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• Not Just Bad Luck

  … and prevent progression to liver cancer. A hepatitis C vaccine is not yet available, but hepatitis C is now curable! Cirrhosis (liver scarring) related to fatty liver disease or heavy alcohol use can be modified or prevented through lifestyle changes. Another way to prevent cancer-related deaths is through early detection and treatment, while the cancer is still curable. This is called secondary prevention. Screening and Early Detection Save Lives! Screening and surveillance (regular monitoring) for liver cancer help detect the cancer early, before symptoms occur and while the tumor is small and can be surgically removed. This greatly increases the survival rate. The American Association for the Study of Liver Diseases recommends that men with hepatitis B should start screening and regular monitoring at age 40 years, and women at age 50. Monitoring should be done at 6-month intervals. But some high-risk groups could benefit from earlier and more frequent monitoring and testing. Read our previous blog on screening and check out Liver Cancer Connect’s webinar series to find out what you need to know about prevention and detection of liver cancer. As with all diseases, there is an element of luck - and bad luck- with liver cancer. But there are also many modifiable risk factors. We don't have to just cross our fingers and hope for the best. We can take action against liver cancer!

  http://www.hepb.org/blog/not-just-bad-luck/
• AASLD 2014 Liver Meeting - HBV Coverage

  … interferon for 48 weeks had a "cure" rate of 5.9% (loss of hepatitis B surface antigen (HBsAg) and development of surface antibodies) and 24.3% lost the HBeAg, and achieved undetectable viral load. A second group treated with tenofovir plus interferon for 16 weeks followed by only tenofovir for 32 weeks had an HBsAg loss rate of 0.6%; and only 20.2% lost HBeAg. None of the group treated with just tenofovir for 48 weeks lost HBsAg and only 8.3% lost HBeAg. Among those treated with just interferon, 1.8% lost HBsAg and 12.5% lost HBeAg. (Abstract 193) Another study followed 303 younger adult patients who had done well on antivirals. Researchers added interferon to the patients' ongoing antiviral treatment for 12 weeks, and then continued them on only the interferon for another 48 or 96 more weeks. After this sequential antiviral and interferon treatment, a cure including HBsAg loss and surface antibody development, reached 16.2% and 12.5% respectively, and 58.7% patients lost HBeAg and developed "e" antibodies. Patients who started with lower HBsAg levels (less than 1,500 IU/mL) achieved higher rates of HBsAg loss. Researchers concluded that HBeAg-positive patients who did well on antivirals were likely to clear HBsAg when switched to interferon treatment. (Abstract LB-10) Hepatitis Plenary Session  http://onlinelibrary.wiley.com/doi/10.1002 /hep.27480/full  Abstract 193. HBsAg Loss with Tenofovir Disoproxil Fumarate (TDF) plus Peginterferon alfa-2a (PEG) in Chronic Hepatitis B (CHB): Results of a Global Randomized Controlled Trial AASLD Late Breaking Abstracts http://www.aasld.org/livermeeting /Documents/ Late-Breaking%20Abstracts% 20TLM14.pdf Abstract Final ID: LB-10. A multi-center randomized study on the efficacy and safety of switching to peginterferonα-2a (40KD) for 48 or 96 weeks in HBeAg positive CHB patients with a prior NUC history for 1 to 3 years: an interim analysis of NEW SWITCH study 2.  Tenofovir continues to excel with no signs of drug

  http://www.hepb.org/blog/aasld-2014-liver-meeting-hbv-coverage/
• Personal Reflection on Yesterday’s FDA Vaccine Advisory Panel Review of Dynavax’s New HBV Vaccine

    I was fortunate to have the opportunity to represent the Hepatitis B Foundation at yesterday’s FDA vaccine advisory panel review of Dynavax’s new HEPLISAV vaccine for hepatitis B.  I was there for the public comment period on the second day of the meeting with my prepared statement. I was surprised to find I was the only one there for public comment. Since I've never been to anything like this, I don't know if that is typical or not.  I think my personal story with HBV, and the message from the HBF was important for the FDA panel to hear, so they were sure to be reminded that there are real people affected by chronic hepatitis B. There has been a great deal of good press about the new Dynavax vaccine. In studies it has superior immunogenicity when compared to the currently available vaccines. Immunity is generated in 2 doses given one month apart, versus the currently available vaccines where it is a three shot series over 6 months. This is particularly important to subpopulations such as those undergoing dialysis, and diabetic adults who are encouraged to be vaccinated against hepatitis B – a new recommendation by the CDC this year. It is also important to the general adult population, where it is found that 30-50% of adults may not complete the 3 shot HBV vaccine series making them vulnerable to infection. This  need for HBV prevention via a more effective vaccine, particularly in needy subpopulations was what was stressed in HBF's public statement. I do believe the panel was well aware of the importance of HBV prevention and one doctor made mention of the importance based on "the public comment", so they were listening. Another doctor mentioned the burden of the disease not only globally, but also in the US. That is often understated. The FDA panel met both Wednesday and Thursday. The public comment period was Thursday, and I remained there for the vote on two vital questions.  The first question was about whether the immunogenicity data was

  http://www.hepb.org/blog/personal-reflection-on-yesterdays-fda-vaccine-advisory-panel-review-of-dynavaxs-new-hbv-vaccine/
• Hepatitis Health Action Alert: Stop the Attacks on Prevention and Public Health Fund

  Action Alert! The Hepatitis Community Responds to Health Care Reform. Tell Congress Not To Cut The Prevention and Public Health Fund The Prevention and Public Health Fund is under attack in Congress once again. Some leaders in the House of Representatives would like to make drastic cuts to the Fund as part of negotiations on a long-term deal on the payroll tax cut and Medicare payments rates to medical providers. The Prevention and Public Health Fund, part of the Affordable Care Act, provides money each year for vital prevention and public health services. The fund will grow each year until it eventually provides $2 billion/year. This fund is extremely important to the nation’s fight against the viral hepatitis epidemic. Later this year, the Department of Health and Human Services is expected to allocate $10 million from the Fund for viral hepatitis screening, testing, and education programs. This initiative will greatly help efforts to identify the millions of Americans who have chronic hepatitis B or C and link them to care and treatment. Please take a few minutes to call Congress in support of this lifesaving program! What YOU can DO: Please call your U.S. House Representative and two U.S. Senators immediately. We are hearing directly from Congressional staff that phone calls are the most effective form of communication.  Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your United States Representative. When you reach your Representative’s office, tell whoever answers the phone that you are a constituent and that you would like to speak to the staff person who handles health care issues. Whether you speak to the staff person live or leave a voicemail, tell him/her: “My name is _______________ and I live in (city/state). I am calling in strong support of the Prevention and Public Health Fund, which is an important part of the Affordable Care Act. This Fund is a great opportunity to provide badly needed funding for viral

  http://www.hepb.org/blog/hepatitis-health-action-alert-stop-the-attacks-on-prevention-and-public-health-fund/
• Got Hepatitis B? Keeping loved ones safe through HBV vaccination

  If you just found out you have hepatitis B, or if you are adopting a child with HBV, you will want to ensure that all household and close contacts are properly vaccinated to prevent the transmission of hepatitis B. Hepatitis B is not transmitted casually, so no need to worry about shaking hands, kissing, hugging, changing diapers and daily living.  HBV is transmitted through infected  blood and sexual fluids and requires direct contact of infected blood to an open sore (from microscopic to gaping), mucous membrane or orifice.  It is also transmitted sexually and via personal care items such as razors, toothbrushes, tweezers and clippers that may contain microscopic blood droplets. Household contacts and loved ones are at greater risk of contracting HBV due to the daily logistics of life.  And of course accidents happen.  HBV may transmitted by borrowed razors, or accidentally touching infected blood. Getting vaccinated is the best way to keep everyone HBV free for life. The hepatitis B vaccine is a safe, and effective, three-shot-series that protects you from HBV.  Typically when you get your HBV vaccine, you do not return to ensure that your vaccine was successful in generating an adequate immune response.  However, if you are living with a loved one with HBV, if would be good to ensure that you are protected.  All it takes is one follow-up blood test.  Ask your doctor to run a quantitative hepatitis B surface antibody test (HBsAb, anti-HBs).  Often HBV antigen/antibody tests are run qualitatively, which means you get a positive/negative or reactive/non-reactive response.  When you get a quantitative HBsAb test, it will tell you how much surface antibody you have.  An adequate titre is a value greater than 10 mIU/mL.  The key is to ensure that you have been tested at the right time.  Keep in mind that you could also have a standard, qualitative surface antigen test run because it will not be reactive unless it is greater than 10.  However, I have

  http://www.hepb.org/blog/got-hepatitis-b-keeping-loved-ones-safe-through-hbv-vaccination/