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Hepatitis B and Chocolate

Planning on digging into your favorite dark-chocolate stash, or biting the ears off of a dark-chocolate bunny this weekend?  Dark chocolate is popping up everywhere.  Even some old favorites have a new, dark chocolate wrapper, replacing the now-passé milk chocolate.  Recently, studies have extolled the benefits of dark chocolate, and how it potentially prevents heart disease, reduces the risk of brain damage after a stroke, lowers the risk of heart failure, lowers blood pressure, reduces heart disease, has anti-cancer benefits, slows dementia, raises libido, and last but not least, is mood enhancing.  What about those suffering hepatitis B associated liver disease?

Last year there was a study out of Spain that investigated the benefits of dark chocolate to patients with liver disease – specifically patients with cirrhosis.  Cirrhosis causes portal pressure to rise, potentially resulting in damage to blood vessels in the liver.  Eating causes an additional rise in pressure, which becomes more dangerous as liver disease progresses.  Half of the study participants were given white chocolate, and the other dark chocolate.  The dark chocolate group saw a larger decrease in the blood pressure of the liver, and increased blood flow.  Keep in mind that this was a small study with only 21 participants.

The good news is that dark chocolate, specifically the cocoa component, is rich in antioxidants called flavonoids, and other beneficial components such as  phenylethylamine, theobromine,  anandamide, magnesium, copper, and vitamins E and B.  That’s certainly a mouth-full, but it is these key components that provide all the benefits of chocolate.

Here’s the bad news.  Many of us enjoy milk chocolate, or even the dreaded white chocolate, which has little or no benefit due to the processing of the cocoa, and the resulting loss of flavonoids.   In fact, the lighter the chocolate, the fewer the benefits.  In a perfect world we would be eating unsweetened, cocoa powder right out of the tin, or a chocolate bar with upwards of 85% cocoa.  That can be a pretty biting chocolate.  The chocolate many of us enjoy has a larger quantity of white sugar , which is not beneficial to the liver, or any other organ, nor is the additional butterfat, which is added to lighter chocolate.  However, if you can adjust your tastes a little and learn to adapt to less sugar and butterfat, dark chocolate is great addition to your diet.

Aren’t most of us looking for an excuse to add chocolate to our diets?  Ultimately, all things in moderation is the key.  A small amount (roughly 6.7 grams) of dark chocolate added to your daily diet is certainly not going to hurt you, and may in fact reduce abdominal pressure and portal pressure in the liver.  Perhaps the greatest redeeming quality of chocolate is it’s mood enhancing qualities.  If it feels good, and eaten in moderation, then why not reap the benefits of dark chocolate and enjoy your improved mood.

Do You Have Hepatitis B?

Have you been told you may be infected with  hepatitis B?  Did you get a letter following a blood donation, or receive lab results indicating infection?  It’s important you relax, educate yourself, and don’t let the news scare you.  The next step is to determine if you are infected, and if so, do you have an acute or chronic infection.

You’ll want to talk with your doctor, and have a hepatitis B blood panel run.  It is essential that you do not ignore the possibility of infection.  That being said, it’s equally important that you not panic.

When you get your lab results, ask your doctor to explain them to you.  It’s possible that you are not infected, but if you are, then you will need follow-up testing.  Be sure to ask for copies of your labs for your own records.  The test results are initially confusing, so you will want to refer back to the hard-copy results.

It is important to determine if you have an acute or chronic infection, but this may take some time.  If you were infected with HBV as an adult, there is a good chance you are acutely infected.  Fortunately, 90% of infected adults resolve the virus on their own. Recently infected adults may have flu-like symptoms, fatigue, yellowing of the eyes, or they may have no symptoms at all.  The answer is in the lab work.  Your doctor may run an HBc-IgM test, which will tell you if the infection is newly acquired. If it is a new infection, you will be monitored for the next one to six months to see if the HBV infection clears, and to ensure you are safe.  During this time, you are infectious to others, so it is important to practice standard precautions and ensure household members are vaccinated.  It is important to eat properly, rest, and avoid alcohol and tobacco. Talk to your doctor about the use of prescription and OTC drugs.  Hopefully your body will be able to mount an appropriate immune response, and you will be able to rid yourself of the virus.  If you remain surface antigen positive (HBsAg+) for more than six months you will be considered chronically infected.

Ten percent of those infected with HBV as an adult, will not clear the virus, and will become chronically infected.  Another group of adults that may just be learning of their Hepatitis B status, are those that acquired HBV at birth.  HBV infected mothers may unknowingly transmit HBV to babies.  Transmission can be prevented with vaccination at birth, but in many countries where HBV is endemic, a cycle of HBV transmission may exist where vaccination has not been available, and the virus is passed unknowingly from one generation to the next. Unfortunately, 90% of those infected at birth are chronically infected, even though it may not be determined until adulthood.  HBV is usually an uncomplaining disease, so it may be picked up accidently with blood-work , or when liver disease progresses due to decades of chronic infection.

Keep in mind that being vaccinated against hepatitis B will not protect you against the virus if you were infected with HBV prior to vaccination.  This can be confusing since most people are not screened prior to vaccination, and is  especially pertinent in high risk groups where the likelihood of mother to child transmission is greater.

The Hepatitis B Foundation has a step-by-step, comprehensive, yet-easy-to-understand tutorial that leads you through the process of determining your hepatitis B status, specific test results, and practical advice for coping with your HBV diagnosis.

Got Hepatitis B? B Sure to Take Care of U!

As a mother of a child with hepatitis B, I was always concerned my child would transmit the virus to others.  One day a toddler came up and bit her in the finger and drew blood.  She was strapped into her stroller, and yet I felt guilty and fearful she might transmit the virus to “the biter”.  I rushed my child to the pediatrician, and immediately inquired about the safety of the other toddler.  He reminded me that that “blood is a two-way street for the transmission of infectious diseases”.   I should worry about MY child.   The other child was likely vaccinated since HBV vaccination is required in my state. I heeded his advice, and from that day forth I started thinking about the safety of MY child and others infected with HBV.

Fortunately, hepatitis B is a vaccine preventable disease, so that does ease concerns regarding the transmission of HBV to others.  A simple three shot HBV vaccine series does the trick.  There is no reason someone should NOT be protected against a vaccine preventable virus that is 100 times more infectious than HIV!   Stop feeling guilty, and start thinking about protecting YOU!

If you have HBV, Hepatitis A (HAV) can be very dangerous.   HAV is vaccine preventable.  A simple two shot series will keep all those with or without HBV safe from highly-contagious HAV.

Unfortunately, there is no vaccine for HCV or HIV.  If you are HBV+, a  co-infection is complicated and dangerous, and can result in significant liver damage.  The best way to combat infection from HCV, HIV and other infectious diseases is to use standard precautions.

Make standard precautions part of your everyday life.  Simple hand washing and proper avoidance of contact with someone else’s blood and body fluids is an easy way to avoid transmission of potentially life threatening illnesses, or any illness.  Cover open cuts with a Band-Aid.  Provide a barrier between someone else’s blood or body fluids, and any open wounds, sores, mucus membranes and orifices.  You don’t want to get infected with another blood borne pathogen!  Does this mean you need to look like someone out of a bio-hazard lab with goggles and gloves?  No!  Use common sense, and you can be safe without going overboard.   A simple barrier between you and someone else’s body fluids is the best way to avoid exposure.  Keep something like a clean diaper, towel or wrapped sanitary pad, in a plastic baggie, in your car, and on each level of your home.

Personal toiletries should be just that…personal.  Keep your toothbrush away from your sibling, friend or SO. Neatly dispose of used feminine hygiene products because it’s the right thing to do.  Don’t leave your razor or nail clippers lying around.  Sharp, personal objects really are a perfect transmission route for infectious disease.

Got HBV?  Remember, keep YOURSELF safe!  And the kid in the stroller… well she’s a teen, today.  Now there’s a whole new set of worries.