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• AGA Publishes New Guidelines on Hepatitis B Reactivation!

  … at the highest risk if they take rituximab (a cancer treatment drug) but are at a moderate risk if they take any of the above-mentioned medications or treatments (Ali et al., 2025).  HBVr can progress rapidly, which is why screening for hepatitis B, prior to beginning treatment for cancers is important. If you take any of the mentioned medications, it is best to discuss with your doctor about your risk of reactivation. If you know about your hepatitis B status, you should disclose it to your provider or ask to get tested for hepatitis B to learn about your risk of reactivation. In the United States, all adults over 18 years of age are recommended to get tested for hepatitis B at least once in their lifetime.  Learn more about the updated guidelines here.  Learn more about hepatitis B Reactivation on our B Heppy Podcast here.     References  Ali, F. S., Nguyen, M. H., Hernaez, R., Huang, D. Q., Wilder, J., Piscoya, A., Simon, T. G., & Falck-Ytter, Y. (2025). AGA Clinical Practice Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals. Gastroenterology, 168(2), 267–284. https://doi.org/10.1053/j.gastro.2024.11.008  

  http://www.hepb.org/blog/aga-publishes-new-guidelines-hepatitis-b-reactivation/
• You Cannot Live Without Your Liver: Celebrating World Liver Day

  What is your body’s largest internal organ that filters and extracts toxins from your blood and can even regenerate on its own?   The liver!  Although the liver may not be discussed as frequently as the brain or heart, the liver is an incredibly critical part of everyday life and plays a role in metabolism, digestion, immunity, and overall keeping the body healthy. On April 19th we celebrate World Liver Day and honor everything it does for our bodies. Just some of the liver’s major roles include the production of bile (which helps break down fats during digestion), detoxification of the blood supply, and storage of essential vitamins (Kalra et al., 2023). The complex involvement of the liver in all these functions means that any injury or damage can cause a cascade of negative consequences. That being said, there are many useful preventative and curative measures that people can utilize to heal the liver. In this post, we gained insight from liver experts, clinicians, and people with lived experience to highlight the good, the bad, and the healthy for all things liver!  Liver Disease  So, what exactly causes someone to get a liver disease?   It all boils down to tissue damage which can be caused by viral infections, excessive alcohol consumption and fat intake, autoimmune disease, and more.  Viral infections  Of course, one of the most common diseases that affects the liver is hepatitis in all its forms. Hepatitis translates to inflammation of the liver, which can be caused by viral infections, excessive alcohol consumption, or autoimmune diseases. Regarding viral infections there are five different hepatitis viruses (A, B, C, D, and E) that can damage the liver. Dr. Su Wang, Senior Advisor for Global Health for the Hepatitis B Foundation and health care provider, explains the mechanism for viral liver damage.  “The virus resides and replicates in the liver and over time can cause chronic inflammation which can lead to fibrosis [mild scarring] and

  http://www.hepb.org/blog/cannot-live-without-liver-celebrating-world-liver-day/
• Time to End the Military's Ban on Enlistees with Hepatitis B

  Image courtesy of vectorolie at FreeDigitalPhotos.net. By Christine Kukka One of the most glaring civil rights abuses facing people with hepatitis B in the United States today is the military’s continued refusal to allow anyone with chronic hepatitis B to enlist. This prohibition continues, despite the fact that all military personnel are vaccinated against hepatitis B, and scientific data shows hepatitis B is not spread through casual contact. “Our brave servicemen and women deserve nothing less than the best, yet many qualified individuals are being prevented from serving in specific roles and/or being promoted within the military’s ranks. That’s simply wrong,” said U.S. Rep. Barbara Lee, D-Calif., in a letter challenging the military’s Uniform Code of Military Justice prohibits people with hepatitis B and C and HIV from enlisting in the Navy, Army, Air Force, Coast Guard, Marine Corps and National Oceanic and Atmospheric Administration. This outdated and scientifically-baseless Department of Defense policy damages the civil liberties of many Americans. Asian and Pacific Islander Americans, African and Middle Eastern immigrants and other ethnic groups are disproportionately impacted by hepatitis B. For example, Asian-Americans make up less than 5 percent of the total U.S. population but account for more than 50 percent of the 2 million people living with hepatitis B cases in the U.S. Immigrants and their children are also disproportionately affected by hepatitis B, due to the lack of vaccinations in their countries of origin. As a result, they are barred from military service, which offers a path to citizenship. What is especially heart-breaking are the young men and women who work hard to get into prestigious military academies, only to be dismissed when it’s discovered they have hepatitis B. This military code historically barred people with serious medical conditions because they were considered unfit to serve, suspected to incur high healthcare

  http://www.hepb.org/blog/time-end-militarys-ban-enlistees-hepatitis-b/
• Taking Antivirals Long-Term for Hepatitis B? Should You Worry About Bone Loss?

  Image courtesy of Sira Anamwong at FreeDigitalPhotos.net. By Christine Kukka To prevent liver damage and cirrhosis and reduce the risk of liver cancer--especially in older patients who’ve had hepatitis B for decades--doctors often prescribe long-term antiviral treatment. But some antivirals cause minor bone loss, which poses a problem for older patients with osteoporosis. According to experts, the risk of bone loss from long-term antiviral treatment is low, and in fact some antivirals do not cause any bone loss at all. But if you are starting antivirals at an older age, or if you have been on antivirals long-term, experts recommend you monitor your potassium and vitamin D levels and regularly test for bone loss in the hip area so you know if you are experiencing bone loss and need a calcium or vitamin D supplement. Antivirals affect bone health by causing a reduction in the amount of phosphorus in your body; a mineral that is essential to bone health. Historically, the antivirals lamivudine (Epivir-HBV) and adefovir (Hepsera) were widely used and adefovir specifically was linked to bone loss. Neither of those antivirals are currently recommended for first-line treatment. Today, the antivirals entecavir and tenofovir are recommended for most patients. Here is how these two antivirals affect bone health. Entecavir (Baraclude) appears to cause no bone loss, according to hepatitis B expert Dr. Robert Gish, medical consultant to the Hepatitis B Foundation and professor consultant of gastroenterology and hepatology at Stanford University. This antiviral, which recently became available as a less-expensive generic, has proven highly effective in reducing viral load (HBV DNA) and reducing liver damage in patients who are taking an antiviral for the first time. If you are an older patient, have signs of bone loss, and have never been treated with an antiviral before, your doctor may recommend this daily antiviral pill. However, entecavir is not an option if you’ve

  http://www.hepb.org/blog/taking-antivirals-long-term-should-you-worry-about-bone-loss/
• History

  Hepatitis B Vaccine History The hepatitis B vaccine is the first anti-cancer vaccine because it can help prevent liver cancer. Worldwide, chronic hepatitis B and C causes 80% of all liver cancer, which is the second most common cause of cancer death. Therefore, a vaccine that protects against a hepatitis B infection can also help prevent liver cancer. History of the Vaccine The hepatitis B virus was discovered in 1965 by Dr. Baruch Blumberg who won the Nobel Prize for his discovery. Originally, the virus was called the "Australia Antigen" because it was named for an Australian aborigine's blood sample that reacted with an antibody in the serum of an American hemophilia patient. Working with Dr. Blumberg, microbiologist Irving Millman helped to develop a blood test for the hepatitis B virus. Blood banks began using the test in 1971 to screen blood donations and the risk of hepatitis B infections from a blood transfusion decreased by 25 percent. Four years after discovering the hepatitis B virus, Drs. Blumberg and Millman developed the first hepatitis B vaccine, which was initially a heat-treated form of the virus.  First Commercial Hepatitis B Vaccine In 1981, the FDA approved a more sophisticated plasma-derived hepatitis B vaccine for human use. This “inactivated” type of vaccine involved the collection of blood from hepatitis B virus-infected (HBsAg-positive) donors. The pooled blood was subjected to multiple steps to inactive the viral particles that included formaldehyde and heat treatment (or “pasteurization”). Merck Pharmaceuticals manufactured this plasma vaccine as "Heptavax," which was the first commercial hepatitis B virus vaccine. The use of this vaccine was discontinued in 1990 and it is no longer available in the U.S. Current Recombinant Hepatitis B Vaccines In 1986, research resulted in a second generation of genetically engineered (or DNA recombinant) hepatitis B vaccines. These new approved vaccines are synthetically prepared and do not contain blood products - it is impossible to get hepatitis B from the new recombinant vaccines that are currently approved in the United States.

  https://www.hepb.org/prevention-and-diagnosis/vaccination/history-of-hepatitis-b-vaccine/
• Hepatitis B Foundation raises alarm about findings from new federal viral hepatitis surveillance report

  A new CDC report shows major COVID-related disruptions in hepatitis B testing and significant health equity concerns about the virus’ impact on the Asian American/Pacific Islander community. Doylestown, Pa., Sept. 15, 2022 – The Hepatitis B Foundation is alarmed by the findings in the newly released viral hepatitis surveillance report from the Centers for Disease Control and Prevention (CDC). As the nation’s leading hepatitis B advocacy and research organization, the Hepatitis B Foundation calls for increased investments to improve hepatitis B screening rates and implement new universal vaccination recommendations. The CDC report shows an estimated 14,000 new acute hepatitis B cases in 2020, a dramatic 32 percent decrease from 2019. The report points to COVID-related disruptions as a driver for such a significant decrease after a decade of stable rates. This is alarming because it highlights a sharp decline in hepatitis B testing due to COVID-19. Pandemic-related disruptions during 2020 resulted in fewer individuals seeking routine healthcare, fewer opportunities for community organizations to engage in testing programs and health department staff being shifted from hepatitis reporting duties to COVID-19 response. A 2020 Hepatitis B Foundation-involved survey found viral hepatitis testing was significantly impacted among clinical providers, health departments, and community-based organizations during the pandemic. Many of these disruptions continue today. “This drop in acute hepatitis B cases in 2020 is unfortunately not a sign of progress toward reducing new cases, but instead is an alarm bell to find and help those individuals not being tested,” said Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH. “We have work to do to reverse this trend, by improving access to testing and ensuring implementation of the new universal adult hepatitis B vaccination recommendations. This would help find those individuals and link them to care or liver cancer-preventing vaccination.” The report found the highest number of new acute cases of hepatitis B were among non-Hispanic White and Black adults, and persons aged 30-59. Injection drug use-related cases remain elevated. The CDC reported a total of 11,600 newly identified cases of chronic hepatitis B in 2020, with alarming rates among Asian Americans and Pacific Islanders of more than 12 times those of non-Hispanic White adults. Asian Americans and Pacific Islanders also bore a disproportionate burden of hepatitis B-related deaths in 2020 with a rate 9 times higher than that of non-Hispanic White adults. Also of note in the report, only around 30% of adults born after 1991 – the year hepatitis B was recommended as a routine childhood vaccine in the U.S. – are protected from the virus, adding to the urgency of implementing new vaccine recommendations. As the nation’s leading hepatitis B advocacy and research organization, the Hepatitis B Foundation calls for increased investments to improve hepatitis B screening rates and implement new universal vaccination recommendations. “We won’t be able to decrease hepatitis B-related deaths and reach our goal of eliminating the disease unless we make major investments in surveillance for chronic cases,” noted Frank Hood, associate director of policy and partnerships at the Hepatitis B Foundation. “We’re missing opportunities all along the care continuum by not vaccinating, testing, or ensuring people can reach care and treatment.”

  https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-raises-alarm-about-findings-from-new-federal-viral-hepatitis-surveillance-report/
• Hepatitis B Foundation senior vice president and board member speak on popular podcast

  Dr. Chari Cohen and Dr. Su Wang were interviewed for This Podcast Will Kill You. Doylestown, Pa., Jan. 27, 2022 – A leading science podcast currently is focusing on hepatitis B, and the two experts interviewed are Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation, and Su Wang, MD, MPH, FACP, a member of the Foundation’s Scientific and Medical Advisory Board and its Board of Directors. This Podcast Will Kill You, has over 14,000 global followers and is one of “The best science podcasts for staying sharp and sounding smart,” according to Popular Science magazine. The first episode of a two-part series on hepatitis B came out on Jan. 25, 2022 and features Dr. Wang, who is medical director for the Center for Asian Health and Viral Hepatitis Programs at the Cooperman Barnabas Medical Center and outgoing president of the World Hepatitis Alliance. Along with her interview, the podcast’s current episode provides background on the science of hepatitis B, including its causes, treatments and history. The second episode, which will be out on Feb.1, features Dr. Cohen and focuses on hepatitis B discrimination, stigma and quality of life. The discussion also covers the Hepatitis B Foundation’s mission and programs, and what it’s like to work in public health. This Podcast Will Kill You was created in 2017 by Erin Allmann Updyke, PhD, a medical student, and Erin Welsh, PhD, a disease ecologist and epidemiologist. They continue to produce it, conducting the interviews and adding their commentary and insights about the subjects they examine. “We’re extremely grateful that Dr. Updyke and Dr. Welsh decided to take a close look at hepatitis B because it’s not been getting the attention that’s necessary and because this is such a popular and well-done podcast,” Timothy M. Block, PhD, president, CEO and co-founder of the Hepatitis B Foundation, said. “I’m pleased they chose to interview Dr. Wang and Dr. Cohen, as they are two of the world’s leading experts on hepatitis B and both extremely adept at explaining to the general public the seriousness of the disease and the issues surrounding it.”   You can learn more about the podcast at thispodcastwillkillyou.com and listen wherever you access your podcasts. About Hepatitis B:  The most common serious liver infection in the world, it is caused by the hepatitis B virus, which attacks and injures the liver. Each year up to 1 million people die from hepatitis B worldwide, even though it is preventable and treatable. 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. Hepatitis B is a “silent epidemic” because most people do not have symptoms when they are newly or chronically infected. Thus, they can unknowingly infect others and continue the spread of hepatitis B. For people who are chronically infected but don’t have any symptoms, their livers are still being silently damaged, which can develop into serious liver disease such as cirrhosis or liver cancer. About the Hepatitis B Foundation: We are 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. Founded in 1991, the Hepatitis B Foundation is based in Doylestown, Pa., with an office in Washington, D.C. To learn more, go to www.hepb.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-senior-vice-president-and-board-member-speak-on-popular-podcast/

• ຍິນດີຕ້ອນຮັບສູ່ ເວັບໄຊຂອງມູນນິທິພະຍາດໄວຣັສ໌ຕັບອັກເສບບີ້ລາວ ໄວຣັສ໌ຕັບອັກເສບບີ້ ຖືກຮັບຮູ້ດີວ່າ ເປັນພະຍາດງຽບ ແລະ ຄົນສ່ວນໃຫຍ່ບໍ່ຮູ້ເລີຍວ່າ ພວກມັນເປັນພະຍາດຕິດແປດ. ເວັບໄຊນີ້ ໃຫ້ຂໍ້ມູນກ່ຽວກັບການປ້ອງກັນ, ການບົ່ງມະຕິພະຍາດ ແລະ ການຄຸ້ມຄອງໄວຣັສ໌ຕັບອັກເສບບີ້. ພວກເຮົາຢາກໃຫ້ທ່ານບອກຂໍ້ມູນນີ້ກັບໝູ່ຄູ່, ຄອບຄົວ ແລະ ບຸກຄົນອື່ນໃນຊຸມຊົນຂອງທ່ານ. ນີ້ແມ່ນບາງຢ່າງທີ່ສໍາຄັນທີ່ຈະຕ້ອງຈື່ຈໍາກ່ຽວກັບໄວຣັສ໌ຕັບອັກເສບບີ້: ໄວຣັສ໌ຕັບອັກເສບບີ້ ບໍ່ແມ່ນພະຍາດສືບທອດທາງກໍາມະພັນ - ມັນເກີດມາຈາກໄວຣັສ໌. 
 ມີຢາສັກທີ່ປອດໄພ ຊຶ່ງຈະປ້ອງກັນທ່ານຈາກການເປັນພະຍາດໄວຣັສ໌ຕັບອັກເສບບີ້ ເພື່ອປົກປ້ອງຊີວິດ. 
 ການກວດເລືອດທີ່ງ່າຍດາຍຈະຊ່ວຍໃນການບົ່ງມະຕິພະຍາດໄວຣັສ໌ຕັບອັກເສບ B. 
 ມີທາງເລືອກໃນການປິ່ນປົວພະຍາດ. ໄວຣັສ໌ຕັບອັກເສບບີ້ ແມ່ນພະຍາດທີ່ເກີດຂຶ້ນທົ່ວໂລກ.ພະຍາດໄວຣັສ໌ຕັບອັກເສບບີ້ ສາມາດຕິດແປດກັບຜູ່ໃດກໍ່ໄດ້ໃນທຸກອາຍຸ ຫຼື ທຸກຊົນເຜົ່າ, ແຕ່ວ່າ ພະຍາດຕັບອັກເສບບີ້ ພົບເຫັນສ່ວນໃຫຍ່ຢູ່ປະເທດອາຊີ, ອາຟຣິກາ ແລະ ອາເມລິກາເໜືອ, ຢຸໂຣບຕາເວັນອອກ, ແລະ ຕາເວັນອອກກາງ ຊຶ່ງເປັນບັນດາພາກພື້ນທີ່ມີຄວາມສ່ຽງສູງໃນການຕິດເຊື້ອ. ພະຍາດຕັບອັກເສບບີ້ ຍັງພົບເຫັນທົ່ວໄປໃນຄົນອາເມລິກາທີ່ເກີດ (ຫຼື ພໍ່ແມ່ເກີດ) ໃນພາກພື້ນເຫຼົ່ານີ້. ມີຫຼາຍຮ້ອຍລ້ານຄົນໃນທົ່ວໂລກທີ່ເປັນພະຍາດຕັບອັກເສບບີ້. ຄົນສ່ວນໃຫຍ່ບໍ່ເຄີຍຮູ້ວ່າພວກເຂົາຕິດເຊື້ອ, ແລະ ບໍ່ມີອາການ - ແຕ່ວ່າມີຫຼາຍຢ່າງທີ່ສໍາຄັນທີ່ທ່ານຄວນຈະຮູ້. ການກວດຫາພະຍາດຕັບອັກເສບບີ້ ຈະສາມາດຮັກສາຊີວິດຂອງທ່ານໄດ້. ຖ້າທ່ານຮູ້ວ່າທ່ານມີພະຍາດຕັບອັກເສບບີ້, ທ່ານສາມາດເລືອກວິທີການໃຊ້ຊີວິດທີ່ເຮັດໃຫ້ຕັບແຂງແຮງ ແລະ ທ່ານສາມາດໄປພົບໝໍ ເພື່ອຊ່ວຍຄຸ້ມຄອງການກະຈາຍຂອງໄວຣັສ໌ ແລະ ປ້ອງກັນຕັບບໍ່ໃຫ້ໄດ້ຮັບອັນຕະລາຍ. ມູນນິທິພະຍາດໄວຣັສ໌ຕັບອັກເສບບີ້ ແມ່ນອົງການຈັດຕັ້ງແຫ່ງຊາດທີ່ບໍ່ສະແຫວງຫາຜົນປະໂຫຍດ ມີຈຸດປະສົງໃນຄວາມພະຍາຍາມຫາວິທີທາງປິ່ນປົວຮັກສາ ແລະ ປັບປຸງຄຸນນະພາບຊີວິດຂອງປະຊາຊົນ ຜູ້ທີ່ໄດ້ຮັບຜົນກະທົບຈາກພະຍາດໄວຣັລ໌ຕັບອັກເສບບີ້ ໃນທົ່ວໂລກ ໂດຍຜ່ານການວິໄຈ, ການສຶກສາ ຄົ້ນຄ້ວາ ແລະ ການສະໜັບໜູນຮ່ວມມືຈາກຜູ້ປ່ວຍ. ການປະຕິເສດຄວາມຮັບຜິດຊອບ: ຂໍ້ມູນທີ່ມີຢູ່ໃນເວັບໄຊນີ້ ແມ່ນມີຈຸດປະສົງເພື່ອການສຶກສາເທົ່ານັ້ນ. ມູນນິທິພະຍາດໄວຣັສ໌ ຕັບອັກເສບບີ້ ບໍ່ແມ່ນອົງການປິ່ນປົວສຸຂະພາບ. ກະລຸນາໂອ້ລົມກັບທ່ານໝໍຂອງທ່ານ ຫຼື ຜູ່ຈັດຫາການດູແລສຸຂະພາບທີ່ມີຄວາມຮູ້ກ່ຽວກັບພະຍາດດັ່ງກ່າວ ເພື່ອໃຫ້ຄໍາແນະນໍາກ່ຽວກັບການດູແລສຸຂະພາບ. Welcome to the Laotian Chapter of the Hepatitis B Foundation Website Hepatitis B is known as a silent disease, and most people don’t even know they are infected. This website contains information about preventing, diagnosing and managing hepatitis B. We encourage you to share this information with your friends, family and others in your community. Here are some important things to remember about hepatitis B: Hepatitis B is not inherited - it is caused by a virus. 
 There is a safe vaccine which will protect you from hepatitis B for life. 
 There is a simple blood test to diagnose hepatitis B. 
 There are treatment options. Hepatitis B is a Global DiseaseHepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. There are hundreds of millions of people worldwide who have hepatitis B. Most people don’t even know they are infected, and don’t have symptoms – but there are many important things you should know. Getting tested for hepatitis B can save your life. If you know you have hepatitis B, you can make lifestyle choices to keep your liver healthy and you can see a doctor to help manage the virus and prevent liver damage. The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure and helping to improve the quality of life for all those affected by hepatitis B worldwide through research, education and patient advocacy. Disclaimer: The information that is provided on this website is for educational purposes only. The Hepatitis B Foundation is not a medical organization. Please talk to your doctor or a qualified health care provider for personal medical care and advice.

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• Distinguished Doctor and Contributor to the Viral Hepatitis Community Dies

  Dr. Emmet B. Keeffe, Professor of Medicine Emeritus at Stanford University in Hepatology, passed away unexpectedly on August 8, 2011 after a distinguished career in hepatology. He was sixty-nine years old. Please join us in extending our condolences to the family, and many friends, colleagues and patients of Dr. Emmet Keeffe.  We are all saddened by his death. Dr. Keeffe was a major contributor in the viral hepatitis community and made significant contributions throughout his 42 years practicing medicine.  Dr. Keeffe had an impressive list of professional achievements, administrative appointments, honors and awards. His clinical research interests focused on the treatment of chronic hepatitis B and C, where he was a principle investigator for many clinical trials treating numerous patients.  Dr. Keeffe has been published extensively throughout his career. Dr. Keeffe was a true thought leader in the field of hepatitis B who grasped all aspects of this liver disease. He created bridges of understanding between the science, medicine and patient experiences for the entire hepatitis B community. We will miss his active involvement and support of the Hepatitis B Foundation, but most importantly, we will miss his vital contributions to the science and medicine of chronic viral hepatitis. Emmet B. Keeffe, MD April 12, 1942 - August 8, 2011  

  http://www.hepb.org/blog/distinguished-doctor-and-contributor-to-the-viral-hepatitis-community-dies/
• Información general

  ¿Qué es la hepatitis B? La hepatitis B es la infección del hígado más común del mundo. La produce el virus de la hepatitis B (VHB), que ataca y daña el hígado. Se transmite a través de la sangre, del sexo sin protección, al compartir o reutilizar agujas y de cualquier madre infectada a su bebé recién nacido durante el embarazo o el parto. La mayoría de los adultos infectados puede eliminar el virus de la hepatitis B sin problemas. Sin embargo, algunos adultos y la mayoría de los bebés y niños infectados no pueden eliminar el virus y desarrollan una infección crónica (para toda la vida). La buena noticia es que existe una vacuna segura para prevenir una infección por hepatitis B y hay tratamientos nuevos para las personas que ya están infectadas con hepatitis B.  ¿Cuántas personas están afectadas por la hepatitis B? A nivel mundial, 2 mil millones de personas (1 de cada 3 personas) se han infectado con hepatitis B y 257 millones de personas tienen infección crónica (lo que significa que no pueden eliminar el virus).Un aproximado de 700,000 personas muere cada año de hepatitis B y sus complicaciones. ¿Por qué la hepatitis B es más común en algunas partes del mundo? La hepatitis B puede infectar a cualquier persona de cualquier edad o etnia, pero las personas que habitan en regiones del mundo donde la hepatitis B es común, como Asia, zonas de África y América del Sur, el este de Europa y el Medio Oriente, corren un riesgo mucho más alto de infectarse. La hepatitis B también es común entre los estadounidenses nacidos (o cuyos padres nacieron) en esas regiones. La hepatitis B es más común en ciertas regiones del mundo porque existen muchas más personas ya infectadas con hepatitis B en esas regiones. Aunque la hepatitis B no es una "enfermedad asiática" ni una "enfermedad africana", afecta a cientos de millones de personas de esas regiones, por lo que hay más personas que pueden transmitir el virus de la hepatitis B a otras personas. Esto aumenta el riesgo de que alguien pueda infectarse. Debido a que hay menos occidentales infectados, este grupo tiene un riesgo más bajo de infección.  En regiones donde la hepatitis B es común, las personas se infectan generalmente desde recién nacidos, de una madre que sin saber le transmite el virus a su bebé durante el parto. Los niños pequeños también están en riesgo si viven en contacto cercano diario con un miembro de la familia infectado. Los bebés y los niños tienen más probabilidades de desarrollar una infección por hepatitis B crónica porque sus sistemas inmunológicos inmaduros tienen problemas para eliminar el virus. Si usted o su familia son de un área de color azul oscuro del mapa, es posible que corran un mayor riesgo de contraer la infección por hepatitis B y deberían hablar con un médico sobre realizarse una prueba. ¿Por qué debería preocuparme por la hepatitis B? La hepatitis B crónica puede ocasionar una enfermedad hepática grave, como la cirrosis o el cáncer de hígado. Es importante realizarse una prueba porque el diagnóstico temprano puede conducir a un tratamiento temprano que le puede salvar la vida. Así mismo, las personas infectadas pueden transmitirles el virus a los demás. Debido a que la mayoría de las personas no saben que están infectadas, se lo transmiten a muchas otras personas sin saberlo. Si las personas no se realizan una prueba, la hepatitis B puede pasar a través de muchas generaciones en una familia y en la comunidad. Un mito frecuente es que la hepatitis B puede "heredarse" debido a que varias generaciones en una familia pueden estar infectadas. Pero la hepatitis B NO es una enfermedad genética; la hepatitis B la produce un virus, el cual se transmite con frecuencia entre miembros de una familia debido a la transmisión de madre a hijo o a la exposición accidental a la sangre en el hogar. Las familias pueden romper el ciclo de infección por hepatitis B al realizarse la prueba, vacunarse y tratarse. ¿Por qué es tan peligrosa la hepatitis B? La hepatitis B es peligrosa porque es una "infección silenciosa" que puede afectar a las personas sin que lo sepan. La mayoría de las personas infectadas con hepatitis B no están conscientes de su infección y pueden, sin saberlo, transmitirles el virus a otras personas a través de su sangre y fluidos corporales infectados.Para los que tienen infección crónica, hay un riesgo mayor de desarrollar insuficiencia hepática, cirrosis o cáncer de hígado más adelante en sus vidas. El virus puede atacar de manera silenciosa y continua el hígado por muchos años sin ser detectado.  ¿Qué es hepatitis B aguda? Una infección aguda por hepatitis B puede durar hasta seis meses (con o sin síntomas) y las personas infectadas pueden transmitirles el virus a otras personas durante este tiempo. Los síntomas de una infección aguda pueden incluir pérdida del apetito, dolor muscular y articular, fiebre de bajo grado y posible dolor de estómago. Aunque la mayoría de las personas no presentan síntomas, estos pueden aparecer 60 o 150 días después de la infección, siendo el promedio a los 3 meses. Algunas personas pueden presentar síntomas más graves, como náuseas, vómitos, ictericia (coloración amarillenta de los ojos y de la piel) o hinchazón del estómago, que los motiva a consultar con un proveedor de atención médica. Una prueba de sangre sencilla puede indicarle a una persona si tiene el virus de hepatitis B en su sangre. Si a usted se le ha diagnosticado hepatitis B aguda, el médico tendrá que evaluar su sangre de nuevo en 6 meses para averiguar si se ha recuperado o si ha desarrollado una infección crónica por hepatitis B. Hasta que su proveedor de atención médica confirme que la prueba de sangre demuestra que ya no hay virus de hepatitis B en su sangre, es importante proteger a los demás de una posible infección. También es importante que su(s) pareja(s) sexual(es) y miembros de su familia (o las personas con las que vive en contacto cercano) se realicen una prueba para detectar hepatitis B. Si no han sido infectados y no han recibido la vacuna de la hepatitis B, entonces deberían comenzar el esquema de vacunación contra la hepatitis B. A las personas que tienen hepatitis B aguda no se les receta ningún tratamiento específico para la hepatitis B; no existe un tratamiento para eliminar la infección aguda por hepatitis B, y la mayoría de las personas infectadas cuando son adultas se recuperan por sí mismas. A veces, una persona con síntomas graves puede ser hospitalizada para obtener ayuda general. El reposo y el control de los síntomas son los objetivos principales de esta atención médica. Una enfermedad poco frecuente y que pone en peligro la vida llamada "hepatitis fulminante" puede aparecer con una nueva infección aguda y requiere atención médica urgente e inmediata debido a que la persona puede presentar insuficiencia hepática repentina. Los consejos sencillos para cuidar su hígado durante una infección aguda por hepatitis B son evitar el alcohol, dejar o disminuir el consumo de cigarrillos, comer alimentos saludables, evitar los alimentos grasos y hablar con su proveedor de atención médica sobre todo medicamento que esté tomando (medicamentos con o sin receta, vitaminas o suplementos naturales) para asegurarse de que sean seguros para su hígado. Ese es un buen momento para hacer cualquier otra pregunta que pueda tener. Es probable que el uso de vitaminas y suplementos para un hígado saludable no lo ayuden en su recuperación y pueden, de hecho, hacerle más daño que bien a su hígado. Asegúrese de realizar el seguimiento con su proveedor de atención médica, de necesitar cualquier prueba de sangre adicional, para confirmar su recuperación de una infección aguda. ¿Qué es la hepatitis B crónica? A las personas cuyas pruebas son positivas para el virus de la hepatitis B por más de seis meses (después de su primer resultado de prueba sanguínea) se les diagnostica infección crónica. Esto significa que su sistema inmunológico no pudo eliminar el virus de la hepatitis B y continúa en su sangre e hígado. Existen maneras eficaces de tratar y controlar una infección crónica, pero no hay cura. Si tiene una infección crónica, el virus probablemente continúe en su sangre por el resto de su vida. Las personas que tienen hepatitis B crónica pueden, sin saberlo, transmitirles el virus a otras personas. La hepatitis B crónica también puede producir enfermedades hepáticas graves, como cirrosis o cáncer de hígado. No todas las personas infectadas de forma crónica desarrollarán una enfermedad hepática grave. Sin embargo, tienen mayor probabilidad de desarrollarla que alguien que no está infectado. El riesgo de desarrollar una infección crónica por hepatitis B se relaciona con la edad en la cual se contagió por primera vez con el virus de la hepatitis B: 90% de los recién nacidos y bebés infectados desarrollarán una infección crónica por hepatitis B. Hasta 50% de los niños infectados (entre 1 y 5 años) desarrollarán una infección crónica por hepatitis B. Entre 5 y 10% de los adultos infectados desarrollarán una infección crónica por hepatitis B (eso significa que el 90% se recuperará). Saber que tiene una infección crónica por hepatitis B puede ser perturbador. Debido a que la mayoría de las personas no presentan síntomas y se les puede diagnosticar décadas después de su exposición inicial al virus de la hepatitis B, puede ser una conmoción y una sorpresa que se les diagnostique una infección crónica por hepatitis B. La buena noticia es que se espera que la mayoría de las personas con hepatitis B crónica vivan una vida larga y saludable. Las mujeres embarazadas infectadas pueden transmitirles el virus a sus recién nacidos durante el parto. Por lo tanto, debido al alto riesgo de que la infección en los recién nacidos se vuelva crónica, la Organización Mundial de la Salud (OMS) y los Centros para el Control y Prevención de Enfermedades (Centers for Disease Control and Prevention, CDC) de los EE. UU. recomiendan que todos los bebés reciban su primera dosis de la vacuna contra la hepatitis B en un plazo de 12 a 24 horas después de nacer. ¡Si está embarazada y sabe que está infectada, puede asegurarse de que su bebé reciba la primera dosis de la vacuna contra la hepatitis B en un plazo de 12 a 24 horas después del  parto! Aunque no existe cura para la infección crónica por hepatitis B, existen terapias eficaces con medicamentos que pueden controlar el virus de la hepatitis B y evitar que dañe el hígado. También existen nuevos medicamentos prometedores en fase de investigación que pudieran proporcionar una cura en un futuro muy cercano. Aunque el riesgo de desarrollar una enfermedad hepática grave o cáncer de hígado es mayor para los que viven con hepatitis B crónica que para los que no están infectados, aún existen muchas medidas sencillas que una persona puede tomar para ayudar a disminuir su riesgo. Programe consultas regulares cada seis meses (o al menos cada año) con un especialista en hígado o un proveedor de atención médica experto en hepatitis B, de modo que puedan supervisar la salud de su hígado. Converse con su proveedor de atención médica sobre si el tratamiento para su infección crónica por hepatitis B sería de utilidad para prevenir una enfermedad hepática grave o cáncer de hígado. Asegúrese de que su proveedor de atención médica le realice pruebas de detección de cáncer de hígado durante sus consultas regulares, ya que la detección temprana equivale a más opciones de tratamiento y a una vida más larga. Evite o limite el consumo de alcohol y cigarrillos ya que ambos le producen mucho estrés a su hígado. Consuma una dieta saludable con muchos vegetales, ya que los alimentos grasosos y fritos son pesados para su hígado. ¿Qué significa ser un "portador crónico"? Cuando alguien tiene infección crónica por hepatitis B, el médico puede referirse a esa persona como "portador crónico". Ser un "portador crónico" significa que usted tiene una infección crónica por hepatitis B, que puede transmitirles el virus a otras personas y que su infección la debería controlar un médico. ¿Existe una cura para la hepatitis B? La mayoría de los adultos se recuperarán de una infección aguda por sí mismos sin necesidad de medicamentos. Para los adultos, bebés y niños que desarrollen una infección crónica por hepatitis B no existe actualmente una cura. 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. 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. ¿Qué opciones existen para tratar mi hepatitis B? Para una infección aguda, por lo general no existe tratamiento más que el descanso y medidas de apoyo para controlar cualquier síntoma. Para la hepatitis B crónica, existen muchos tratamientos disponibles. Es importante entender que no todas las personas con hepatitis B crónica necesitan tratamiento. Su médico lo ayudará a decidir si necesita medicamentos o si puede esperar y supervisar su enfermedad. Existen varios medicamentos antivirales que desaceleran o detienen la reproducción del virus de la hepatitis B, lo cual disminuye la inflamación y el daño al hígado. Esos antivirales se toman como una píldora una vez al día y al menos durante 1 año, aunque generalmente por más tiempo. Hay 6 antivirales aprobados por la Administración de Alimentos y Medicamentos (Food and Drug Administration, FDA) de los EE. UU., pero solo se recomiendan tres 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. Para las personas que no responden o no tienen acceso a los tratamientos antivirales de primera línea, existen otras opciones disponibles: telbivudine (Tyzeka, Sebivo), adefovir dipivoxilo (Hepsera) y lamivudina (Epivir-HBV, Zeffix, Heptodin). Aunque la FDA aprobó estos antivirales para la hepatitis B crónica, estos no ofrecen una cura completa. Sin embargo, pueden disminuir en gran medida el riesgo de desarrollar daño hepático y cáncer de hígado. 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 la hepatitis B crónica. Así mismo, existen medicamentos inmunomoduladores 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). Usted y su médico deberán conversar sobre las opciones de tratamiento antes de decidir cuál es, de haberla, la mejor para usted. Para muchas personas, estos medicamentos disminuirán o detendrán el virus de la hepatitis B. 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. Para ver una lista completa de los medicamentos aprobados por la FDA y otros medicamentos prometedores en desarrollo para la hepatitis B, visite nuestro Drug Watch (Observatorio de medicamentos). General Information What is hepatitis B? Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B.  How many people are affected by hepatitis B? Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world? Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B? Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous? Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected.  What is acute hepatitis B? An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver. Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. What is chronic hepatitis B? People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected. The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with the hepatitis B virus: 90% of infected newborns and babies will develop a chronic hepatitis B infection Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risk. Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver. Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer. Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life. Avoid or limit alcohol and smoking since both cause a lot of stress to your liver. Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver. What does it mean to be a “chronic carrier”? When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B? Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. 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. 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. What options are there to treat my hepatitis B? For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals 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: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. 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 hepatitis B. There are also immunomodulator 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). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. 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. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.

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