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  • Minority Health Awareness Month: Why does hepatitis B disproportionately affect some groups more than others? 

                          Hepatitis B is a global public health crisis. While it is heavily underreported across the world, experts estimate that there are approximately 300 million people living with chronic hepatitis B. Anyone can get hepatitis B. The hepatitis B virus does not discriminate. This is why it is crucial for everyone to get tested for hepatitis B at least once in their lifetime and get the hepatitis B vaccine.  However, some people are at a greater risk for developing chronic hepatitis B than others. This is not necessarily because some people are genetically predisposed to the virus but because of poor awareness and lack of resources to prevent or treat hepatitis B.  It is important to understand that health is influenced by many different factors including genetics, our environment, availability of resources and access to care. To fully understand the reasons behind racial and ethnic disparities in hepatitis B prevalence across the globe, we must understand the social determinants of health associated with hepatitis B testing and care.   Differences in HBV Genotypes  Genotypes describe the characteristics of the virus. The hepatitis B virus (HBV) contains many different genotypes, which explains why the virus impacts people in different ways (i.e., how the virus spreads to others, likelihood of developing serious liver disease, etc.). Some genotypes such as genotype A can increase the chances of chronic (long-term) infection.  Certain HBV genotypes are more common in some regions of the world than others, which may explain why some people are more likely to experience worse health outcomes than others (Sunbul, 2014).   Genotype A is commonly found in the African region. Genotypes B and C are found in the Asia Pacific regions. Genotype D is less likely to lead to a chronic infection but can still result in serious liver failure without proper intervention. Genotype D is found mostly in South

    http://www.hepb.org/blog/minority-health-awareness-month-hepatitis-b-disproportionately-affect-groups-others/
  • The History of National African Immigrant and Refugee HIV & Hepatitis Awareness Day 2019

      Each year in September, the Hepatitis B Foundation recognizes National African Immigrant and Refugee HIV and Hepatitis Awareness Day (NAIRHHA). Founded by advocates in Massachusetts, Washington D.C., and New York, NAIRHHA Day has been observed annually on September 9th by healthcare professionals, awareness campaigns, and other organizations since 2014. Although not yet nationally recognized, the multicultural AIDS Coalition (MAC) and the Coalition Against Hepatitis B for People of African Origin (CHIPO) are working to establish NAIRHHA day as its own federally designated awareness day. As explained by Chioma Nnaji, Director at the Multicultural AIDS Coalition’s Africans For Improved Access (AFIA) program, there is a great need to establish NAIRHHA day as its own day.  “Several of the current awareness days are inclusive of African immigrant communities, but do not comprehensively address their unique social factors, cultural diversity as well as divergent histories and experiences in the US.” Why NAIRHHA Day?  People born outside of the U.S. often face different health challenges than those born in the country and face various barriers to accessing important healthcare services. African immigrants (AI) are disproportionately burdened by HIV and viral hepatitis. Advocates for NAIRHHA Day recognized the need to address these health issues in the community and thought that a combined awareness day would be the most effective way to reach the largest number of people impacted.  Hepatitis B presents a significant public health burden for many African countries, and subsequent immigrant populations living in the United States. Although data is limited on hepatitis B infection among African immigrant (AI) and refugee communities in the U.S., studies have shown infection rates are high - between 5 and 18%1,2,3,4,5. One community study in Minnesota even found AIs accounting for 30% of chronic hepatitis B infections 6. AI communities are also known to be

    http://www.hepb.org/blog/history-national-african-immigrant-refugee-hiv-hepatitis-awareness-day-2019/
  • What's the difference: Hepatitis B vs. Hepatitis E

    With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver! This is the final installment in a three-part series. You can click the links to view more about hepatitis A and hepatitis C. What is Hepatitis? Hepatitis means “inflammation of the liver”. A liver can become inflamed for many reasons, such as too much alcohol, physical injury, autoimmune response, or a reaction to bacteria or a virus. The five most common hepatitis viruses are A, B, C, D, and E. Some hepatitis viruses can lead to fibrosis, cirrhosis, liver failure, or even liver cancer. Damage to the liver reduces its ability to function and makes it harder for your body to filter out toxins. Hepatitis B vs. Hepatitis E Globally, hepatitis E is a common liver infection. The World Health Organization estimates that 20 million people are infected each year. The virus has 4 known types: genotype 1, genotype 2, genotype 3, and genotype 4. Genotypes 1 and 2 are primarily spread through  fecal-oral transmission or by consuming food or water that has been contaminated and are only found in the human population. Typically, these genotypes are found in Africa, Asia, and Mexico. Poor sanitation and lack of clean water infrastructure contribute to the spread of genotypes 1 and 2. Image Courtesy of Canva Genotypes 3 and 4 are found in animal populations and can be passed on to a human if their meat is undercooked and consumed. Pigs, deer, boar, and chickens have all been found to carry the hepatitis E virus, but studies have shown that consuming undercooked infected pig (pork) and wild boar have commonly been the main source of animal-to-human transmission. Although less common, shellfish has also been found to carry the hepatitis E virus as well. Genotypes 3 and 4

    https://www.hepb.org/blog/whats-difference-hepatitis-b-vs-hepatitis-e/
  • What's the Difference: Hepatitis A vs Hepatitis B

    With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver! This is part two in a three-part series. What is Hepatitis? Hepatitis means “inflammation of the liver”. A liver can become inflamed for many reasons, such as too much alcohol, physical injury, autoimmune response, or a reaction to bacteria or a virus. The five most common hepatitis viruses are A, B, C, D, and E. Some hepatitis viruses can lead to fibrosis, cirrhosis, liver failure, or even liver cancer. Damage to the liver reduces its ability to function and makes it harder for your body to filter out toxins. Hepatitis A vs. Hepatitis B While hepatitis A and B both impact the liver, the two viruses differ greatly from one another. Hepatitis B is a blood-borne pathogen; its primary mode of transmission is through direct blood-to-blood contact with an infected person. In contrast, hepatitis A can be spread by fecal-oral transmission or by consuming food or water that has been contaminated. It is important to note that a person cannot contract hepatitis B through casual interactions such as holding hands, sharing a meal with, or eating foods prepared by someone who is infected. There is no need to keep plates and utensils separate. However, hepatitis A can be spread through food that is prepared by an infected person. Hepatitis A is primarily caused by poor sanitation and personal hygiene. Poor sanitation and hygiene can be the result of a lack of essential infrastructure like waste management or clean water systems. It can also result from a lack of education. Hepatitis A is an acute infection; the virus typically stays in the body for a short amount of time and most people make a full recovery after several weeks. Recently, the United States has seen a

    http://www.hepb.org/blog/whats-difference-hepatitis-vs-hepatitis-b/
  • Hepatitis B ECHO Hubs

    Hepatitis B ECHO Program Project ECHO is case-based learning sessions between HBV specialists and primary care providers. Below is a list of ECHOs available from a wide range of organizations.  Title  Hub time zone Hub sponsor ECHO schedule   Registration link East Coast ET Hepatitis B Foundation; Hep B United Philadelphia 4th Thursday of every month – 12:00PM – 1:00PM https://us02web.zoom.us/meeting/register/tZYsc-mrqjMjEtZaabsz-qr5iRYvVjKq75ec West Coast PT Hep B Free San Francisco Bay Area 3rd Tuesday of every month, 12:30pm-1:30pm https://www.sfhepbfree.org/single-post/hepatitis-b-echo-program Hawaii Hawaii Time Hawaii Health and Harm Reduction Center; Hep Free Hawaii Every Monday, 12:00pm-1:15pm, 8/22/22-12/12/22 https://www.hawaiilearning.org/ Gulf Coast CT Texas Heart Institute with Baylor St. Luke Medical Center 3rd Wednesday of every month – 12:00PM-1:00PM https://redcap.research.bcm.edu/redcap/surveys/?s=TCJ7WC74A7 UK GMT King’s College Hospital: HBV-HDV ECHO Once monthly, dates vary, 1:00pm-2:00pm   Alaska AKDT Alaska Native Tribal Health Consortium 2nd Tuesday of every month – 8:00am-9:00am https://www.anthc.org/what-we-do/clinical-and-research-services/hep/liverconnect/ Seattle, WA PT University of Washington Viral Hepatitis ECHO     Lagos, Nigeria    LAGOS VIRAL HEPATITIS ECHO   Dr Ganiyat OYELEKE and Prof Lesi                       drgoyeleke@yahoo.com South Africa   University of Cape Town, Viral Hepatitis in Sub-Saharan Africa   Wendy SprearmanG-ECHO clinics: Chris KassianidesProject administrator:Cheryl Valentine cheryl.valentine@uct.ac.za Canada EDT University Health Network Ontario, Liver ECHO Every Monday, 12:00pm-1:30pm https://uhn.echoontario.ca/Our-Programs/Liver Ethiopia Kenya Time Gastroenterology Sub-Saharan Africa ECHO Clinic St.Paul's Hospital Millenium Medical College Bi-weekly 4pm 2nd and 4th Tuesday   https://echo.zoom.us/meeting/register/tJ0vd-6sqDgqE93zDlc9TkTbASlHWxW4Ss-z Professors Hailemichael Desalegn and M Topazian; drhailedy@gmail.com United States EST dkbmed Weekly sessions for 4 weeks from 12-1 pm EST:  Tues: 4/25, 5/2, 5/9, 5/16 Thur: 4/27, 5/4, 5/18, 5/25 https://echo.dkbmed.com/programs/4#schedule-tab If you would like your ECHO featured on this page, please email us at info@hepb.org. 

    https://www.hepb.org/resources-and-support/online-training/hepatitis-b-echo-hubs/
  • Hepatitis B Foundation president responds to Janssen decision on the company’s hepatitis B drug development program

    The Johnson & Johnson subsidiary is ending efforts produce a treatment for hepatitis B, a life-threatening infection that impacts 300 million people worldwide. Doylestown, Pa., Feb. 10, 2023 – Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH, today expressed frustration that Janssen has decided to shut down its program to develop a drug to treat hepatitis B, which is incurable and infects millions in the U.S. and globally. Industry publications have reported that J&J plans to walk away from its hepatitis B and D portfolio and pull out of the hepatitis B space. “This is, of course, disappointing news for us in the hepatitis B and D world,” Dr. Cohen said. “And this serves as a reminder to us, too. Companies operate at the whim of their leadership team and are not beholden to any specific cause. We have seen companies leave the field before, and will likely see this happen again in the future. This is why it is so important that the Hepatitis B Foundation and the Baruch S. Blumberg Institute are here. We remain steadfast to the cause of hepatitis B. We will always be here, and will be needed, to advocate for those living with hepatitis B, and raise our voices to prioritize hepatitis B, D and liver cancer.” Timothy M. Block, PhD, founding president of the Hepatitis B Foundation and its research arm, the Baruch S. Blumberg Institute, is a virologist who has been working in hepatitis B for more than three decades. “We entered 2023 with a robust and diverse pipeline of potential treatments for hepatitis B, but this news demonstrates the precarious nature of the pipeline,” Dr. Block said. “The pipeline is only as rich and diverse as marketplace forces and commercial interests permit. That’s why our work at the Hepatitis B Foundation and Blumberg Institute is so important; we do not waver from our primary, original mission, which is to find a cure for hepatitis B and support scientists worldwide who are also doing this critical research.” J&J’s lead drug candidate was RNA interference therapeutic JNJ-3989, which the company had been developing with Arrowhead Pharmaceuticals. The Foundation provides an online database of drugs in development for hepatitis B and D, called Drug Watch, which is consulted daily by thousands of people living with hepatitis B, care providers, health care professionals, scientists, pharmaceutical professionals, industry analysts, regulators and others. As the nation’s leading hepatitis B advocacy and research organization, the Hepatitis B Foundation is one of the most active proponents of improving hepatitis B screening, prevention and treatment of the disease. In the U.S., up to 2.4 million people are chronically infected and worldwide about 300 million people have the disease. 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. Each year up to 1 million people die from hepatitis B worldwide, even though it is preventable and treatable. 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 offices in Washington, D.C., and Philadelphia. 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. About the Baruch S. Blumberg Institute:  An independent, nonprofit research organization, the Blumberg Institute was launched in 2003 by the Hepatitis B Foundation to advance its research mission. Today, the Institute is one of the nation’s leading centers for translational research in hepatitis B and liver cancer. The Institute supports drug discovery, biomarker discovery and translational biotechnology around common research themes such as chronic hepatitis, liver disease and liver cancer in an environment conducive to interaction, collaboration and focus. The Blumberg Institute is located in the Pennsylvania Biotechnology Center, which it manages, near Doylestown, Pa. For more, go to www.blumberginstitute.org and follow us on Twitter @BlumbergInstit1.  

    https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-president-responds-to-janssen-decision-on-the-companys-hepatitis-b-drug-development-program/
  • Action Alert! Urge Members of Congress to Include Viral Hepatitis Funding in Programmatic Requests

    If you read Hepbtalk's blog last week summarizing the Viral Hepatitis Policy Summit, you know that it will take efforts from all advocacy organizations and people like YOU telling your story and asking that money be dedicated to viral hepatitis. Please get involved. We need YOUR help!   On February 13, 2012, President Obama kicked off the Fiscal Year 2013 appropriations process with the release of his budget proposal.  The President's FY2013 budget flat funds the Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis (DVH) at the total funding level of FY2012 – including the $10 million from the Prevention and Public Health Fund.  We need your help in raising awareness among Members of Congress about viral hepatitis and asking their support for increased funding for viral hepatitis activities at the federal level.  Viral hepatitis advocates are urging for protection of the President’s request and an increase to $59.8 million for DVH, which is $30.1 million more than the current funding level of $29.7 million. In the next 2-3 weeks, 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 FY2013. 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 $29.7 million in federal funding dedicated to fund viral hepatitis activities nationwide at the CDC.  Members of Congress need to know that viral hepatitis is a concern in their district, that their constituents are being

    http://www.hepb.org/blog/action-alert-urge-members-of-congress-to-include-viral-hepatitis-funding-in-programmatic-requests/
  • Hepatitis C Coinfection

    Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases worldwide. Because the two viruses share similar modes of transmission, co-infection with the two viruses is not uncommon, though the vast majority of those coinfected with HCV and HBV acquired these viruses through intravenous drug use, unscreened blood products, or exposure to dirty needles and unsterilized medical equipment The exact number of patients co-infected with HCV and HBV is unknown and may be underestimated because the hepatitis C virus can become the "dominant" liver virus, and reduces hepatitis B virus levels to be nearly undetectable. In patients with chronic hepatitis B, estimates of the rates of HCV co-infection vary from 9% to 30%. The primary concern with HBV/HCV co-infection is that it can lead to more severe liver disease and an increased risk for progression to liver cancer (HCC). Treatment of HBV/HCV coinfected patients can represent a challenge. AASLD recommends starting people with HBV/HCV coinfection, who meet the criteria for treatment of active HBV infection, on therapy at the same time or before starting direct acting antiviral (DAA) for HCV treatment. Patients with low or undetectable HBV DNA levels should be monitored at regular intervals during hepatitis C treatments. Those requiring treatment for HBV should be placed on therapy based on AASLD’s HBV treatment guidelines. Those with HCV who have resolved the HBV virus, whether spontaneously resolving the infection or following treatment, should be monitored for HBV reactivation while on DAA therapy. Visit HCVguidelines.org for additional information.  For more information on the treatment and management of a Hepatitis B/Hepatitis C coinfection, visit the Cleveland Clinic website at: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatitis-C/ 

    https://www.hepb.org/what-is-hepatitis-b/hepatitis-c-co-infection/
  • Hepatitis B Facts and Figures

    Hepatitis B is a global public health threat and the world’s most common serious liver infection. It is up to 100 times more infectious than the HIV/AIDS virus. It also is the primary cause of liver cancer (also known as hepatocellular carcinoma or HCC), which is the second-leading cause of cancer deaths in the world. Hepatitis B Around the World Two billion people have been infected with the hepatitis B virus (one out of three people). Approximately 1.5 million people become newly infected each year. Almost 300 million people are chronically infected. Approximately 10% of infected individuals are diagnosed. An estimated 820,000 people die each year from hepatitis B and related complications such as liver cancer.¹ Approximately two people die each minute from hepatitis B. Hepatitis B In the United States Up to 2.4 million people are chronically infected. Rates of acute hepatitis B infection have risen 50%-450% in states impacted by the opioid crisis. For many countries, chronic hepatitis B rates are higher in males than females and have declined over the past three decades, but no consistent pattern is seen between rates for U.S. immigrants and residents.  More than 50% of people living with chronic hepatitis B are of Asian, Pacific Islander or African descent. Hepatitis B and the resulting liver cancer are among the largest health disparities for these groups. The weighted average chronic hepatitis B prevalence for all foreign-born people in the U.S. in 2018 was about 3%. Around 59% of those U.S. residents with chronic hepatitis B in the U.S. in 2018 emigrated from Asia, 19% from the Americas and 15% from Africa. Only 25% of infected individuals are diagnosed. Thousands of people die each year from hepatitis B.   1. In 2019, there were approximately 820 000 [450 000–950 000] people who died from hepatitis B-related causes globally: Web Annex 1. Key data at a glance. In: Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. Geneva: World Health Organization; 2021. License: CC BY-NC-SA 3.0 IGO.  

    https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/facts-and-figures/
  • Visiting Your Doctor

    When you first visit your doctor, he/she will take your medical history and give you a physical exam. They will also take some blood for tests and perhaps order an ultrasound of the liver. To prepare for your doctor’s visit, take a list of questions (see below) with you bring copies of your previous blood test results invite a friend or family member along for support try to take notes while you talk to the doctor so that you have important information written down Questions to Ask Your Doctor What kind of hepatitis B infection do I have: a new "acute" infection, or a "chronic" infection? Could you please explain each hepatitis B blood test result, and any additional test results (ultrasound)? Please make copies of my test results for my own personal files. Where can I get my family, spouse or sexual partner tested and vaccinated for hepatitis B? What do I need to do to protect them until they are completely vaccinated? Am I a good candidate for treatment? If not, why not? If yes, please explain why and tell me about the treatment options? If I am not eligible for medical treatment, what do I need to do to monitor my hepatitis B?  Do I need to be regularly screened for liver cancer? If yes, how often?  Could you tell me about clinical trials? Do you offer any clinical trials for hepatitis B? If so, could you please explain them to me? For young women: If I want to have children, should I wait to start treatment? If I need to start treatment now, at one point can I consider having children? How will having hepatitis B affect my job or ability to work? How will having hepatitis B affect my health insurance or my ability to get health insurance? Here are the names of the medications that I currently take – are they safe for my liver? What over the counter medications or herbal supplements can I safely take for pain, cold symptoms, etc.? Should I be tested for other liver diseases, such as hepatitis C or D? Should I be vaccinated to protect myself against hepatitis A?  

    https://www.hepb.org/treatment-and-management/adults-with-hepatitis-b/visiting-your-doctor/