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• CHIPO Partner Highlight: Community Vision Group

  … programs are that specifically address hepatitis and other health concerns? According to a 2022 Chiwindi Survey done in Karonga and Lilongwe, 95% of those interviewed who were living with hepatitis B were not aware of their hepatitis B status (Riches et al., 2023). This shows the gap in awareness. Community Vision Group is addressing hepatitis concerns in Africa, particularly in the context of Malawi, through engaging the public during major hepatitis-related events including World Hepatitis Day, outreach to schools and churches, targeted outreach programs to villages, and engaging in hepatitis B screening. What is the main geographic area in which Community Vision Group works? There are twelve districts in Malawi. Currently, we are focusing  in Zomba district and surrounding areas as our catchment areas with hope that we can grow and move across the country of Malawi. 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? The biggest challenge at hand is to take hepatitis messages to the larger masses since our capacity is small in both human and financial resources. The other challenge is reception of messages regarding hepatitis. This is because of both religious and cultural beliefs where some people do not even want to hear any message to do with hepatitis because it is highly linked or related to HIV/ AIDS. There is also resistance when it comes to receiving medical care for those living with hepatitis, as some of them resort to going for traditional healing remedies which can be very dangerous to their health. More awareness work needs to be done. Additional resources would be very helpful so that CVG can reach the communities with these messages. Examples of these resources would be funding, training materials, printed literature on hepatitis B to distribute to both urban and rural areas,

  http://www.hepb.org/blog/chipo-partner-highlight-community-vision-group/
• Reactivation with Hepatitis B: Understanding Risk Factors and Prevention Strategies

  … a past infection, the cccDNA is present and may reactivate. It is not clearly understood why this may happen, but certain factors may increase the risk for reactivation.   To learn more about the core, click here.  What puts one at risk for reactivation?  Virologic factors such as high baseline HBV DNA, hepatitis B envelope antigen positivity (HBeAg), and chronic hepatitis B infection that persists for more than 6 months. Detectable HBV DNA levels and detectable levels of HBsAG can increase the risk for HBRr (reactivation)  Testing positive for HBeAg also increases the risk for reactivation  Co-infection with other viruses such as hepatitis C or hepatitis Delta  Older age  Male sex  Cirrhosis  An underlying condition requiring immunosuppressive therapies (rheumatoid arthritis, lymphoma, or solid tumors)  Certain medications can increase the likelihood of reactivation by more than 10%.   B-cell depleting agents such as rituximab, ofatumumab, doxorubicin, epirubicin, moderate or high-dose corticosteroid therapy lasting more than 4 weeks.  How to prevent reactivation of hepatitis B  Hepatitis B reactivation is a serious condition that can lead to health complications, Reactivation is avoidable if at-risk individuals are identified through screening. Current guidelines recommend that individuals at the highest risk (those receiving B-cell depleting therapies and cytotoxic regimens) should receive antiviral therapies as prophylaxis before beginning immunosuppressive therapy. These antiviral therapies should also be continued well beyond stopping the immunosuppressive therapies. Be sure to talk to your doctor to be sure you are not at risk for reactivation.   References  Hepatitis b virus reactivation: Risk factors and current management strategies. Reactivation of hepatitis B virus: A review of Clinical

  http://www.hepb.org/blog/reactivation-hepatitis-b-understanding-risk-factors-prevention-strategies/
• 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

  http://www.hepb.org/blog/join-morethanb/
• Hepatitis B Foundation Introduces 300 Million Reasons Movement

  By Beatrice Zovich The Hepatitis B Foundation is excited to launch a new movement called 300 Million Reasons, named for the almost 300 million people worldwide who are living with hepatitis B. The goal of this movement is to improve awareness about hepatitis B and liver cancer worldwide, to promote engagement of key stakeholders, and to empower people impacted by hepatitis B across the globe to become vocal advocates. We want to amplify the voices and stories of the millions of people directly affected by this disease, in order to make sure that hepatitis B is granted the funding, attention, and serious consideration that it deserves. The 300 Million Reasons movement will be officially launched in July of 2021, in time for World Hepatitis Day, but we wanted to begin sharing resources and information now.  This movement is divided into four branches: B Informed, B Connected, B the Voice, and B the Change. Each of these arms is described below.  B Informed Hepatitis B can be prevented, treated, and managed. The B Informed branch of the 300 Million Reasons movement involves raising awareness about hepatitis B and liver cancer, providing accurate information, dispelling myths and misconceptions, decreasing stigma and discrimination, and providing simple hepatitis B educational tools, which will focus on transmission, prevention, liver cancer screening, and living with chronic hepatitis B. We have created a free and downloadable social media toolkit that can help spread the word about statistics, vaccines, testing, monitoring and care, symptoms, blood tests, acute vs. chronic hepatitis B and more. Check it out today!  B Connected You are not alone! The B Connected arm of 300 Million Reasons works to increase access to clinical trials, expand global connections to support people living with hepatitis B and their loved ones around the world, establish international peer mentoring programs, and create a social network and further community engagement opportunities for

  http://www.hepb.org/blog/hepatitis-b-foundation-introduces-300-million-reasons-movement/
• Recap of NAIRHHA Day 2020 Celebration

  … he overcame stigma and barriers, Bright replied that the biggest barrier is the mental hurdle. It took him about two years to not feel overwhelmed. Bright does still struggle with feeling rejected from clinical trials and finds this very frustrating - he still feels like he is being punished for having chronic hepatitis B. The best advice that Bright can offer is to always be your own advocate and do your own research. If the first doctor or liver specialist that you find does not take you seriously or you feel that they are not doing enough for you, you do not need to stay with them and you can absolutely find another doctor. Bright went through this process himself and eventually found a doctor he likes at Johns Hopkins, through a friend of his. This can be a challenge with language barriers, but there are organizations that can help and there is a Specialist Directory tool on the Hepatitis B Foundation website, a resource that Bright stated he found very helpful, along with the website of the National Institutes of Health (NIH). Farma reiterated that the HBF website is a great place to visit to understand lab results in plain language, and offers a good collection of resources for family and community members of people living with hepatitis B. Bright finds that the most important questions to ask are: What exactly is your status and viral load? What should reasonable expectations for your life and health be? Is treatment appropriate and if so, which one? It is crucial to establish mutual respect with your doctor, and to iterate what expectations you have for your doctor as well. The most important messages are: Reach out. Ask questions. Stand up for yourself. You are not alone. The Important Role that NAIRHHA Day Plays from a National and Policy Prospective Moderator: Chioma Nnaji, MPH, MEd, Program Director, Multicultural AIDS Coalition Panelists: Boatemaa Ntiri-Reid, JD, MPH, Hepatitis Director, NASTAD Jennease Hyatt, Community Liaison for Boston/New England,

  http://www.hepb.org/blog/recap-nairhha-day-2020-celebration/
• Hepatitis B Foundation applauds release of National Hepatitis Strategic Plan

  Doylestown, Jan. 7, 2021 – Today the U.S. Department of Health and Human Services (HHS) released the Viral Hepatitis National Strategic Plan, which provides a roadmap toward the elimination of viral hepatitis in the U.S. (2021-2025), including key objectives and strategies to eliminate hepatitis B and related health inequities. The HHS hepatitis plan establishes five high-level goals: prevent new viral hepatitis infections, improve viral hepatitis-related health outcomes of people with viral hepatitis, reduce viral hepatitis-related disparities and health inequities, improve viral hepatitis surveillance and data usage, and achieve integrated, coordinated efforts that address the viral hepatitis epidemics among all partners and stakeholders. In the U.S., hepatitis B affects up to 2.2 million people and the majority remain undiagnosed. Despite having effective tools, including vaccines to prevent and therapies to treat hepatitis B and liver cancer, rates of acute hepatitis B infection have spiked in some sections of the country. That is particularly true in regions hardest hit by the opioid epidemic and where significant disparities in hepatitis B-related mortality rates persist. “Historically, hepatitis B has been under-prioritized as an urgent public health threat in the U.S., and progress on the prevention of hepatitis B infection has stalled,” Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation and co-chair of the Hep B United coalition, said. “We commend HHS for their leadership in developing comprehensive strategies to guide our work and for recognizing the need to advance research to achieve a hepatitis B cure, strengthen hepatitis B surveillance data, increase treatment access and reduce hepatitis B-related disparities among highly-impacted communities, including foreign-born populations and people who inject drugs.” The HHS hepatitis plan includes objectives to increase hepatitis vaccine uptake and development, and strategies to provide vaccination at a broad range of clinical, community-based and high-risk settings such as treatment and harm-reduction sites. The HHS plan also discusses strategies to reduce health inequities among communities disproportionately impacted by chronic hepatitis B infection and identifies priority populations, including Asian American and Pacific Islander and African/non-Hispanic Black communities. In 2020, the COVID-19 global pandemic revealed the lack of resources dedicated to the public health care system including impacts on viral hepatitis services. The challenges underscore the need to invest in innovation and coordination. The Hepatitis B Foundation looks forward to collaborating with the Biden Administration, federal partners and community stakeholders to coordinate efforts and activate resources to implement the viral hepatitis elimination strategies guided by the HHS hepatitis plan. The Hepatitis B Foundation and Hep B United responded to the HHS Request for Information on the draft National Viral Hepatitis Strategic Plan. Our comments can be found here. The HHS National Viral Hepatitis Strategic Plan: A Roadmap to Elimination for the United States (2021-2025) is posted here.

  https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-applauds-release-of-national-hepatitis-strategic-plan/
• David's Story

  David learned as a teenager that he has hepatitis B, and at first, he was confused and depressed. During his freshman year of high school, he attempted suicide. After that, David started therapy, but the sessions focused solely on his suicide attempt and not on the questions and challenges he was dealing with related to his hepatitis B diagnosis. His frustrations continued, and led him to opioids, forcing him and his family to finally have conversations about his questions, fears, and hopes for the future. Through the support of his family, David is now living healthfully with the virus.    

  https://www.hepb.org/research-and-programs/patient-story-telling-project/davids-story/
• Hepatitis B Foundation launches the first global registry of discrimination against people living with hepatitis B

  The online survey’s results will be shared with policymakers, scholars and the public. Doylestown, Pa., May 13, 2021 – People globally who are living with hepatitis B often experience discrimination in variety of ways, including denial of access to employment and education, even in the U.S., and an American nonprofit organization has launched the world’s first initiative to track and analyze that discrimination. The Hepatitis B Foundation is launching the Hepatitis B Discrimination Registry, which will be a permanent and sophisticated database, with a worldwide communications campaign to encourage people living with the serious liver disease to share their stories. The Registry will allow people around the world to confidentially document their hepatitis B related discrimination experiences anonymously. Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation, said the primary means for collecting patients’ accounts will be the Foundation's brief online survey, which will be supplemented over time with patient interviews. “We hope this registry will provide us with the much-needed documentation to demonstrate that discrimination is a significant human rights violation for those living with hepatitis B that impacts all aspects of life,” Dr. Cohen said. “To our knowledge, no worldwide discrimination registry exists for individuals living with hepatitis B, and we intend to fill this gap.” Along with asking people living with hepatitis B to complete the survey, the Foundation is requesting that their families, health care providers, advocates, government leaders, other nonprofit organizations and academia to help raise awareness about the new registry, particularly in regions with high infection rates. The Hepatitis B Foundation has successfully worked to improve protections against discrimination in the U.S., such as winning inclusion of hepatitis B as a protected condition under the Americans with Disabilities Act (ADA) in 2013. The Discrimination Registry’s data will be used to develop policy and advocacy efforts intended to eliminate hepatitis B-related discrimination in the future. The Foundation will share the data through reports that will include high-level information (country-level, type of discrimination, etc.) on what is reported through the Registry. No identifiable information submitted by a person experiencing discrimination will be made available under any circumstances. The Foundation’s public health staff, which regularly publishes articles in scholarly journals, will publish analyses of the data. Discrimination against people living with hepatitis B has been documented in the U.S. and many other countries and anecdotally reported through the Foundation’s social media channels and consultation lines with more frequency. But a greater number of discrimination reports may not mean the incidence is rising, according to Catherine Freeland, MPH, public health program director at the Hepatitis B Foundation, who is leading the Registry project. “The increase is probably because more people are coming out and talking about discrimination, and improved access to technology—more people around the world have access to the internet, social media and email—make it easier for people to find us and share their stories,” Ms. Freeland said. According to the Foundation, discrimination is defined as the unjust, unfair or prejudicial treatment of a person on the grounds of their hepatitis B status. In other words, being treated differently because of one’s hepatitis B infection. People with hepatitis B often face discrimination in many ways: denied employment or education, treated unfairly while at work or in school, not allowed to enter certain countries, not permitted to serve in the military or treated unfairly by health care providers and institutions. About Hepatitis B: The number of adults living in the U.S. who have chronic hepatitis B infection may be as high as 2.4 million, which is nearly three times greater than the federal government’s official estimate, according to a new report by a team of public health experts, scientists and physicians. The report’s authors included Dr. Cohen and Foundation President Timothy M. Block, PhD, Foundation Medical Director Robert Gish, MD, and Foundation Board Member Carol Brosgart, MD. Worldwide, an estimated 292 million people are chronically infected with hepatitis B, less than 10% of infected individuals are diagnosed and an estimated 884,000 people die each year from hepatitis B and related complications such as liver cancer. The Hepatitis B Foundation called for universal hepatitis B screening in the U.S. in 2018, as the only screening strategy that will help us make progress towards the 2030 goal of eliminating hepatitis B in this country. About the Hepatitis B Foundation: The nation’s leading nonprofit organization solely dedicated to finding a cure for hepatitis B and improving the quality of life for those affected worldwide through research, education and patient advocacy, the Hepatitis B Foundation was founded in 1991 and is based in Doylestown, Pa., with an office in Washington, D.C. To learn more, go to www.hepb.org and www.hepb30years.org, read our blog at hepb.org/blog, follow us on Twitter, Instagram and Facebook (@hepbfoundation) or call us at 215-489-4900. To donate, contact Jean Holmes at 215-489-4900 or jean.holmes@hepb.org.

  https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-launches-first-global-registry-of-discrimination/
• Cómo vivir con la hepatitis B

  ¿Me recuperaré de una infección por hepatitis B? La mayoría de los adultos sanos que se infectan por primera vez se recuperarán sin problemas. Sin embargo, es posible que los bebés y niños pequeños no puedan eliminar de manera exitosa el virus. Adultos: 90% de los adultos sanos eliminarán el virus y se recuperarán sin problemas; 10% desarrollará hepatitis B crónica. Niños pequeños: hasta un 50% de los niños pequeños infectados, entre 1 y 5 años, desarrollarán una infección crónica por hepatitis B. Bebés: 90% desarrollará infección crónica; solo un 10% podrá eliminar el virus.  ¿Cuál es la diferencia entre una infección "aguda" y "crónica" por hepatitis B? Una infección por hepatitis B se considera "aguda" durante los primeros 6 meses después de la exposición al virus. Esta es la cantidad de tiempo promedio que toma recuperarse de una infección por hepatitis B. Si sus pruebas aún resultan positivas para el virus de la hepatitis B (HBsAg+) después de 6 meses, se considera que tiene una infección "crónica" por hepatitis B, la cual puede durar toda la vida.  ¿Me enfermaré si tengo hepatitis B aguda? La hepatitis B se considera una "infección silenciosa" porque a menudo no produce ningún síntoma.La mayoría de las personas se sienten saludables y no saben que están infectadas, lo que significa que pueden transmitirles el virus a otras personas sin saberlo. Otras personas pueden tener síntomas leves, como fiebre, fatiga, dolor muscular o articular o pérdida del apetito, que se pueden confundir con la gripe. Los síntomas menos frecuentes pero más graves incluyen náuseas y vómitos intensos, coloración amarillenta de los ojos y de la piel (llamada "ictericia") e hinchazón del estómago. Estos síntomas requieren atención médica inmediata y es posible que sea necesario hospitalizar a la persona. ¿Cómo sabré cuándo me he recuperado de una infección "aguda" por hepatitis B? Una vez que su médico haya confirmado a través de las pruebas de sangre que usted ha eliminado el virus de su cuerpo y ha desarrollado anticuerpos protectores (HBsAb+), estará protegido de cualquier infección futura por hepatitis B y ya no será contagioso para los demás. ¿Qué debería hacer si se me diagnostica hepatitis B crónica? Si sus pruebas resultan positivas para el virus de la hepatitis B durante más de 6 meses, esto indica que tiene una infección crónica por hepatitis B. Debería solicitar una cita con un hepatólogo (especialista en hígado), un gastroenterólogo o un médico de familia que esté familiarizado con la hepatitis B. El médico le ordenará unas pruebas de sangre y posiblemente un ultrasonido hepático para evaluar cuán activo está el virus de la hepatitis B en su cuerpo y supervisar la salud de su hígado. Probablemente su médico desee verlo al menos una o dos veces al año para supervisar su hepatitis B y determinar si se beneficiaría de un tratamiento. Todas las personas con infección crónica deberían consultar con su médico al menos una vez al año (o con más frecuencia) para recibir una atención de seguimiento médico regular, inicien o no un tratamiento. Incluso si el virus está en una fase de menor actividad, produciendo poco o ningún daño, esto puede cambiar con el tiempo, por lo que es muy importante la supervisión regular. La mayoría de las personas con infección crónica por hepatitis B pueden esperar vivir vidas prolongadas y saludables. Una vez que se le diagnostique hepatitis B crónica, el virus puede permanecer en su sangre e hígado para toda la vida. Es importante que sepa que puede transmitirles el virus a otras personas, incluso si no se siente enfermo. Por eso es muy importante que se asegure de que todos los contactos cercanos en el hogar y de parejas sexuales se vacunen contra la hepatitis B. ¿Qué pruebas se utilizarán para supervisar mi hepatitis B? Las pruebas frecuentes que usan los médicos para supervisar la hepatitis B incluyen la serie de pruebas de sangre de hepatitis B, pruebas de función hepática (alanina aminotransferasa [ALT], aspartato aminotransferasa [AST]), antígeno e de la hepatitis B (HBeAg), anticuerpo e de la hepatitis B (HBeAb), cuantificación del ADN de la hepatitis B (carga viral) y un estudio por imagen del hígado (ultrasonido, FibroScan [elastografía transitoria] o tomografía axial computarizada [TAC]). ¿Existe una cura para la hepatitis B crónica? Actualmente no existe una cura para la hepatitis B crónica, pero la buena noticia es que existen tratamientos que pueden ayudar a desacelerar la progresión de la enfermedad hepática en las personas con infección crónica al desacelerar el virus. Si se produce menos virus de hepatitis B, entonces se le ocasiona menos daño al hígado. A veces esos medicamentos pueden incluso eliminar el virus, aunque no es lo común.  Con toda la nueva y fascinante investigación, existe mucha esperanza de que se encontrará una cura para la hepatitis B crónica en el futuro cercano. Visite nuestro Drug Watch (Observatorio de medicamentos) para ver una lista de otros medicamentos prometedores en desarrollo. ¿Existe algún medicamento aprobado para tratar la hepatitis B crónica? Los tratamientos actuales para la hepatitis B se clasifican en dos categorías generales, antivirales e inmunomoduladores: Medicamentos antivirales: son medicamentos que desaceleran o detienen el virus de la hepatitis B, lo cual disminuye la inflamación y el daño al hígado. Se toman como una píldora, una vez al día y al menos durante 1 año, aunque generalmente por más tiempo. Existen 6 antivirales aprobados por la FDA, pero solo se recomiendan tres tratamientos antivirales de primera línea: tenofovir disoproxilo (Viread/TDF), tenofovir alafenamida (Vemlidy/TAF) y entecavir (Baraclude). Se recomiendan los antivirales de primera línea porque son más seguros y los más eficaces. También tienen un mejor perfil de resistencia que los antivirales antiguos, lo que significa que cuando se toman como se recetan, existe menos probabilidad de mutación y resistencia. La resistencia hace que sea más difícil tratar y controlar el virus. Medicamentos inmunomoduladores: estos son medicamentos que estimulan el sistema inmunológico para ayudar a controlar el virus de la hepatitis B. Se administran como inyecciones durante 6 meses a 1 año. Los que se recetan con más frecuencia incluyen interferón alfa-2b (Intron A) y el interferón pegilado (Pegasys). Este es el único tratamiento recomendado para pacientes coinfectados con hepatitis delta. ¿Estos medicamentos ofrecen una "cura" para la hepatitis B crónica? Aunque no proporcionan una cura completa, los medicamentos actuales desacelerarán el virus y disminuirán el riesgo de enfermedad hepática más grave más adelante en la vida. Esto logra que los pacientes se sientan mejor en unos pocos meses porque el daño hepático del virus se habrá desacelerado, o incluso revertido en algunos casos, cuando los medicamentos se toman a largo plazo. Los antivirales no se deben detener y comenzar, por eso es tan importante una evaluación a fondo por parte de un médico experto antes de comenzar el tratamiento para el VHB crónica. Si tengo una infección crónica por hepatitis B, ¿debería tomar medicamentos? Es importante entender que no todas las personas con hepatitis B crónica necesitan tomar medicamentos. Debería hablar con su médico sobre si usted es un buen candidato para recibir terapia con medicamentos. Ya sea que usted y su médico decidan o no iniciar un tratamiento, debería ver con regularidad a un especialista en hígado o un médico experto en hepatitis B. ¿Es seguro tomar remedios o suplementos naturales para la infección por hepatitis B? Muchas personas se interesan en usar remedios o suplementos naturales para estimular su sistema inmunológico y ayudar al hígado. El problema es que no existe regulación de las compañías que fabrican esos productos y esto significa que no existen pruebas rigurosas de seguridad ni pureza. La calidad de los remedios naturales o de los suplementos vitamínicos puede ser diferente de una botella a otra. Así mismo, algunos remedios naturales pudieran interferir con sus medicamentos recetados para la hepatitis B u otras enfermedades; algunos pueden de hecho dañar su hígado. Esos remedios naturales no curarán una infección crónica por hepatitis B. Hay muchas compañías que hacen falsas promesas en Internet y a través de los medios de comunicación social sobre sus productos. Las exposiciones en línea y los testimonios de pacientes en Facebook son falsos y los usan para engañar a las personas para que compren remedios y suplementos naturales costosos. Recuerde: si parece demasiado bueno para ser cierto, probablemente no lo es. A continuación se presentan fuentes confiables de información sobre medicamentos naturales y alternativos. Esta información se basa en evidencia científica, no en falsas promesas. Revise si los ingredientes activos de sus remedios o suplementos naturales son reales y seguros para su hígado. Lo más importante es proteger su hígado de cualquier daño o lesión adicional. ¿Qué consejos existen sobre cómo mantener un hígado saludablepara las personas que viven con hepatitis B crónica? Las personas que viven con infección crónica por hepatitis B pueden necesitar o no tratamiento con medicamentos. Pero hay muchas otras medidas que los pacientes pueden tomar para proteger su hígado y mejorar su salud. ¡A continuación se encuentra nuestra lista de las 10 mejores elecciones saludables que se pueden comenzar hoy! Programe consultas regulares con su especialista en hígado o proveedor de atención médica para cuidar su salud y la de su hígado. Vacúnese contra la hepatitis A para protegerse de otro virus que ataca el hígado. Evite beber alcohol y fumar ya que ambos dañarán su hígado, que ya está lesionado por el virus de la hepatitis B. Converse con su proveedor antes de iniciar cualquier remedio natural o suplemento vitamínico porque algunos pueden interferir con sus medicamentos recetados para la hepatitis B o incluso dañar su hígado. Revise con su farmacéutico cualquier medicamento sin receta (p. ej., acetaminofén, paracetamol) o los medicamentos con receta que no son para la hepatitis B antes de tomarlos, para asegurarse de que sean seguros para su hígado, debido a que muchos de estos medicamentos se procesan a través de su hígado.  Evite inhalar gases de pinturas, diluyente de pintura, pegamento, productos de limpieza para el hogar, removedores de esmalte de uñas y otros químicos posiblemente tóxicos que pudieran dañar su hígado. Siga una dieta saludable de frutas, granos enteros, pescado y carnes magras, y muchos vegetales. Los "vegetales crucíferos”, en particular el repollo, el brócoli y la coliflor, han demostrado que ayudan a proteger el hígado contra los químicos ambientales.  Evite comer mariscos crudos o poco cocidos (p. ej., almejas, mejillones, ostras, vieiras) porque pudieran estar contaminados con una bacteria llamada Vibrio vulnificus, muy tóxica para el hígado y que pudiera ocasionar mucho daño. Busque signos de moho en las nueces, el maíz o elote, el cacahuate o maní, el sorgo y el mijo antes de usar esos alimentos. Es más probable que el moho sea un problema si la comida se almacena en condiciones de humedad y de sellado inapropiado. Si hay moho, la comida pudiera estar contaminada por "aflatoxinas", que son un factor de riesgo conocido para el cáncer de hígado. Reduzca sus niveles de estrés al comer alimentos saludables, hacer ejercicios regularmente y descansando lo suficiente.  Tenga presente que todo lo que coma, beba, respire o absorba a través de la piel finalmente lo filtra el hígado. Por esto, ¡proteja su hígado y su salud! ¿Puedo donar sangre si tengo hepatitis B? No. El banco de sangre no aceptará sangre que haya estado expuesta a hepatitis B, incluso si ya se recuperó de una infección aguda. Living with Hepatitis B  Will I recover from a hepatitis B infection? Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B. Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection. Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus. What is the difference between an "acute" and a "chronic" hepatitis B infection? A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.  Will I become sick if I have acute hepatitis B? Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection? Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B? If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment. All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B? Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B? Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.  With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B? Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B? Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication? It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection? Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these produces, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tipsare there for those living with chronic hepatitis B? People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver. Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.  Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver. Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals.  Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer. Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.  Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.

  https://www.hepb.org/languages/spanish/living-with-hepatitis-b/
• What Is Hepatitis B?

  Hepatitis B is the most common serious liver infection in the world. It is caused by the hepatitis B virus that attacks and injures the liver. Two billion people (or 1 in 3) have been infected and about 300 million people are living with a chronic hepatitis B infection. Each year up to 1 million people die from hepatitis B despite the fact that it is preventable and treatable.   Hepatitis B is transmitted through direct contact with infected blood or certain bodily fluids. The virus is most commonly transmitted from an infected pregnant person to their baby during childbirth, due to the blood exchange that happens between mother and baby. It is also transmitted through unsterile medical or dental equipment, unprotected sex, or unsterile needles, or by sharing personal items such as razors, toothbrushes, nail clippers, body jewelry. Hepatitis B is a “silent epidemic” because most people do not have symptoms when they are newly infected or chronically infected. Thus, they can unknowingly spread the virus to others and continue the silent spread of hepatitis B. For people who are chronically infected but don’t have any symptoms, their liver is still being silently damaged which can develop into serious liver disease such as cirrhosis or liver cancer. The good news is that hepatitis B is preventable and treatable. There is a simple blood test to diagnose a hepatitis B infection. Testing is the only way to know for sure if you are infected. There is a safe vaccine to prevent hepatitis B. There are effective drug therapies that can manage a chronic hepatitis B infection, and a cure is within sight. Hepatitis B and Your Liver The liver is such an important organ that we can survive only one or two days if it completely shuts down - if the liver fails, your body will fail, too. Fortunately, the liver can function even when up to 80% of it is diseased or removed. This is because it has the amazing ability to regenerate - or create - itself from healthy liver cells that still exist. If your body were an automobile, your liver would be considered the engine. It does hundreds of vital things to make sure everything runs smoothly: Stores vitamins, sugar and iron to help give your body energy Controls the production and removal of cholesterol Clears your blood of waste products, drugs and other poisonous substances Makes clotting factors to stop excessive bleeding after cuts or injuries Produces immune factors and removes bacteria from the bloodstream to combat infection Releases a substance called "bile" to help digest food and absorb important nutrients The word “hepatitis” actually means “inflammation” of the liver. Thus, “hepatitis B” refers to inflammation of the liver caused by the hepatitis B virus. With early detection and appropriate follow-up medical care, people living with a chronic hepatitis B infection can expect to enjoy a long and healthy life. About the Hepatitis B Virus The hepatitis B virus is a small DNA virus that belongs to the “Hepadnaviridae” family. Related viruses in this family are also found in woodchucks, ground squirrels, tree squirrels, Peking ducks, and herons. Structure of the Hepatitis B Virus The hepatitis B virus contains an outer envelope and an inner core. The outer envelope of the virus is composed of a surface protein called the hepatitis B surface antigen or "HBsAg". The HBsAg can be detected by a simple blood test and a positive test result indicates a person is infected with the hepatitis B virus. The inner core of the virus is a protein shell referred to as the hepatitis B core antigen or "HBcAg," which contains the hepatitis B virus DNA and enzymes used in viral replication. Life Cycle of the Hepatitis B Virus The hepatitis B virus (HBV) has a complex life cycle. The virus enters the host liver cell and is transported into the nucleus of the liver cell. Once inside the nucleus, the viral DNA is transformed into a covalently closed circular DNA (cccDNA), which serves as a template for viral replication (creation of new hepatitis B virus). New HBV virus is packaged and leaves the liver cell, with the stable viral cccDNA remaining in the nucleus where it can integrate into the DNA of the host liver cell, as well as continue to create new hepatitis B virus. Although the life cycle is not completely understood, parts of this replicative process are error prone, which accounts for different genotypes or “genetic codes” of the hepatitis B virus.

  https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/