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Hepatocellular Carcinoma, Liver, Liver Cancer, Liver Health, Living with Hepatitis B

How artificial intelligence (AI) technology is helping doctors understand liver cancer

 

 

 

 

 

 

 

 

 

Liver cancer is a serious disease that can be difficult to detect early. When a patient’s symptoms raise a concern, physicians usually use medical images, such as CT scans or MRIs, to look for signs of cancer or abnormal growth in the liver. But sometimes, these images are challenging to read, and small tumors can be missed. That’s where artificial intelligence (AI) comes in. 

A recent study looked at how AI is being used to help doctors find and understand liver cancer better. 

What is AI? 

AI stands for artificial intelligence, which means computer programs that can learn from data and make decisions or predictions. In medicine, AI can look at lots of information, such as diagnostic images of the body, lab test results and patient history, and find patterns that might show signs of disease. 

How is AI used in liver cancer? 

In liver cancer, AI can be used to: 

  • Find tumors: AI can scan medical images and spot areas that look unusual (this can indicate abnormal tissue growth or cancer cells), even if they’re very small. 
  • Measure tumors: It can outline the shape and size of a tumor, which helps doctors plan treatment. 
  • Predict risks: AI can estimate how likely it is that the cancer will come back or spread. 
  • Help choose treatments: Based on the available data, AI can suggest which treatments might work best for a patient. 

What kinds of AI tools are there? 

Researchers are using different types of AI tools to help study liver cancer. Each tool works in its own way, but they all have the same goal: to look at medical data and help doctors understand what’s going on inside the body. 

Here are the main types:

Machine Learning (ML):  

  • Machine learning is a type of computer program that learns from examples. For liver cancer, it might look at thousands of patient records and medical images to learn what cancer looks like. Once it’s trained, ML can analyze new cases and predict whether someone might have cancer or how serious it is. 
  • Think of it like teaching a computer to recognize patterns, just like how you might learn to spot different dog breeds by looking at lots of pictures. 

 Deep Learning (DL) 

  • Deep learning is a more advanced kind of machine learning. It’s especially good at looking at pictures, such as CT scans or MRIs, and finding tiny details that might be hard for a human to see. These tools use a neural network, which is a system that works kind of like a human brain; it connects lots of pieces of information to make decisions. 
  • Deep learning is often used to find small tumors, measure their size and even tell if they’re likely to grow or spread. 

Multi-Modal Systems 

  • “Multi-modal” means using more than one type of information at the same time. These systems combine medical images with lab test results, patient history and other health data. By looking at everything together, AI can give a more complete picture of the patient’s condition and medical needs. 
  • It’s like solving a puzzle; you need all the pieces to see the full image. These tools help doctors understand not just where the cancer is, but how it might behave and what treatments could work best. 

What are the challenges? 

Even though AI is helpful, it’s not perfect. It needs a lot of good-quality data to work well. If the data is missing or not diverse, AI can make mistakes. Also, many AI tools are still being tested and aren’t used in hospitals yet. Doctors still need to understand how AI makes its decisions, which isn’t always easy. While it’s still being developed, artificial intelligence is helping researchers learn more about liver cancer and how to treat it. 

Reference: 

Wang, L., Fatemi, M., & Alizad, A. (2024). Artificial intelligence techniques in liver cancer. Frontiers in Oncology, 14, 1415859. https://doi.org/10.3389/fonc.2024.1415859 

300 Million Reasons, About Hepatitis B, HBV, Hepatitis B Diagnosis & Monitoring, Hepatocellular Carcinoma, Liver, Liver Cancer, Liver Health

Beyond the Liver: The broader impact of living with chronic hepatitis B

 

 

 

 

 

 

 

 

 

When we talk about chronic hepatitis B virus (HBV) infection, the focus is usually on the liver and for good reason. HBV is a leading cause of liver cirrhosis and liver cancer. However, new research shows that HBV’s impact goes far beyond the liver. It can increase the risk of other cancers in the body.  

Hepatitis B and non-liver cancers 

A major population-based study in China found that people with chronic hepatitis B had significantly higher risks of several types of cancer beyond liver cancer. These included stomach, colorectal, pancreatic, oral cancers, and lymphoma (a type of cancer that affects the immune system). For example, the risk of lymphoma was nearly double in HBV-positive individuals compared to those without the virus (Song et al., 2019). This suggests that HBV may play a role in cancer development outside the liver, possibly through long-term inflammation or high viral load that affects other tissues and nearby cells. 

How hepatitis B affects other organs 

Hepatitis B isn’t limited to liver cells. It can also be found in the pancreas, kidneys, and blood cells, where it may cause inflammation and target the immune system (Tang, 2020). Long-term inflammation, especially without proper treatment or management, caused by hepatitis B can raise the risk of cancer, and, because the virus can stay in different parts of the body, not just the liver, it may help explain why it’s linked to other types of cancers.  

In addition to cancer, hep B can also cause inflammation in other organs. One example is kidneys. Some people with HBV develop a condition called glomerulonephritis, which is a type of kidney inflammation. Over time, this can lead to serious kidney damage if not treated. 

HBV may also be linked to certain blood disorders and metabolic issues, especially when combined with other health problems such as diabetes or MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease. These conditions can make it harder for the body to stay balanced and healthy (Karayiannis, 2017). 

Mental and emotional health 

Living with chronic hepatitis B often can affect a person’s mental health. Some people feel anxious, stressed, or even depressed because of the stigma, the fear of passing the virus to others, or worries about their future health. These feelings can make it more challenging to stay on top of treatment and care. 

What Can Be Done? 

Fortunately, hepatitis B is manageable. Antiviral medications can suppress the virus, which may reduce the risk of complications and help with inflammation of not just liver cells but also other cells and tissues in the body. Regular monitoring and early treatment are key, not just for liver health, but for preventing other health issues linked to hepatitis B. Learn more about hepatitis B management and updated recommendations here. Check out our Liver Cancer Connect program to learn more about liver cancer prevention and management. 

While liver cancer is one of the most serious outcomes of chronic hepatitis B, the virus can also harm other parts of the body, including the stomach, pancreas, and even the immune system. That’s why managing hepatitis B isn’t just about protecting the liver; it’s about protecting your whole health. Staying connected to care, getting regular checkups, and following treatment plans are key to detecting problems early and living well with hepatitis B.  

References: 

Song, C., Lv, J., Liu, Y., et al. (2019). Associations between hepatitis B virus infection and risk of all cancer types. JAMA Network Open, 2(6), e195718. https://doi.org/10.1001/jamanetworkopen.2019.5718  

Tang, H. (2020). Hepatitis B Virus Infection: Molecular Virology to Antiviral Drugs. Springer. https://doi.org/10.1007/978-981-13-9151-4  

Karayiannis, P. (2017). Hepatitis B virus: virology, molecular biology, life cycle and intrahepatic spread. Journal of Gastroenterology, https://doi.org/10.1007/s12072-017-9829- 

300 Million Reasons, About Hepatitis B, Hepatitis B Advocacy, Hepatitis B Awareness

Should hepatitis B screening be mandatory for jobs or immigration? Let’s talk ethics

 

 

 

 

 

 

 

 

 

Hepatitis B (HBV) is a virus that affects the liver and can lead to serious health problems like liver cancer. Because it can spread through blood and other body fluids, some governments and employers have considered making HBV screening mandatory, especially for people applying for jobs or immigration. But is that fair? Let’s break down the ethical issues. 

Hepatitis B screening is a simple blood test that checks if someone has the virus. The U.S. Centers for Disease Control and Prevention (CDC) now recommends that all adults get screened at least once, even if they don’t have symptoms (Schillie et al., 2023). That’s because many people don’t know they have it, and early treatment can prevent serious illness. 

The problem with making it mandatory 

While screening can help protect public health, forcing people to get tested—especially for employment- or immigration– related reasons can harm communities and increase stigma and discrimination.  

  1. It can take away personal choice.

Mandatory screening means people don’t get to decide for themselves if they want to be tested. Often people are not even informed of the testing taking place or why it is occurring. That goes against the idea of informed consent, which is a basic principle of medical ethics. People should be able to choose whether to get tested, especially when it involves sensitive health information. 

  1. It can lead to discrimination.

HBV is more common in certain parts of the world, such as Asia and Africa. So, if screening is required for immigrants, it could unfairly target people from those regions. That can lead to stigma and even racism. In fact, studies show that people in Asian and Black communities in the U.S. are more likely to die from HBV-related illnesses than White communities (Schillie et al., 2023). Many communities in parts of Africa and East Asia are unfairly targeted through these mandatory screening tests which limit economic opportunities and lead to social isolation and stigma.  

  1. What happens after the test?

Another issue is what happens if someone tests positive. Will they be denied a job or visa? Will they get access to treatment or linkage to care? If screening is mandatory, there should also be support systems in place—such as affordable health care and protection from discrimination. Otherwise, it’s not just unfair—it’s harmful.  

  1. Privacy matters.

Health information is personal. If employers or immigration officers have access to someone’s HBV status, that could well be a privacy violation. People might lose jobs or face rejection just because of a medical condition that’s manageable with treatment. 

A better way forward 

Instead of making HBV screening mandatory, experts suggest offering it as part of routine health care. That way, people can get tested without feeling singled out. Universal screening also helps reduce stigma because it treats everyone equally. Additionally, people who test positive or need the hepatitis B vaccine should have easy access to medical care and vaccination options. 

In short, HBV screening is important, but it should be done in a way that respects people’s rights and reduces stigma and discrimination.  

References: 

Schillie, S., Wester, C., & Vellozzi, C. (2023). Universal adult hepatitis B screening: Updated recommendations from the CDC. Morbidity and Mortality Weekly Report, 72(6), 145–150. https://doi.org/10.15585/mmwr.mm7206a1 

 

About Hepatitis B, HBV, Liver, Liver Health, Living with Hepatitis B

Microbiome matters: What your gut says about your liver

 

 

 

 

 

 

 

 

 

Did you know that the tiny organisms living in your gut, called the microbiome, can have a strong impact on your liver? Recent research shows that the bacteria and fungi in your digestive system play a major role in keeping your liver healthy and may even affect how hepatitis B progresses. 

The gut-liver connection 

Your gut and liver are closely connected through something called the gut-liver axis. When your gut microbiome is balanced, it helps protect your liver by producing helpful substances such as butyrate and tryptophan. These can reduce inflammation and support liver function. But when the microbiome is out of balance (a condition called dysbiosis), harmful bacteria and toxins can leak into the bloodstream and reach the liver, causing damage (Zhang et al., 2024). 

What happens in hepatitis B 

Hepatitis B virus (HBV) can lead to serious liver problems, including cirrhosis. A 2025 study found that people with HBV-related cirrhosis had fewer good bacteria such as alistipes and lachnospira, and more harmful ones including Fusobacterium and Enterococcus in their gut (Chen et al., 2025). These changes were linked to lower levels of important nutrients like tocopherol, which help protect the liver. 

Another study looked at how the mix of bacteria in the gut changes as hepatitis B gets worse. Researchers found that people with chronic hepatitis B had a wider variety of bacteria compared to people without hepatitis B. They also noticed changes in the balance between two major groups of bacteria (firmicutes and bacteroidetes) that are important for digestion and immune health. These shifts in gut bacteria could help doctors understand any changes or advances in hepatitis B and possibly even predict how it might develop over time (Wang et al., 2023). 

Bile acids and bacteria 

Bile acids, which help digest fats, also interact with gut bacteria. In HBV-related liver disease, high bile acid levels were linked to more lactobacillales and fewer clostridiales, which suggests another kind of imbalance (Zhou et al., 2025). This connection could lead to new treatments that target both bile acids and bacteria. 

Your gut microbiome does a lot more than help you digest food. It’s deeply connected to your liver and can influence how hepatitis B develops and changes over time. As scientists learn more, we may see new treatments that focus on fixing the microbiome to protect and promote liver health. 

 

References: 

Chen, Y., et al. (2025). Gut microbiota and metabolomic profiles in HBV-related cirrhosis. Journal of Hepatology Research. 

Li, X., et al. (2024). Gut mycobiome and liver disease: Emerging insights. Liver International. 

Wang, J., et al. (2023). Microbiota diversity across HBV disease stages. Microbiome Medicine. 

Zhang, L., et al. (2024). Gut microbiota and chronic liver disease: Mechanisms and interventions. Hepatology Reviews. 

Zhou, H., et al. (2025). Microbiota–bile acid crosstalk in HBV-induced cirrhosis. Clinical Gastroenterology. 

 

About Hepatitis B, CAB Corner, Hepatitis B Awareness, Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B, Relationships

Importance of disclosing your hepatitis B and hepatitis D status

 

 

 

 

 

 

 

 

 

Written By: Soumen B., Silvana L., Partizan M. 

Thirteen years ago, I experienced a profound shock. My wife was in the third trimester of her pregnancy, and I was eagerly anticipating fatherhood, filled with plans for our future with the baby. As part of routine procedures, we both were asked to undergo various diagnostic tests. One day, the gynecologist unexpectedly called us in for an urgent meeting. I was asked to wait outside while my wife entered the doctor’s office. When she emerged after half an hour, I noticed a deeply worried expression in her eyes. As I greeted her, she responded with a blank stare, as if the world were crashing down around her.  

We returned home in silence, and then she broke down in tears. My wife shared with me that my blood test revealed I was infected with hepatitis B. How could this have entered my body? The doctor told my wife that the disease was terminal and that I might not survive for long. Our world began to crumble. I have always been a respectful and loyal family member with minimal alcohol consumption. How could this happen to me?  

The most challenging part was figuring out how to explain this to my wife… 

After I was diagnosed, I began online research and reached out to a nonprofit organization (Liver Foundation West Bengal). I gathered information about the disease and accessed health support. I then had an open and candid discussion with my wife, free of embellishments. I explained that I was one of millions affected worldwide and that the disease could have been transmitted through less common means, such as unsterile equipment used during a haircut, like razors, at the salon.* She was extremely cooperative and listened patiently. She also helped me confront the stigma and face the reality of the situation. My wife and I looked up more information so that we could learn about hepatitis B. We talked to our doctors to learn about how we can reduce the risk of transmission and maintain our health. My wife made sure to receive the hepatitis B vaccine, and we made certain that our baby received the vaccine immediately after childbirth.  

Later, I took her to meet members of the nonprofit, including experts and other patients, to engage in an open conversation about the disease and its implications. Both my wife and baby are now vaccinated and protected against hepatitis B infection. 

 

* Hepatitis B is highly infectious, and if tools and surfaces are not properly disinfected, it can survive for up to seven days. If you are exposed to hep B from a small wound (like the ones that happen during a short hair cut or shaving with tools that are not sterilized), even the smallest drops of blood from someone living with hepatitis B could cause an infection. Sexual transmission is a primary mode of transmission for hepatitis delta. 

 

Key Questions and Answers from this Story:  

If hepatitis B is sexually transmitted, how come my partner isn’t infected? 

Hepatitis B virus (and hepatitis delta virus) can be sexually transmitted. The virus is present in an infected person’s blood and bodily fluids commonly exchanged during sexual activity, such as semen and vaginal fluids. There are many reasons your partner might not be positive for hepatitis B after sexual activity including: 

  1. Vaccination status: If your partner has received the full schedule of the hepatitis B vaccine, they are likely protected. The vaccine prompts your body to start producing antibodies that neutralize (attack) the virus. This stops hepatitis B from infecting your body. 
  1. Viral load: The amount of hepatitis B in your blood and bodily fluids—known as the viral load—affects transmission risk. A lower viral load reduces the likelihood of transmitting the virus to your unprotected/unvaccinated partner during sexual contact. 
  1. Type of sexual activity: Different sexual practices carry varying levels of risk. Anal sex poses a higher risk due to potential tissue damage and blood contact. Oral sex is considered “less risky” since it is less likely that there will be blood contact. The presence of cuts or sores can increase one’s risk of infection. It is always a good idea to use protection (latex condoms) when engaging in any form of sexual contact. 
  1. Use of protection: Consistent and correct use of condoms significantly reduces the risk of hepatitis B transmission to your partner by preventing direct contact with infectious fluids. While condoms are crucial in reducing the risk of transmitting hepatitis B (and D) during sex, they do not eliminate the risk completely. New condoms must be used every time you and your partner have sex, from start to finish. Latex or polyurethane condoms are most effective; avoid natural skin (lambskin) condoms, as they are not as good at blocking the virus. 

  

For peace of mind and health assurance, you and your partner should consider: 

  • Testing: A blood test can determine if your partner has been exposed to hepatitis B or has developed immunity from a previous infection. If they are not protected, they should start the vaccination series. 
    • If you are living with hepatitis B, it is important to ask your doctor to test you for hepatitis D. 
  • Vaccination: If a person is not already vaccinated, receiving the hepatitis B vaccine is the only way that one can achieve full protection against the virus.  
    • There is no vaccine solely for hepatitis D, but since hepatitis D relies on hepatitis B to survive, the vaccine protects against both viruses. 
  • Discuss your status: If you are starting a new romantic or sexual relationship, you should consider telling your partner about your hepatitis B (or D) status before any sexual encounter. By sharing your status, you not only instill trust in your relationship and build confidence; you and your partner can also take the necessary steps towards reducing your risk of transmitting the virus.  

You can read more about tips and tricks about disclosing your status to family members in this blog

300 Million Reasons, About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Prevention, Liver

Podcast Recaps: Barriers to Hepatitis B Programs in Prisons

 

 

 

 

 

 

 

 

 

Did you know that people in prison are at much higher risk for hepatitis B than the general population? You would think that means there are programs in place to prevent and treat it — but unfortunately, that’s often not the case. 

In a recent episode of the B Heppy podcast, researchers Heidi Emery and Kathryn Jack talk about some of the major barriers to accessing critical hepatitis B prevention and treatment services in prisons. Dr. Emery and Dr. Jack, who work at the University of Nottingham School of Medicine, reviewed prior research on the topic and spoke with people in the prison system — including those who are incarcerated, prison healthcare workers, and even guards — to understand what was happening within the prison system and hepatitis B. 

You can find their published research here.  Additionally, the Hepatitis B Foundation has also released a white paper on recommendations for HBV screening and prevention in corrections.  

Common Barriers to Care: 

  1. Stigma and lack of information about hepatitis B 

One of the biggest roadblocks? People just do not know enough about hepatitis B. There is  a lot of fear and misunderstanding about how hepatitis B spreads and what it means to have it. That leads to stigma — and stigma makes people less likely to get tested or treated. 

  1. Health care isn’t always a priority in prisons

Prisons are mostly focused on safety and security — not health care. That means people might miss appointments because of lockdowns or staffing shortages. Even if someone wants care, they might not get it when they need it. 

  1. Lack of resources

Many prisons just don’t have the staff, funding, or systems in place to handle hepatitis B testing, treatment, or education properly. This makes it difficult for people to get timely education on hepatitis B prevention, management, and treatment. 

  1. No support after release

Often, there’s no follow-up care or connection to outside health services after someone is released from prison. So even if someone starts treatment, it might not continue. People are less likely to follow up with care when they are out of the prison system or may lack the resources to navigate the health system on their own. 

Recommendations to improve care 

Within this review, researchers provided recommendations on how to address these major challenges to hepatitis B prevention, care, and treatment within the prison system. They are described below-  

  1. Education makes a big difference 

When people understand hepatitis B better — both those in prison and those working there, stigma goes down, and people are more likely to get help. Education programs can make a big difference to address low knowledge and stigma. 

  1. Better health systems inside and out 

Connecting prison healthcare to public health systems on the outside means care doesn’t have to stop once someone is released. It can be an opportunity to make sure people stay connected to health care after they get out. 

  1. Policy changes that put health first 

Routine testing and vaccinations for hepatitis B should be part of prison intake. With the right policies, prisons could become places where people actually get the health care they have been missing out on. 

This issue is not just about prisons — it’s about public health. If we ignore hepatitis B in these high-risk settings, we miss a big chance to stop the virus from spreading in communities, too. 

300 Million Reasons, About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Treatment, Hepatitis D Drug Development, Liver, Liver Health, Living with Hepatitis B

The dangers of unregulated alternative medicine for people living with hepatitis B: Why evidence-based information matters!

 

 

 

 

 

 

 

 

 

Alternative medicine is becoming more popular, but it can be risky, especially when it’s not regulated. This is a big concern for people living with hepatitis B in places where access to medical care and treatment options may be limited. Some people sell untested treatments, promising quick cures without any scientific proof. These treatments can actually make things worse for patients. It is also important to note that currently there is no cure for hepatitis B but there are safe and effective medications to manage your condition and improve your health. 

Why unregulated alternative medicine is risky:

When alternative medicine isn’t regulated, it means the treatments haven’t been properly tested. For hepatitis B patients, using these treatments can lead to serious health problems. The safety and effectiveness of these treatments aren’t guaranteed, and they can sometimes cause more harm than good. Some practitioners claim their treatments work because of divine intervention and charge high fees, taking advantage of patients’ financial circumstances and leading to false hope in their medical care. 

Why evidence-based health decisions are important:

Making health decisions based on scientific evidence is crucial. Evidence-based medicine uses the best available research and clinical expertise to make decisions about patient care. This approach helps ensure treatments are safe and effective. 

For people living with hepatitis B, evidence-based methods are especially important. Chronic hepatitis B can cause serious liver damage, and managing the condition requires careful monitoring and appropriate treatment. The World Health Organization (WHO) warns that while some alternative medicine practices can be beneficial, the lack of regulation and scientific validation can make them dangerous. 

While the idea of quick fixes through alternative medicine can be tempting, it’s essential for hepatitis B patients to prioritize evidence-based treatments. By doing so, they can make the best decisions for their health and well-being. Always consult healthcare professionals and rely on credible sources to guide your health decisions. 

Safe and effective treatment for hepatitis B: 

People with chronic hepatitis B can live long and healthy lives by making liver-friendly choices like regular check-ups, avoiding alcohol and tobacco, and eating healthily. Approved drugs for adults and children help control the virus and reduce the risk of serious liver disease, though there’s no complete cure yet. 

Treatments fall into two categories: 

  • Immune modulator drugs: Interferon-type drugs that boost the immune system to fight the virus, given as shots for 6 months to 1 year. 
  • Antiviral drugs: Pills taken daily to stop or slow the virus, reducing liver inflammation and damage, usually taken for at least 1 year. 

Not everyone with chronic hepatitis B needs treatment; it’s most effective for those showing signs of active liver disease. 

Helpful resources for hepatitis B patients 

To make informed health decisions, it’s important to rely on credible sources and consult healthcare professionals. It’s also important to do your own research to find out more about the benefits or harms of a medication or herbal treatment. Here are some resources to help: 

Centers for Disease Control and Prevention (CDC): The CDC provides comprehensive information on Hepatitis B treatment options, including antiviral medications and lifestyle recommendations. 

Hepatitis B Foundation: This organization offers detailed guidance on managing Hepatitis B, including the latest research on treatment options. 

 

HDV, Hepatitis B Awareness, Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Research, Hepatitis Delta (HDV), Research

Breaking barriers and improving outcomes: Overcoming challenges in hepatitis B and delta screening, prevention and linkage to care among people who use drugs in Philadelphia

Little is known about the prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD). Despite being a high-risk population, awareness of these viruses is still low among both community members and healthcare providers. Two recent studies conducted in Philadelphia, which were led by the Hepatitis B Foundation in partnership with Prevention Point Philadelphia, highlight different aspects of this ongoing public health concern. The first identified barriers to screening, prevention and linkage to care, while the other aimed to dismantle those barriers.

The first study explored the obstacles to HBV and HDV prevention, diagnosis and follow-up care. The study evaluated current knowledge levels and identified the needs and preferences of both people who use drugs and providers that serve them. Data was collected through an anonymous online provider-focused survey, and interviews were conducted with community members, and both medical and non-medical staff from different harm reduction settings in Philadelphia, Pennsylvania.

Interviews with key informants revealed that:

  • 48% of interviewed providers reported confusion about insurance coverage as a barrier to HBV screening.
  • 45% of providers mentioned the need to address and prioritize other pressing health needs, as a challenge to conducting HBV screening.
  • 52% of providers noted patient hesitancy as a barrier to HBV vaccination.
  • 39% of providers identified the need to administer multiple doses as a challenge for completing the HBV vaccination series.
  • 62% of providers reported low knowledge of HDV tests as a barrier to HDV testing.
  • 31% of providers indicated complexity of guidelines as a challenge in HDV testing.

Overall, awareness of HBV and HDV in the community, and among staff and health care workers was low, and stigma related to drug use and harm reduction was a significant barrier to care. There is an urgent need to address this issue in a non-judgemental and non-stigmatizing way that is clear, factual and empowering. Continued financial and political support for harm reduction organizations is essential for improving health care access for people who use drugs. More efforts are needed to overcome barriers to vaccination, testing and linkage to care to create better health outcomes and ultimately increase the quality of life of people who use drugs. 

The second study aimed to assess the prevalence of HBV and HDV and enhance access to care among people who use drugs, through a harm reduction organization (HRO) in Philadelphia. Participants first completed a demographic survey to help researchers gather information about their backgrounds and lifestyles, and to improve understanding of HBV and HDV risk factors within the community. Participants were then screened for HBV, and if they tested positive for certain HBV markers, they were automatically tested for hepatitis delta. 

Of the 498 participants:

  • 25.3% did not have hepatitis B immunity.
  • 52.6% had been vaccinated against HBV.
  • 17.9% had recovered from a past HBV infection.
  • 2.2% tested positive for isolated HBV core antibody.
  • 2.0% tested positive for HBV surface antigen.
  • 0.2% tested positive for HDV antibody.
  • 10% of those who were living with an active HBV infection had an HBV/HDV coinfection.

This study found that rates of current HBV infection in this community were nearly three times greater than in the general U.S. population, and the 10% coinfection rate of HDV is also significantly higher. Risk factors associated with a positive HBV status included a history of incarceration, experiences with homelessness and transactional sexual encounters. These findings highlight the prevalence of hepatitis B and D in this population. These viruses pose serious and critical public health concerns and remain under-prioritized among people who use drugs. Consistent and robust screening, vaccination, and linkage to care efforts can positively impact health outcomes for this community. Approving a hepatitis B point-of-care test (so that people who get tested can get results almost immediately), support in the form of funding and policy to allow HROs to provide full healthcare services, and adequate insurance coverage for vaccines can contribute to positive outcomes for hepatitis B and D diagnosis, prevention and treatment. These recommendations can advance elimination efforts, lower mortality, increase quality of life and center the health and needs of people who use drugs. 

References

  1. Zovich, B., Freeland, C., Moore, H. et al. Identifying barriers to hepatitis B and delta screening, prevention, and linkage to care among people who use drugs in Philadelphia, Pennsylvania, USA. Harm Reduct J 21, 199 (2024). https://doi.org/10.1186/s12954-024-01117-4
  2. Zovich, B., Freeland, C., Moore, H., Sapp, K., Qureshi, A., Holbert, R., Zambrano, J., Bhangoo, D., Cohen, C., Hass, R. W., & Jessop, A. (2024). Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia. Viruses, 16(4), 628. https://doi.org/10.3390/v16040628

300 Million Reasons, About Hepatitis B, Hepatitis B Awareness, Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Research

AGA Publishes New Guidelines on Hepatitis B Reactivation!

 

 

 

 

 

 

 

 

 

The American Gastroenterological Association (AGA) has released updated guidelines to prevent and treat hepatitis B reactivation (HBVr) among at risk populations. Hepatitis B Reactivation is a serious health issue for many people undergoing treatment for cancer or people on other medications. Learn more about HBVr here. 

Immunosuppressive medications are used to treat many different health conditions and most types of cancers. Sometimes, these medications can cause sudden increases in HBV DNA levels and cause reactivation. This can lead to liver failure, severe liver damage and death. Because reactivation can happen to anyone, it is important to test for hepatitis B before starting any kind of immunosuppressive treatment as this can help doctors understand the patient’s previous or current exposure to hepatitis B and prevent reactivation altogether (Ali et al., 2025). If someone is at risk for reactivation, it can be prevented, and this testing helps to ensure that.  

The new guidelines have identified individuals that are most at risk of HBVr according to their hepatitis B status and the immunosuppressive medications they are receiving. 

People who are positive for chronic hepatitis B are at the highest risk if they take the following medications  

  • Anthracycline derivatives, anti-tumor necrosis factor (TNF) agents, or anti-interleukin-6 (IL-6) therapies. 
  • B cell-depleting agents (E.g., rituximab), chimeric antigen receptor (CAR)-T cell therapies, or cytokine/integrin inhibitors. 
  • Tyrosine kinase inhibitor (TKI) therapies or Janus kinase (JAK) inhibitors. 
  • Liver cancer treatment -transarterial chemoembolization (TACE)) 
  • Co-infected with hepatitis C and on direct-acting antiviral (DAA) therapy. 
  • High doses of corticosteroids for longer than a month 

People who were previously exposed to hepatitis B (through a positive anti-HBc) or if they tested negative for surface antigen are at the highest risk if they take rituximab (a cancer treatment drug) but are at a moderate risk if they take any of the above-mentioned medications or treatments (Ali et al., 2025). 

HBVr can progress rapidly, which is why screening for hepatitis B, prior to beginning treatment for cancers is important. If you take any of the mentioned medications, it is best to discuss with your doctor about your risk of reactivation. If you know about your hepatitis B status, you should disclose it to your provider or ask to get tested for hepatitis B to learn about your risk of reactivation. In the United States, all adults over 18 years of age are recommended to get tested for hepatitis B at least once in their lifetime. 

  • Learn more about the updated guidelines here. 
  • Learn more about hepatitis B Reactivation on our B Heppy Podcast here.  

 

References 

Ali, F. S., Nguyen, M. H., Hernaez, R., Huang, D. Q., Wilder, J., Piscoya, A., Simon, T. G., & Falck-Ytter, Y. (2025). AGA Clinical Practice Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals. Gastroenterology, 168(2), 267–284. https://doi.org/10.1053/j.gastro.2024.11.008  

HBV, Hepatitis B Awareness

CHIPO Partner Highlight: Hepatitis Outreach Network

The Coalition Against Hepatitis for People of African Origin (CHIPO) is a national community coalition that is led by the Hepatitis B Foundation and is composed of organizations and individuals interested in addressing high rates of hepatitis B infection among African communities globally. Over the past year, CHIPO has grown its membership to include over 70 community-based organizations and federal agencies, all of which are working to raise awareness about hepatitis B among African immigrant communities, and increase rates of screening, vaccination, and linkage to care. This month, we are excited to highlight the work of one of our partners, the Hepatitis Outreach Network (HONE) at the Ichan School of Medicine at Mount Sinai Hospital in New York City, and their Project Coordinator, Assita Belemkoabga. Please enjoy a recent interview with Assita, as she describes her work, including successes and challenges, the positive impacts she and HONE have had, and hopes for the future. 

Could you please introduce yourself and your organization?  

My name is Assita Belemkoabga, and I am the Coordinator for the Hepatitis Outreach Network (HONE) at the Icahn School of Medicine at Mount Sinai. HONE focuses on hepatitis B and C prevention, screening, and linkage to care for immigrant and minority groups in New York City (NYC) for chronic hepatitis B and C. The goals of our organization are: raising awareness and providing education on hepatitis B and C; providing free comprehensive screening for hepatitis B and C, and ALT levels; and connecting people who have completed screening to healthcare services, including vaccination and treatment. My focus is providing HONE services in the African community.  

Could you tell me a little bit about what some of HONE’s programs are that specifically address hepatitis and other health concerns in African communities?  

The HONE program provides hepatitis B and C screening in the community and connects individuals who test positive or require vaccination to medical care and treatment.  

In addition to screening, we also provide culturally sensitive hepatitis B educational presentations which are tailored to specific communities, educating them about transmission, symptoms, treatment options, and prevention. We also do outreach in African, Russian, Chinese and Hispanic communities and foster partnerships with community organizations, places of worship, and leaders to maximize our reach and create awareness. We provide programs in a variety of languages including English, French, Spanish, Mandarin and Russian. In the communities we serve there are many people without health insurance, thus making HONE a viable option for many people. 

Which countries are primarily represented in the African diaspora that HONE serves?  

The HONE program has expanded significantly since its beginning as a research study focused on West African and Asian communities. In the African community, our outreach efforts have not targeted any specific nationalities, but through faith-based organizations (FBOs) we see individuals of various nationalities. This year alone, we have engaged individuals from numerous countries, including Senegal, Burkina Faso, Togo, Ghana, Gambia, Mauritania, Ivory Coast, and Guinea.  

What are some of the biggest challenges in addressing hepatitis and other health concerns at the community level? How have you worked to overcome these? Are there any additional resources that would be helpful to have?  

I have identified three primary barriers to effective health education and outreach from my experience. Firstly, linguistic barriers pose a significant challenge, as many community members may not speak English or French fluently. Secondly, stigma and mistrust towards the healthcare system affect our efforts to engage community members in health education and screening. Lastly, socio-economic factors often take priority over health concerns, leading some individuals to prioritize work over preventive measures.   

To overcome these challenges, community leaders play a vital role in explaining the importance of our program and the benefits of screening. We are also fortunate to have volunteers who assist with on-the-spot translation. However, having access to additional volunteers or health educators who speak one or two major African dialects would be incredibly valuable in helping us better serve our community. 

What are your favorite parts about your job? What got you interested in this work?  

I truly enjoy the sense of fulfillment that comes with making a positive impact in people’s lives. In my role, I have the opportunity to connect with people from diverse backgrounds and provide support, resources, and education that can significantly improve their health and well-being. 

What drew me to this work is the desire to address health disparities and promote health equity, particularly in the African immigrant community that I am part of. Seeing the tangible difference our efforts make in people’s lives is incredibly rewarding. Whether it is helping someone access life-saving treatment, providing education on disease prevention, or simply being a listening ear, I know that my work is making a real difference. That’s what motivates me to continue doing this work. 

Any other thoughts or ideas you’d like to share for improving health and closing health disparities among African immigrant communities in the US? 

Through my experience working with HONE, I have had the opportunity to connect with other organizations doing similar work. Building on this network, I encourage us to continue efficient outreach and providing tailored education. 

Our program at HONE has successfully streamlined the care process: Participants are able to receive a comprehensive initial visit within two weeks of their viral hepatitis B or C diagnosis. The initial visit with a gastroenterologist includes consultation, blood work, Fibroscan, and ultrasound. Expanding this model to a wider audience would be a significant step forward in addressing viral hepatitis disparities in our community. 

Thank you so much for taking the time to speak with me today and for sharing more about the great work HONE has done and will continue into the future! 

Baruch S. Blumberg Institute