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Tag Archives: HBV Awareness

Hepatitis B Mutation Seen in Only Men, Increased Risk of Liver Cancer

High Level of Sexual Harassment in Men Linked to Purging: Study

Are you depressed? (Photo : Reuters)

Posted in Science World Report, October 17, 2013

A recent study looks at a form of hepatitis B that is only found in men and may explain higher rates for certain types of cancer.

According to a team of researchers from Seoul National University in Korea, they identified a mutation from the hepatitis B virus that seems to appear only in men and may explain why HBV-infected males are roughly five times more likely than HBV-infected women to develop certain types of liver cancer. Continue reading "Hepatitis B Mutation Seen in Only Men, Increased Risk of Liver Cancer"

Join Hep B United, CDC DVH, HBF, AAPCHO and CDC NPIN for a Twitter Chat!

Mark you calendars! Join Hep B United,CDC Division of Viral Hepatitis , HBF, AAPCHO and CDC NPIN for a Twitter Chat on Tuesday, November 19th, 3pm EST to discuss the Know Hepatitis B campaign and what Hep B United, partners and coalition members are doing to raise awareness and increase hepatitis B testing and vaccination among Asian Americans and Pacific Islanders (AAPIs). Hepatitis B is the leading cause of liver cancer and a major health disparity among AAPIs who are disproportionately impacted by HBV. Continue reading "Join Hep B United, CDC DVH, HBF, AAPCHO and CDC NPIN for a Twitter Chat!"

HBV Journal Review – September 2013

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

  • 39.2% of U.S. Newborns Aren’t Getting Hepatitis B Vaccine at Birth
  • Researchers Suggest Banning or Restricting Lamivudine to Avoid Drug Resistance
  • Knowledge Gap About Hepatitis B Persists Among Asian-Americans
  • Even Liver Specialists Fail to Immunize Patients Against Viral Hepatitis
  • Many Seek Viral Hepatitis Tests Only When Symptoms Appear
  • After Six Years of Tenofovir Treatment, Still No Signs of Drug Resistance
  • More Studies Examine Link Between Vitamin D and Liver Damage
  • Study Examines Which Hepatitis B Patients Relapse with Chemotherapy
  • Interferon Treatment May Cause Some Hearing Loss
  • African-Americans Suffer the Highest Rates of New HBV Infections in the U.S.

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

 

 39.2% of U.S. Newborns Aren’t Getting Hepatitis B Vaccine at Birth

Which newborns aren’t getting immunized against hepatitis B in the U.S.? The infants who:

  • • Do not have health insurance
  • • Live in states without a universal hepatitis B vaccine supply policy
  • • And have only one provider who administered vaccines.

According to a U.S. Centers for Disease Control and Prevention study, published in the August issue of the journal Preventive Medicine, an alarming 39.2% of newborns missed the first, critical birth dose of hepatitis B vaccination that can protect newborns from hepatitis B even if their mothers are infected.

These results come from data analysis of the 2009 National Immunization Survey of 17,053 U.S. children, aged 19-35 months.

“Children who reside in states without a universal hepatitis B vaccine supply policy, and are not covered by health insurance are two important modifiable risk factors for not receiving the birth dose hepatitis B vaccination, future intervention studies could be needed to help control those modifiable risk factors,” CDC researchers wrote.

Source: www.ncbi.nlm.nih.gov/pubmed/23988497

Researchers Suggest Banning or Restricting Lamivudine to Avoid Drug Resistance
A global team of researchers suggest lamivudine (Epivir-HBV) never be used to treat hepatitis B patients because it frequently leads to drug resistance and sets the stage for resistance to other antivirals, such as entecavir (Baraclude).

Lamivudine, the first antiviral approved for hepatitis B treatment, has fallen out of favor in North America and Europe because of its high rate of drug resistance. But because of its low cost, it continues to be commonly used to treat hepatitis B virus (HBV) infection in Asia and Africa, where the majority of the world’s hepatitis B patients live.

This report, published in the July 30 issue of PLoS One, examined the molecular make-up of the virus in many patients who had been treated with lamivudine as well as patients who had never been treated. They found the many untreated patients carry a mutation that allows HBV to quickly mutate and develop resistance to lamivudine.

“Our findings strongly suggest that the use of lamivudine will not benefit …patients,” they wrote because of the high risk of lamivudine resistance.

“Finally, since patients can quickly develop drug resistance to entecavir in the presence of lamivudine mutations, the lamivudine mutations can significantly compromise the efficacy of entecavir,” they concluded.

They proposed that doctor screen patients for these mutations before ever prescribing lamivudine,”… to most effectively treat chronic hepatitis B patients by selecting only sensitive drugs.” …

Continue reading about this and additional HBV related studies

Joan Block, Hepatitis B Foundation Co-founder, Honored for Advocacy Work

A wonderful article (reprinted below) and short video was published last weekend in Phillyburbs.com recognizing the work of Joan Block, the Executive Director and co-founder of the Hepatitis B Foundation. In commemoration of World Hepatitis Day, Joan and Dr. Anna Lok were honored by the Viral Hepatitis Action Coalition of the Centers for Disease Control Foundation, for advocacy work resulting in the protection of medical students from HBV discrimination, and ultimately having HBV recognized as a disability protected under the Americans with Disabilities Act (ADA). This amazing accomplishment is just one of the many successes Joan and the HBF have had over the last 23 years as a result of her tireless efforts and dedication to the mission to help improve the lives of those affected by hepatitis B.

Please visit Phillyburbs.com to access to view the short video where Joan talks about the Foundation’s beginnings and how the HBF has grown from a grass roots effort to the leading national nonprofit for hepatitis B. Joan Block and the HBF truly are the “voice of hepatitis B”.

Read more about the story and the mission of the Hepatitis B Foundation and be sure to visit the HBF website to learn more about hepatitis B and the work of the Foundation.

For more than two decades, the Hepatitis B Foundation has fought to find a cure for the liver disease and advocate for those who have it.

What started as a grass-roots effort of four passionate people has grown into one of the leading nonprofit research and disease advocacy organizations in the United States.

“We are the voice for hepatitis B in the United States,” said co-founder and executive director Joan Block. “There’s still a lot of work to do, but we’ve accomplished a lot in the past 23 years.”

Earlier this year, the foundation’s mission got a boost when the U.S. Department of Justice said hepatitis B patients are protected under federal disability law in a case brought by the foundation against a New Jersey medical school on behalf of two students who were denied admission because they had the disease.

The case earned Block and Dr. Anna Lok, director of clinical hepatology at the University of Michigan Health System, recognition from the Centers for Disease Control Foundation, which honored both women on World Hepatitis Day July 25.

“That award is really being given to the foundation,” said Block, who lives in Doylestown Township. “It’s not me; it’s the work of the foundation. Without the foundation, I honestly don’t know if hepatitis B would even have much on the radar screen. There are very few voices, and we are probably the primary voice at the national level.”

Hepatitis B is an infectious liver disease that can be spread by sexual contact, sharing infected needles or at birth from mother to child, according to the Centers for Disease Control and Prevention. Chronic infection can lead to liver failure and cancer.

Block, her husband, Timothy Block — a researcher and academic who more often serves as the public face of the foundation — and New Hope philanthropists Jan and Paul Witte founded the Hepatitis B Foundation 23 years ago to draw more attention to and develop a cure for the disease, which affects up to 1.4 million Americans.

The couples initially started out to help a local family dealing with the disease. But what they found was little interest from the public health sector in researching a cure. The hepatitis B vaccine has led to dramatically lower rates of infection, and the prevailing, yet incorrect, belief at the time was that the disease infected mainly gay men and intravenous drug users.

“The more we dug, the more we realized there was nothing out there,” Joan Block said. “It was really grass roots, just the four of us in (the Wittes’) kitchen. We had the grand mission of raising a lot of money to start a research effort. That’s really what we needed. But it was hard to raise money when people didn’t know what hepatitis B was.”

Over the years, she said, the foundation has received numerous phone calls from people who believed they were being discriminated against because they have the disease. Some of them were medical professionals.

In 2011, four students contacted the foundation over six months, all claiming they were denied admission to or kicked out of medical and dental schools after discovering they had hepatitis B. All four were Asian Americans who were infected at birth. About half of infected patients in the U.S. are of Asian descent.

“It seemed like an avalanche,” said Block, a registered nurse who taught at Abington’s nursing school.

The foundation and Lok lobbied the CDC to update hepatitis B guidelines for medical professionals and students last changed in 1991. Since that last update, there have been no reports of hepatitis B transmission from medical or dental students, according to the CDC.

The Hepatitis B Foundation also filed a lawsuit on behalf of two students denied admission to the University of Medicine and Dentistry of New Jersey. The school settled with the Department of Justice.

In an added step, the departments of justice, health and human services and education sent a joint letter to the nation’s medical and dental schools about hepatitis B, encouraging them to adopt the CDC guidelines and informing them that people with hepatitis B are protected under the Americans with Disabilities Act.

But the foundation’s advocacy work is far from over. The organization is now lobbying on behalf of servicemen and women who are fighting discharge from the military on the grounds that they’re infected with the disease.

And the foundation’s executive director continues to push for a cure.

“We still want that cure,” Joan Block said. “We’re not satisfied that it’s preventable and controllable. We still have an urgent mission. That has not changed.”

 

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

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

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

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

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

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

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

If you appear to be in the HBeAg-Positive Chronic Hepatitis / Immune Reactive phase, be sure you continue with regular monitoring with your doctor and don’t be afraid to ask questions about your hep B infection and the health of your liver.

 

World Hepatitis Day in Ghana

Ghanians lined up for a viral hepatitis screening at last year's World Hepatitis Day event in Tamale, Ghana (Northern Region)

HBF is pleased to share World Hepatitis Day plans of our friend Theobald Owusu-Ansah of the Theobald Hepatitis B Foundation in Ghana. The Foundation is also a voting member of the World Hepatitis Alliance. 

On July 28th, 2013, The Theobald Hepatitis B Foundation and the Hepatitis Coalition of Ghana will join the World with one voice to celebrate World Hepatitis Day in Sunyani at Victoria Park. In attendance will be the Chiefs, members of Parliament, District Chief Executives, Municipal Chief Executives, Assembly Members and all the Opinion Leaders of the Region.

The Theobald Hepatitis B Foundation is a non-profit organization whose main aim is to educate and create awareness of hepatitis B and C to the general public, ranging from the causes, and symptoms of viral hepatitis, to preventive measures.

On World Hepatitis Day, the activities will start with an early morning Float with music and dance throughout the principal streets of Sunyani, along with the members and volunteers of the Foundation and the Coalition distributing educational materials to the crowds. These leaflets, posters, banners and stickers are part of the ongoing media blast that will draw the public’s attention to problem of chronic hepatitis B among the people of Ghana.

Free screening and hepatitis B vaccinations will be ongoing throughout the day’s activities. Resource persons will be delivering their messages and educating the general public about viral hepatitis. It is important that the people learn and understand whether or not they are positive or negative for viral hepatitis, and if they are positive, what is next.

The Delegation of the Government and other health care professionals will educate the public on Viral Hepatitis Policies and the way forward. Dieticians will also take the general public through the kind of food and diet one needs to eat, and the importance of avoiding alcohol, in order to defuse the public cry of the cost of prevention and treatment of hepatitis B.

Participating organizations will then take the opportunity to appeal for funds from the government officials and the Chiefs of the region present, in order to enable us to successfully organize our last programme of the year.

At the end of the event, the public will be provided with advice, and directed to seek medical information from qualified health professionals, in order to avoid falling into wrong hands of those trying to sell false cures for those with hepatitis B.

Please join us for our World Hepatitis Day activities in Victoria Park if you are in Sunyani, Ghana.

Theobald Owusu Ansah
Theobald Hepatitis B Foundation
P.O. Box GP 21325 Accra-Ghana:

Phone: 00233-20-8269214
theobald2003@yahoo.com
Theobald Hepatitis B Foundation website

 

Hepatitis B and Social Security Disability Benefits

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

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

You can learn more about SSDI and SSI here

Hepatitis B and Qualifying for Benefits

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

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

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

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

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

Applying for Social Security Disability Benefits with Hepatitis B

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

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

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

 

Big Thank You to 2 Hep B Heroes

 

HBF would like to thank Hep B Heroes Nina and Richie Kahn. Richie recently ran the Delaware Marathon, and he and Nina used this opportunity to raise money for the Hepatitis B Foundation. Nina and Richie, thank you for your generous donation and your commitment to those living with hepatitis B!

“Back in 2008, I suffered a pretty horrific knee injury running the Philadelphia Half-Marathon. Several years, surgical procedures, and rehabilitation sessions later, I’m running again. So, I figured why not put my stamina to the test by running my first marathon while raising money for a wonderful cause?

On May 12th, I ran the Delaware Marathon to raise money for the Hepatitis B Foundation (HBF). For those of you who haven’t had the pleasure of working with HBF, the foundation is the only national non-profit organization solely dedicated to the global problem of hepatitis B. They are dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide. This commitment includes funding focused research, promoting disease awareness, supporting immunization and treatment initiatives, and serving as the primary source of information for patients and their families, the medical and scientific community, and the general public.

I finished the race in 3:59:23, 218th overall. More importantly, thanks to the generous support of friends, co-workers, and colleagues, we were able to raise nearly $3,000 for the Hepatitis B Foundation. Be sure to check out the Hepatitis B Foundation’s website to learn about the excellent work they do at http://hepb.org/.”

 

 

HBF and HBUP’s Hepatitis B Awareness Raising Event at the Philadelphia Art Museum

 

What a great hepatitis B awareness raising event for the Hepatitis B Foundation (HBF) and Hep B United Philadelphia (HBUP). The event took place at on the “Rocky Steps” of the Philadelphia Art Museum.  Participants including student volunteers, community leaders and health care professionals were dressed in their super hero t-shirts and red capes for their run up the steps to raise HBV awareness.

 

 

 

 

 

 

 

 

 

 

 

Hep B Heroes joined Philadelphia Councilman David Oh as he presented a city council resolution to eliminate Hepatitis B in the City of Philadelphia.

 

A special guest appearance was made by HBF’s own mascot, O’Liver B Hepatitis. In the past, O’Liver has appeared at numerous public events, and he was thrilled to step up and raise HBV awareness on the Rocky Steps.

 

 

 

 

 

Multicultural dancers get a thumbs up from O’Liver as he and other participants enjoy their performance on the steps.

 

 

 

 

 

 

 

B A Hero. B sure. Get Tested. Get vaccinated…