!

New Year’s resolutions can be difficult to keep, especially if you are trying to do them all at once. The important part is to begin! If you are having trouble meeting your goals, pick one to start with and add another goal once it becomes a part of your routine.

 

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

Hepatitis B in Asian Populations

In the United States, an estimated 2.2 million people are living with chronic hepatitis B infection and most do not know they have it. Without diagnosis and treatment, 1 in 4 persons will develop cirrhosis or liver cancer. Hepatitis B is associated with significant health disparities, disproportionately impacting Asian American, Pacific Islander, and African immigrant communities. Asian Americans and Pacific Islanders make up 50% of the hepatitis B infection burden in the United States and have liver cancer rates that are up to 13 times higher than Caucasian populations despite making up 6% of the United States’ population.

Why are People of Asian Descent Disproportionately Affected?

 First-generation Asians from China, Korea, Vietnam, and those from the Pacific Islands are particularly highly impacted by hepatitis B due to the history of the virus (the virus has been circulating in certain areas of the world for thousands of years), as well as historically low infant immunization rates against the disease in many countries. Most Asians and Pacific Islanders who have hepatitis B were infected during childbirth from their mothers who were infected – that is why it is common to see multiple members of the same family affected by hepatitis B.

The great news is that the birth dose of the hepatitis B vaccine has been increasing in uptake in Asian countries. The Centers for Disease Control and Prevention (CDC) reported in the South East Asian Region that the hepatitis B vaccine birth dose and third dose coverage increased from 34% to 54% and from 89% to 91%, respectively. In 2019, nine of 11 countries in the region achieved ≥90% of the hepatitis B vaccine third dose coverage nationally, and three of eight countries that provide the hepatitis B birth-dose achieved ≥90% coverage.1 This great news comes with the World Health Organization announcing cases of hepatitis B in children under age five had dropped below 1% in 2019 which can be attributed to the increased uptake in vaccinations.2

Are You at Risk for Hepatitis B?

If you are interested in knowing if you are at risk for hepatitis B, this half-page questionnaire is a quick and easy assessment to determine if you should be tested for hepatitis B. The assessment is available in English, Chinese, Vietnamese, Korean, Burmese, Hmong, Khmer, and Lao. Download the risk assessment here.

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

References

  1. The Centers for Disease Control and Prevention
  2. The World Health Organization

 

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

Hepatitis B and Stigma

 

Hepatitis B and Stigma

World Kindness Day is just around the corner on November 13th. On World Kindness Day, we celebrate kindness and spread it around the world. Let’s celebrate this day by treating people living with hepatitis B with kindness, compassion, and respect.

Unfortunately, hepatitis B is often highly stigmatized – and the people living with it can feel ostracized. Why is there so much stigma surrounding hepatitis B? A study found that among Asians, the majority thought hepatitis B was a genetic disease which is why the family might feel stigmatized if a family member is living with it.1 Due to cultural values, interdependence, collectivism, and family centeredness, persons of Asian descent might think that having hepatitis B is a reflection on the family.1 This attitude could lead to people not wanting to get tested for hepatitis B because they worry about bringing stigma to the family.1 Another study found that among African communities, individuals were confused about the differences between hepatitis B, HIV, malaria, and other infectious diseases.2 This misattribution and confusion could lead to a person living with hepatitis B being perceived as an outsider to society and can cause stigma or discrimination.2

The studies demonstrate that the lack of education and information surrounding hepatitis B contributes to the stigma that individuals living with hepatitis B face. There is a lot of ignorance, myths, and misconceptions about hepatitis B. Let’s debunk some of these notions!

Hepatitis B cannot be spread through casual contact, only through blood-to-blood contact or sexual transmission. This means you can hug, kiss, and share a meal with your friends and family without worrying about contracting hepatitis B. In Asian communities, it is especially important to emphasize that family members living with an individual who has hepatitis B, can share meals with each other. And there is a safe and effective vaccine to protect loved ones – so transmission can be prevented!

Sometimes people do not want to discuss their hepatitis B status because of its association with intravenous drug use. People who inject drugs experience more discrimination because of the stigma surrounding addiction. On the flip side, individuals who do not inject drugs but are living with hepatitis B, might not want to discuss their status for fear that other people will stigmatize or label them as drug users. Additionally, people might assume individuals living with hepatitis B engage in risky sexual behavior which can further stigmatize them. This stigmatization only harms people living with hepatitis B because they cannot talk about their status openly, which would help destigmatize the disease.

Even extending past World Kindness Day, we encourage you to be kind to people living with hepatitis B. And if you are living with hepatitis B, please be kind to yourself! Continue to educate yourselves on hepatitis B to help lessen the stigma and discrimination surrounding it.

Below is a brief list of resources for people living with hepatitis B or individuals living with people living with hepatitis B.

  1. Transmission of hepatitis B – how hepatitis B can be transmitted
  2. Online Support Groups
  3. Factsheet – When Someone in the Family has Hepatitis B
  4. Know Your Rights – for anyone experiencing discrimination because of their hepatitis B status

References

  1. Kim, M. J., Lee, H., Kiang, P., Watanabe, P., Torres, M. I., Halon, P., Shi, L., & Church, D. R. (2015). Debunking the myth: low knowledge levels of HBV infection among Asian American college students. Asia-Pacific journal of oncology nursing, 2(1), 8–16. https://doi.org/10.4103/2347-5625.152399
  2. Mokaya, J., McNaughton, A. L., Burbridge, L., Maponga, T., O’Hara, G., Andersson, M., Seeley, J., & Matthews, P. C. (2018). A blind spot? Confronting the stigma of hepatitis B virus (HBV) infection – A systematic review. Wellcome open research, 3, 29. https://doi.org/10.12688/wellcomeopenres.14273.2

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