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  • Hepatitis is Still the Silent Killer

    Great way to wrap up World Hepatitis Day events with a commentary from our viral hepatitis champions on Capitol Hill. A big thank you to Senator Mazie K. Hirono and Representatives, Michael M. Honda, Hank Johnson, and Bill Cassidy for their tireless efforts. Viral Hepatitis is a problem we cannot ignore! Roll Call (online) By Sen. Mazie K. Hirono, and Reps. Michael M. Honda, Hank Johnson, and Bill Cassidy. July 31, 2014, 5 a.m. Although the price of a revolutionary new hepatitis C treatment has made headlines recently, the real hepatitis crisis continues largely unreported. A more immediate problem for many Americans is not how much one hepatitis C treatment might cost; it is how many Americans are infected with viral hepatitis and do not even know it. World Hepatitis Day, July 28, reminds us that more than 5 million Americans — or 2 percent of the population — are living with viral hepatitis. Yet the Centers for Disease Control and Prevention (CDC) estimates as many as 75 percent of these Americans are unaware they have the virus. This “silent killer” goes undetected because the virus often remains asymptomatic until it has already wreaked havoc on the liver, causing cirrhosis, end-stage liver disease, or liver cancer. According to the CDC, more than 30 percent of infected individuals will develop one of these conditions. Meanwhile, since the majority of infected individuals don’t realize they have hepatitis, they do not take the necessary precautions and can unknowingly transmit the virus to others. More Americans die every year from hepatitis C than HIV. Without effective intervention, it is estimated that deaths due to the hepatitis C virus will double, or even triple, in the next 20 years. Baby boomers — Americans born between 1945 and 1965 — make up 75 percent of Americans with hepatitis C, and are five times more likely to have the virus than the general population. Hepatitis disproportionately affects communities of color. One in 12

    http://www.hepb.org/blog/hepatitis-is-still-the-silent-killer/
  • 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/
  • Joan Block, Hepatitis B Foundation Co-founder, Honored for Advocacy Work

    A wonderful article (reprinted below) and short video was published last weekend in Phillyburbs.com recognizing the work of Joan Block, the Executive Director and co-founder of the Hepatitis B Foundation. In commemoration of World Hepatitis Day, Joan and Dr. Anna Lok were honored by the Viral Hepatitis Action Coalition of the Centers for Disease Control Foundation, for advocacy work resulting in the protection of medical students from HBV discrimination, and ultimately having HBV recognized as a disability protected under the Americans with Disabilities Act (ADA). This amazing accomplishment is just one of the many successes Joan and the HBF have had over the last 23 years as a result of her tireless efforts and dedication to the mission to help improve the lives of those affected by hepatitis B. Please visit Phillyburbs.com to access to view the short video where Joan talks about the Foundation’s beginnings and how the HBF has grown from a grass roots effort to the leading national nonprofit for hepatitis B. Joan Block and the HBF truly are the “voice of hepatitis B”. Read more about the story and the mission of the Hepatitis B Foundation and be sure to visit the HBF website to learn more about hepatitis B and the work of the Foundation. For more than two decades, the Hepatitis B Foundation has fought to find a cure for the liver disease and advocate for those who have it. What started as a grass-roots effort of four passionate people has grown into one of the leading nonprofit research and disease advocacy organizations in the United States. “We are the voice for hepatitis B in the United States,” said co-founder and executive director Joan Block. “There’s still a lot of work to do, but we’ve accomplished a lot in the past 23 years.” Earlier this year, the foundation’s mission got a boost when the U.S. Department of Justice said hepatitis B patients are protected under federal disability law in a case brought by the foundation against a New

    http://www.hepb.org/blog/joan-block-hepatitis-b-foundation-co-founder-honored-for-advocacy-work/
  • 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/
  • Viral Hepatitis Action Alert!

    *ACTION ALERT* HAP - Hepatitis Appropriations Partnership  Urge Your Members of Congress to Support Viral Hepatitis Funding In Their Appropriations Programmatic Requests     With the passage of the continuing resolution (CR) for FY2013 at the FY2012 levels (before the sequester) and no Prevention and Public Health Fund allocations, we do not know the total, final funding level for FY2013 at the Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis (DVH) or the future of the $10 million they received in FY2012 for a testing initiative. The President's FY2014 budget has not yet been released. We need your help in raising awareness among Members of Congress about the viral hepatitis epidemics and asking their support for increased funding for viral hepatitis activities at the federal level.  Viral hepatitis advocates are urging for a total funding at the Division of Viral Hepatitis of $35 million, an increase of $5.3 above the total FY2012 level. In the next week and a half, all Senators and Representatives will write their “programmatic appropriations request letters,” which ask members of the Appropriations Subcommittees (who put together the federal funding legislation) to include funding for their priorities. The more Members of Congress that include a request for hepatitis funding in their letters, the greater the likelihood the Appropriators will include additional funding in FY2014. As you know, viral hepatitis impacts over 5.3 million people nationwide. With a lack of a comprehensive surveillance system, these estimates are likely only the tip of the iceberg and 75% of those infected do not know their status. Even with these daunting figures, there are only $19.7 million in federal funding dedicated to fund viral hepatitis activities nationwide at the CDC in the CR for FY2013, before sequester.  Members of Congress need to know that viral hepatitis is a concern in their district, that their constituents

    http://www.hepb.org/blog/viral-hepatitis-action-alert/
  • High Viral Load, HBeAg Positivity Increased Risk for Mother-to-Infant HBV Transmission

    … Once again, read and print a copy of "Chronic Hepatitis B in Pregnancy" for your doctor. Insist you are screened for HBV, and if you are HBsAg+, please be sure prophylaxis will be available at the hospital where you will give birth to your baby. If you find you are HBeAg+, with a high viral load, please speak to a liver specialist to see if an antiviral is an option for you to prevent HBV transmission to your baby. Don’t’ forget to have your baby tested at 18 months to ensure your baby is HBV free. *Please note you can convert copies per milliliter (cp/ml) to IU/mL for the article below using WHO’s international standard where 1 IU/mL = 5.2 copies/mL. Please ask your doctor or your lab if you have specific questions regarding the conversion. Infants born to mothers with a high hepatitis B viral load, particularly those positive for hepatitis B e antigen, are at high risk for contracting hepatitis despite immunoprophylaxis, according to recent results. Researchers evaluated 303 mother-infant pairs in which mothers tested positive for hepatitis B surface antigen (HBsAg). Maternal viral load and hepatitis B e antigen (HBeAg) status were determined, and children were tested for HBsAg at ages 4 to 8 months (n=250) and/or 1 to 3 years (n=53 for an initial test; n=183 for a follow-up test). All children received HBV vaccine within the first week of birth and at 1 and 6 months, with a 100% completion rate; children born to mothers who tested positive for HBeAg received hepatitis B immunoglobulin within 24 hours of birth. HBeAg-positive mothers (81 cases) had higher viral loads than those who did not (7.4 ± 1.9 log10 copies/mL vs. 2.7 ± 1.4 log10 copies/mL; P<.0001 for difference). Chronic HBV infection was identified in 10 children, all born to HBeAg-positive mothers with high viral loads (range 6.5-9.5 log10 copies/mL), and all with the same HBV genotypes and subtypes as their mothers. Investigators identified a significant association between maternal viral

    http://www.hepb.org/blog/high-viral-load-hbeag-positivity-increased-risk-for-mother-to-infant-hbv-transmission/
  • Simple Impediments to Hepatitis B and C Screening

    There was an article in the Baltimore Sun a couple of weeks ago that discussed screening for hepatitis B and C.  Approximately 600 million people around the world and five million people in the U.S. are infected with viral hepatitis. According to the Annals of internal Medicine, the CDC reports that there are more deaths attributed to HCV than HIV in the U.S. The Baltimore doctor believes that ideally, everyone should be tested for hepatitis B and C. Although he is not alone in his thinking, there are many physicians that may not be as aware of the need for screening, and even those in high risk groups may be inadvertently missed. And should a physician decide to screen, there is no ICD code, or International Classification of Diseases code for high-risk based HCV or HBV screening. Insurance companies use these codes to determine if services and payment is warranted. An insurance company may actually deny payment for HBV or HCV testing if they do not believe there is a valid reason for screening.  For example, elevated ALT levels might prompt a physician to “legitimately” screen for viral hepatitis. There is also no problem with ICD codes if you are already diagnosed with HBV or HCV, but you can’t readily be screened using a convenient code. Viral hepatitis does not discriminate. There are certainly high risk groups where HBV or HCV may be more prevalent, but that should not discourage a doctor from screening a patient if she feels it is warranted. How might a doctor get around a lack of adequate diagnostic codes? We asked a physician who cares for Asian-Americans. This group is at particular risk for HBV infection and should be screened whether they have elevated ALTs or not. He circumvents the lack of an official ICD code with a work-around. He uses the “CMS code V15.85 – Contact with and (suspected) exposure to potentially hazardous body fluids”. This works, but some physicians may not be as comfortable as others with this work-around. Sadly, this

    http://www.hepb.org/blog/simple-impediments-to-hepatitis-b-and-c-screening/
  • 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/