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  • Why Postpartum Women Struggle with HBV Treatment Adherence and What We Can Do About It

                      Hepatitis B remains a global health challenge.. There are strategies to prevent perinatal (mother to child) transmission of hepatitis B. Prevention includes testing all pregnant persons for the marker of hepatitis B infection (HBsAg), if the pregnant person is positive, then assessment is needed throughout pregnancy. If the pregnant person's viral load becomes high, antiviral treatment (TDF) might be recommended during the second trimester taken throughout pregnancy. Data shows this is safe and effective, and reducing the viral load can reduce the risk of transmission.   Additionally, making sure that all infants get hepatitis B birth dose as soon as possible after delivery, ideally within the first 24 hours of birth followed by at least two subsequent doses of hepatitis B vaccine (usually part of global childhood immunization series ex: the pentavalent vaccination). However, for many individuals, adhering to these guidelines in many parts of the world can be a challenge. Recent research sheds light on the barriers and opportunities to improve treatment adherence during this important period. Treatment adherence means taking your medicine the right way, at the right time, in the right amount, and for as long as your doctor tells you. It’s about sticking to your treatment plan to maintain your health.   The postpartum drop-off: a hidden risk  A study published in the Journal of the Pediatric Infectious Diseases Society explored adherence to tenofovir disoproxil fumarate (TDF), a medication used to treat HBV, among pregnant individuals. While adherence during pregnancy was relatively high, many women discontinued treatment postpartum. A mix of factors contributed to the drop in HBV treatment adherence following delivery including:   Lack of follow-up care after delivery  Low awareness about health risks that may come from stopping medication  Limited knowledge about the long-term benefits

    https://www.hepb.org/blog/postpartum-women-struggle-hbv-treatment-adherence-can/
  • Nurses need to help wipe out chronic hepatitis B, a disease borne by 300 million people

                    Nurses such as you and me – yes, that means all nurses (and our welcomed health care counterparts) – likely come across a patient or parent who declines vaccinations for themselves or their children. And it is not uncommon for nurses to be first in line to receive the unfavorable statements refusing these life-sustaining vaccines.  While every nurse may provide vaccine education at some point in a patient's life, those in neonatal and maternal-newborn nursing have a greater responsibility with the hepatitis B vaccine. It is for good reason the hep B vaccine is the first immunization given to newborns within 24 hours of birth, followed by a second dose at 1 months, and the third at 6 months. However, communicating those reasons to parents of our newborn patients takes a compassionate, strong and skillful approach. Especially when we are faced with resistance and the unyielding declinations for the hepatitis B vaccine.   There are various clinical settings and times when nurses can educate new parents and those with children about how the hepatitis B vaccine works and why it is necessary. We have numerous opportunities to identify misconceptions, fears and inaccurate information a parent might have regarding the vaccine. When addressing the highly recommended CDC’s vaccine schedule with parents, the rule of thumb is letting them know to expect their child will get the hep B vaccine series starting at birth. It is typically at this time when pushback from the parents begins to emerge. First and foremost, determining the “why” in what is making the parent hesitant about or declining the hep B vaccine is vital when trying to help them understand the reason vaccination is strongly advised.  Resistance to hep B vaccination typically relates to not understanding the risks of contracting the virus, a perceived low risk of exposure or safety of the vaccine. Educating parents about complications that

    http://www.hepb.org/blog/nurses-need-help-wipe-chronic-hepatitis-b-disease-borne-300-million-people/
  • Hep Matters Vignettes: Waiting for a Cure.

                    Hep Matters: Brief vignettes focused on promoting awareness of hepatitis B and liver cancer through fictional narratives inspired by real events and experiences     The Scenario          Amina was born and raised in Kandahar, Afghanistan. At the age of 17, she moved to the United States with her family. During a routine check-up with her primary care doctor, Amina discovered that she had hepatitis B. She had never heard of the disease and explained that she always takes care of herself. The doctor told her that hepatitis B is a virus that damages the liver, and anyone can get it unless they are vaccinated to protect against it. Amina recalled that she never received any vaccinations for hepatitis B. Her family members were also unaware of how hepatitis B gets transmitted.      Amina asked her doctor how she could get rid of this virus. Her doctor explained to her that there is no cure for hepatitis B, but antiviral treatment options do exist. While she may not be able to completely get rid of the virus, she can help protect herself from serious conditions such as hep B related cirrhosis or liver cancer with treatment. Amina’s doctor encouraged her to get treatment to prevent any serious problems from occurring. He also mentioned that treatment for hepatitis B is safe and effective. This did not make any sense to Amina. She thought to herself that if a treatment wouldn’t cure her of the disease, then there is no point in taking it. She felt healthy and did not show any symptoms. After the doctor suggested treatment options, she said that she will wait for the cure.     After moving to the U.S., Amina had gotten busy with school and work and did not follow up with her primary care doctor for years. Amina experienced stomach pains from time to time but they often went away on their own. On one occasion, her stomach pain worsened. She had to take a few days off

    http://www.hepb.org/blog/hep-matters-vignettes-waiting-cure/
  • Partner Highlight: Philadelphia Department of Public Health’s Viral Hepatitis Program Makes Great Strides Towards Elimination!

                  Happy Hepatitis Awareness Month! Continue reading to get to know the Viral Hepatitis Program at the Philadelphia Department of Public Health (PDPH)!   The Viral Hepatitis Program at PDPH strives to support Philadelphia residents and service providers in several ways, including preventing viral hepatitis infection through education, screening, and vaccination; improving and providing access to affordable treatment; and supporting provider efforts to provide comprehensive viral hepatitis care/treatment. There are many tools that exist to prevent and treat viral hepatitis infections, and even cure them in the case of hepatitis C. Access to these services, however, is not readily available for everyone. The Viral Hepatitis Program aims to increase access and reduce inequities in care through collaborations and programming, in hopes of achieving the 2030 goal of hepatitis B and hepatitis C elimination.   The Viral Hepatitis Program performs a number of exciting projects to achieve this work!        Patient Engagement  Many members of the Viral Hepatitis Program spend their days interacting with patients over the phone. Public health surveillance allows the program to work with hepatitis B and hepatitis C patients to provide individualized support. This outreach provides patients with viral hepatitis education, linkage-to-care, and care navigation along with access to harm reduction materials, support for substance use disorder care, and additional resources.            Above: Viral Hepatitis team member, Cassandra Lamadieu, provides viral hepatitis educational materials to community members in attendance at the 2023 Philadelphia Block Captain Rally.    Philly InSync: Provider Engagement   Through collaborations within PDPH and with a partner organization, the Philly InSync Project provides education and technical assistance to healthcare providers and facilities to

    http://www.hepb.org/blog/partner-highlight-philadelphia-department-public-healths-viral-hepatitis-program-makes-great-strides-towards-elimination/
  • Hepatitis B and Injection Drug Use: Risks, Barriers to Care, and Prevention Strategies

                      Hepatitis B is a liver infection which is caused by the hepatitis B Virus (HBV). Hepatitis B is transmitted from person to person through blood, semen, or other bodily fluids. You can learn more about the ways hepatitis B is spread here. People who inject drugs (PWID) are at high risk for contracting the virus due to the sharing of needles and low  awareness and education about hepatitis B. HBV Prevalence among PWID Communities People who inject drugs (PWID) are at high risk for hepatitis B virus infection due to various factors, including sharing injection equipment and lack of awareness about hepatitis B transmission. Using unclean needles to inject drugs can result in the exchange of blood. This increases a person’s risk of being exposed to the virus. Hepatitis B prevalence among PWID is much higher than in the general population. Chronic HBV infection has been identified in 3.5% to 20.0% of PWID in a variety of settings, and 22.6% of PWID have evidence of past infection (Haber & Schillie, 2021). Drug injection is the most common risk for persons ages 18-40 years old with hepatitis B virus.  Barriers to Care for PWID Communities Access to treatment can be a significant barrier for PWID, who may face stigma and discrimination in healthcare settings. To find out if someone has hepatitis B it is recommended that a triple panel hepatitis B test be run (which includes HBsAg, HBcAb and HBsAb). These tests will help identify people with hepatitis B, a previous exposure to hepatitis B and those who have protection against hepatitis B infection (through vaccination). For those with hepatitis B, treatment options for hepatitis B consist of antiviral medications that can help to control the virus and reduce the risk of serious liver damage, cirrhosis, and liver cancer. Treatment is taken daily for life generally. PWID lack access to these treatments due to the stigma attached with substance use and

    http://www.hepb.org/blog/hepatitis-b-injection-drug-use-risks-barriers-care-prevention-strategies/
  • Will herbals, natural “remedies”, Ayurveda or Traditional Chinese Medicine, supplements, or vitamins and minerals control hepatitis B?

    We get many people living with chronic hepatitis B asking about various herbals and supplements. The Hepatitis B Foundation does not recommend using these, as they are not FDA approved. Health authorities in different countries also don’t vet the content of such herbs or supplements. This is because they are not tested or regulated for effectiveness, safety, and purity. This lack of regulation means that you do not know what you are getting from dose to dose. The lack of testing means that taking some of these could do more harm to your liver than good. At best, these “might” be supportive of the liver, but they will not change the course of the virus and the damage to the liver that the virus may be doing. Keep in mind that not everyone needs treatment, but if you do, please talk to a knowledgeable doctor about getting first line antivirals (tenofovir (TDF), tenofovir (TAF) or entecavir) to control and suppress the hepatitis B virus. We know many are often “prescribed” a potentially supportive vitamin complex. Unless you have a vitamin deficiency, you may benefit equally as well by focusing on eating a healthy, well-balanced diet. Here is more information on how to maintain a healthy liver. There are many people out there trying to sell you a “cure”, but we can assure you that at this time, chronic hepatitis B is not a curable disease. If it sounds too good to be true, it is not true. if this is your first time being diagnosed with hepatitis B, discuss with your doctor whether this is an acute or chronic infection. If this is an acute infection, it is likely that you will resolve the infection without the need for medication or supplements.  Find more Frequently Asked Questions here.  Page updated 02/09/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/will-herbals-natural-remedies-ayurveda-or-traditional-chinese-medicine-supplements-or-vitamins-and-minerals-control-hepatitis-b/
  • CDC awards a $1.375 million, five-year grant to the Hepatitis B Foundation for expansion of Hep B United, a nationwide coalition

    Hep B United operates in 23 states, 30 cities and Washington, D.C. Aug. 13, 2021 – The U.S. Centers for Disease Control and Prevention has awarded a $1.375 million, five-year grant to the Hepatitis B Foundation to continue leading and expanding Hep B United, a nationwide coalition that operates in collaboration with the Association of Asian Pacific Community Health Organizations (AAPCHO). Hep B United is dedicated to reducing the health disparities associated with hepatitis B. With the new funding, the Foundation and AAPCHO will build the capacity of community coalitions to increase hepatitis B education and testing and improve linkage to care in a culturally and linguistically responsive manner for communities disparately impacted, including Asian Americans, Native Hawaiians and Pacific Islanders, African Immigrants and persons who inject drugs. Hep B United is composed of 50 national organizations and local community coalitions in 22 states, 30 cities and Washington, D.C. It promotes cross-sector partnerships between community organizations, health departments and Federally Qualified Health Centers, and has been building the capacity of multi-sectoral community coalitions to address hepatitis B in a nationally coordinated manner. Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation and co-chair of Hep B United, said the CDC’s new grant validates the work that’s being done by the Foundation’s staff, the AAPCHO team and others who are part of Hep B United across the country. “We appreciate the CDC’s continued support and commitment to eliminating hepatitis B and improving testing and linkage to care in highly impacted communities in the U.S.,” Dr. Cohen said. “The hundreds of partners who help to deliver hepatitis B-focused programs and initiatives clearly have benefited communities across the country and it’s gratifying that the CDC has recognized the successes of Hep B United over the past eight years.” Through a health equity lens, the Hepatitis B Foundation will build and strengthen the HBU network and offer capacity building, training, technical assistance and networking. The project also includes continued partnership in the development and dissemination of the Know Hepatitis B campaign, a national multi-lingual campaign led by CDC and co-branded with Hep B United. Jeffrey Caballero, MPH, co-chair and co-founder of Hep B United and executive director of the Association of Asian Pacific Community Health Organizations (AAPCHO), noted that the new grant will permit Hep B United to expand its work with African immigrant and Pacific Islander communities, along with minority-serving Federally Qualified Health Centers (FQHCs). “We are excited about the opportunity to increase our capacity to reach underserved populations nationwide while continuing to work alongside the community and our partners since we started in 2012,” Caballero said. “One of our key new initiatives will be growing a Hepatitis B Community Health Center Learning Collaborative to foster partnerships with a new cohort of FQHCs to implement hepatitis B education, screening and linkage to care programs.” The Foundation’s program strategies will include monthly coalition calls and webinars; mini-grants to support hepatitis awareness, education, testing and linkage to care; peer mentoring to foster the development of local and/or state hepatitis community coalitions and address specific capacity building needs; and the Hepatitis B Public Health Education Program, which utilizes the ECHO tele-education platform to train health educators and community leaders in an effort to improve hepatitis prevention and control strategies. Since 2012, Hep B United has awarded 28 mini-grants totaling $411,000 to partners in 17 states. The CDC grant also will support maintaining the Hep B United Community Coalition Leadership Development Program to focus on improving the capacity of individual local community leaders to lead and grow community-based hepatitis coalitions; and expanding the Hep B United Pacific Islander Community and Harm Reduction Strategy Workgroups to address the high rates of chronic hepatitis B among Pacific Islander communities and people who inject drugs, respectively. Hep B United’s National Advisory Committee members are:  Oakland, Calif., Jeffrey Caballero, MPH, co-chair and co-founder, executive director, Association of Asian Pacific Community Health Organizations (AAPCHO). Doylestown, Pa., Chari Cohen, DrPH, MPH, co-chair, senior V.P., Hepatitis B Foundation. Honolulu, Hawaii, Thaddeus Pham, co-director, Hep Free Hawaii, and viral hepatitis prevention coordinator, Hawaii Department of Health. Northern Virginia, Amy Trang, PhD, MEd, administrator, National Task Force on Hepatitis B: Focus on Asian & Pacific Islander Americans; founder and CEO, Social Capital Solutions Inc. Berkeley, Calif., Carol Brosgart, MD, consultant, Biotechnology, Public Health and Public Policy. Doylestown, Pa., Joan M. Block, RN, BSN, co-founder/co-chair emeritus and senior advisor. There is information about our local partners here on the Foundation website, including a list of partners and links to their websites. For more information, please send a note to info@hepb.org.

    https://www.hepb.org/news-and-events/news-2/cdc-awards-a-1-375-million-five-year-grant-to-the-hepatitis-b-foundation-for-expansion-of-hep-b-united-a-nationwide-coalition/
  • Hepatitis B Foundation Joins Forces with Grace Meng and NYC Hep B Coalition to Promote Awareness in Asian American Community

    Meng Lauded for Leadership in Hep B Cure Campaign FLUSHING, NY (May 2, 2018) – The Hepatitis B Foundation (HBF) and the New York City Hep B Coalition, founded by the New York City Department of Health and Mental Hygiene, co-sponsored a community forum on “Eliminating Hepatitis B in New York City,” at the Flushing Branch of the Queens Library in Flushing, NY. U.S. Representative Grace Meng (D-6th CD, Queens), the keynote speaker, stated that “hepatitis B is a major health issue that disproportionately impacts Asian Americans and Pacific Islanders (AAPI).” Meng added that “the virus can lead to cirrhosis, liver failure, or liver cancer if left untreated. That is why it’s critical for AAPI communities to become more aware of hepatitis B, and the importance of getting tested. I hope that this forum will help accomplish that goal, and I encourage my constituents to attend.” Ms. Meng, who co-chairs the Congressional Hepatitis Caucus, pointed out that her congressional district is 42% Asian American and in Flushing, Asian Americans make up 67% (48,500) of her constituents. “I am deeply concerned that most people living with chronic hepatitis B are not aware that they have this life-threatening infection, and most of those who have been diagnosed are not being treated” said Meng. “I hope that this forum will help get the word out and begin to turn that around and I believe this can be achieved with the excellent healthcare resources we have at the Charles B. Wang Community Health Centers and many other health professionals, and with citywide and community-based members of the NYC Hep B coalition committed to eliminating hepatitis B.” Dr. Ann Winters, Medical Director of the Viral Hepatitis Program at New York City’s Department of Health and Mental Hygiene said that the department is working to ensure that all New Yorkers at risk are screened for hepatitis B, including the uninsured.“We urge providers to screen patients from countries with high prevalence for hepatitis,” said Winters. “Patients diagnosed with chronic hepatitis B should have a complete medical evaluation including an evaluation for fibrosis, should receive antiviral treatment if indicated, and should be screened for hepatocellular carcinoma according to guidelines. There are many programs in NYC that provide affordable care for the uninsured.” The Hepatitis B Foundation’s (HBF) vice president for public policy, Alan P. Brownstein, supported Meng’s call for hepatitis B awareness, and pointed out “there is still no cure for hepatitis B.” He praised “Congresswoman Meng’s congressional leadership in the nationwide Hep B Cure Campaign.”Brownstein presented HBF’s Hep B Cure Campaign, which features a “Roadmap for a Cure” based on priority research recommendations of top scientists convened by HBF. Brownstein said “Congresswoman Meng helped launch the Hep B Cure Campaign at a congressional briefing in Washington, D.C. last May. And in just one year, we were able to achieve: • Congressional support for funding hepatitis B cure research;• Support from the National Institutes of Health (NIH) for hepatitis B cure research; and,• Publication of two scientific papers in prestigious medical journals on HBF’s ‘Roadmap for a Cure.” Brownstein cautioned that ”this is just the beginning and we have defined what more needs to be done to accomplish our goal” concluding that “a cure for hepatitis B is a ‘winnable battle’ that will be accomplished with sustained science-driven advocacy.” The cornerstone of the Hep B Cure Campaign is a consensus “Roadmap for a Cure” that is contained in reports developed by the Hepatitis B Foundation (HBF), which convened a virtual workshop of 35 of the world’s leading scientists to determine what research is needed to find a cure for hepatitis B. The two reports, “Research Priorities for the Discovery of a Cure for Chronic Hepatitis B: Report of a Workshop”(Antiviral Research, 2018)” and “A Research Agenda for Curing Chronic Hepatitis B Virus Infection,” (Hepatology, 2018) identify specific research projects in virology, immunology, and liver cancer, as well as strategies for expanding clinical research for therapeutic drug testing. Despite the magnitude of hepatitis B, NIH funding for hepatitis B is only $49 million per year and has declined almost 16% since 2012. By applying the scientific projects identified into existing NIH research funding mechanisms, a “professional judgment budget” was developed, documenting the need for an estimated additional $39 million a year for six years over current NIH research funding for hepatitis B and liver cancer to fund the priority projects identified by HBF. The Hepatitis B Forum in Flushing was opened by Chari Cohen, DrPH, MPH, HBF’s vice president for public health, who cited statistics about chronic hepatitis B affecting 2 million Americans and 292 million worldwide, leading to nearly 800,000 deaths each year, primarily from liver cancer—the second leading cause of cancer deaths worldwide. She also cited the recent reports from the World Health Organization (WHO, 2016) and the U.S. National Academies of Sciences, Engineering, and Medicine (NASEM, 2017) declaring that with appropriate action, the elimination of hepatitis B is now possible. “Increased awareness and advocacy for a cure are necessary if we hope to eliminate hepatitis B,” said Dr. Cohen. ### About the Hepatitis B Foundation: The Hepatitis B Foundation is the leading national 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. To learn more, visit Web site - www.hepb.org; blog - hepb.org/blog; Twitter - @HepBFoundation; Facebook - facebook.com/hepbfoundation; or call, 215-489-4900. About the NYC Hep B Coalition: The NYC HEP B Coalition coordinates efforts to prevent, manage and reduce hepatitis B among all residents of New York City. The coalition seeks to foster an inclusive collaboration among all stakeholders to advance hepatitis B awareness, screening, access to care, and vaccination through education, outreach, advocacy and support of research.

    https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-joins-forces-with-grace-meng-and-nyc-hep-b-coalition-to-promote-awareness-in-asian-american-community/
  • Treatment Options for Hepatitis B

    People living with chronic hepatitis B infection should expect to live a long and healthy life. There are decisions people can make to protect their livers such as seeing a liver specialist or health care provider regularly, avoiding alcohol and tobacco, and eating healthy foods. There are also approved drugs for both adults and children that control the hepatitis B virus, which helps reduce the risk of developing more serious liver disease, but there is still no complete cure. Current treatments for hepatitis B fall into two general categories:   Immune modulator Drugs – These are interferon-type drugs that boost the immune system to help get rid of the hepatitis B virus. They are given as a shot (similar to how insulin is given to people with diabetes) over 6 months to 1 year. Antiviral Drugs – These are drugs that stop or slow down the hepatitis B virus from reproducing, which reduces the inflammation and damage of your liver. These are taken as a pill once a day for at least 1 year and usually longer. It is important to know that not everyone with chronic hepatitis B infection needs to be treated. This can be difficult to accept when first diagnosed because taking a drug to get rid of the virus seems like the first step to getting better. Current treatments, however, are generally found to be most effective in those who show signs of active liver disease (e.g. through a physical exam, blood tests and imaging studies such as an ultrasound). So talk to your health care provider about whether you are a good candidate for any of the approved drugs. In addition, ask your provider if they participate in any clinical trials that are testing several new hepatitis B drugs. Learn more about Hepatitis B Clinical Trials. Whether you start treatment or not, it is very important to be regularly seen by a liver specialist or a health care provider who is knowledgeable about hepatitis B. The standard recommendation is every 6 months, but some people may be checked more often or even just once a year. During these check-up visits, your provider will monitor your health through a physical exam, blood tests and imaging studies (such as an ultrasound, FibroScan [Transient Elastography] or CT scan). The goal of these check-ups is to make sure that you are staying healthy and to detect any liver problems as early as possible.   Hepatitis B Drug Watch The Hepatitis B Foundation created the HBF Drug Watch to keep track of approved and promising new treatments. In 1991, “interferon alpha” was the first drug approved for hepatitis B and given as a series of injections over 1 year. In 1998, “lamivudine” was approved as the first oral antiviral drug taken once a day.   There are now 7 approved drugs for hepatitis B in the United States -- 2 types of injectable interferons and 5 oral antivirals – that control the hepatitis B virus. A cure, however, may be in the near future because there is exciting research being done today to generate promising new drugs. These new drugs all work differently than the approved treatments, so a possible cure could include a combination of the old and new drugs. Several of the new drugs are already being tested in people. Learn more about HBV Clinical Trials. Visit the HBF Drug Watch for a complete list of the approved treatments for hepatitis B and promising new drugs in development.

    https://www.hepb.org/treatment-and-management/treatment/
  • Adoption

    The key to successful adoption of a child with hepatitis B is to be prepared with accurate information about the disease, and to protect yourself and other members of your household with the hepatitis B vaccine prior to the child's arrival. International and Domestic Adoption Many people wish to adopt children from countries where hepatitis B infections are common: Asia, South America, Eastern Europe, and some parts of Africa. Children from these regions are often infected with the virus from their birth mothers who have hepatitis B and unknowingly pass the disease on to their children during delivery. In addition, many of these countries re-use needles for medications or blood tests, a practice that places children at risk if they have not already been infected at birth. Domestic adoptions also present some risk to potential adoptive families. Children born to women in high-risk groups (e.g. illicit drug users, multiple sexual partners, etc.) could have been infected with hepatitis B at birth. In addition, children from group homes are at increased risk for hepatitis B infection. Hepatitis B Testing Your agency should be able to tell you if a child has been tested for hepatitis B. With an international adoption, it is advised that you do not request that your child be tested since the blood test itself could be a source of infection. If you are concerned about the results of these tests, please contact us to speak with our knowledgeable staff. We can also refer you to a parent who has adopted a child with hepatitis B. Reassurance for Adoptive Parents Finding out that the child you wish to adopt has chronic hepatitis B can be upsetting, but should not be cause for alarm or stopping an adoption. We hope that a hepatitis B diagnosis will not change your decision to adopt a child. You can be reassured that most children will enjoy a long and healthy life. Hepatitis B does not usually affect a child's normal growth and development, and there are generally no physical disabilities or restrictions associated with this diagnosis.

    https://www.hepb.org/treatment-and-management/children-with-hepatitis-b/adoption/