ACIP review of the hepatitis B birth dose vaccination remains a grave concern - Please read more here.

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  • Diagnosed With Hepatitis B? Symptoms? Learning the HBV Basics

    The tricky part about hepatitis B symptoms is that there are often no symptoms. That is why hepatitis B is referred to as a “silent infection”. This can be a little confusing to people newly diagnosed with HBV – whether it is determined you have an acute or chronic infection. If you have a new, acute infection, there is a good chance you will be one of the roughly 69% with no notable symptoms. You may feel a little under-the-weather or a little more tired then usual, or you may notice no difference at all. You may learn about your infection through blood work following a possible exposure, or following screening from a blood donation. Since 90% of adults infected with hepatitis B will clear the infection – most with no medical intervention, it is possible for you to be infected, clear the virus, and never even know until blood work shows evidence of a past infection. Then again you may be one of the roughly 30% who do have symptoms. You may experience flu-like symptoms such as achy muscles and joints, a low-grade fever and fatigue. Because your liver plays a role in digestion, you may experience a loss of appetite, feel a little nauseous, or experience pain in the upper right quadrant of your abdomen. You may have dark, tea colored urine. Then again, these symptoms may not be so severe that you take much notice. It’s okay, because these symptoms typically do not require treatment. However, if you are symptomatic, or you are concerned, please see your doctor, so blood tests can be run to be sure your liver is safe. Here are the important symptoms that you need to have checked-out immediately: jaundice, severe nausea and vomiting, and bloating or swelling of the abdomen. If you have any of these symptoms, you need to seek immediate medical attention. Your doctor will want to run blood work, which will likely need to be repeated while you are symptomatic and as you recover, to monitor your condition and be sure you are safe. At this time, your doctor will

    http://www.hepb.org/blog/diagnosed-with-hepatitis-b-symptoms-learning-the-hbv-basics/
  • Learn Which Cancer, Arthritis or Asthma Drugs Can Reactivate Hepatitis B – Even If You’ve Cleared the Infection

    Courtesy of Pixabay. By Christine Kukka Drugs that suppress your immune system in order to treat cancers, rheumatoid arthritis, psoriasis, COPD and asthma can cause a life-threatening reactivation of your hepatitis B. This dangerous viral rebound can occur if you are currently infected or even if you cleared the infection and now test negative for the hepatitis B surface antigen (HBsAg) and positive for the surface antibody (HBsAb). These drugs weaken the immune system, which allows your infection to rebound with a vengeance, spiking your viral load and causing life-threatening liver damage within weeks of starting chemotherapy or high-dose steroids. What's behind this reactivation risk? Think herpes or chicken pox (shingles). You might get rid of the infections and the ugly blisters, but small amounts of virus remain and as we age and our immune systems weaken, they can reappear. The hepatitis B virus (HBV) behaves similarly. When we lose HBsAg and/or develop surface antibodies, there are still small amounts of HBV lurking in our bodies. When we’re healthy, our immune systems effectively contain these trace amounts of virus, but old age, another serious medical condition or immune-suppressing drugs allow hepatitis B to reactivate. Today, medical guidelines require doctors to test everyone they plan to treat with any immune-suppressing drugs for the hepatitis B core antibody (HBcAb) so they know who has been infected with hepatitis B. If a patient tests positive, doctors must run more tests to determine what risk the new drug will pose. When a patient is at risk of reactivation, doctors will simultaneously treat them with antivirals (either tenofovir or entecavir) and continue antiviral treatment for six more months after the immune-suppressing therapy ends to prevent reactivation. U.S. CDC. This mandatory testing is important because some people don’t know they should tell their doctors about their past infection, and many don’t know they’re infected. Here

    http://www.hepb.org/blog/learn-cancer-arthritis-asthma-drugs-can-reactivate-hepatitis-b-even-youve-cleared-infection/
  • When Can Hepatitis B Patients Stop Taking Antivirals? Experts Finally Have Some Answers

    Image courtesy of foto76 at FreeDigitalPhotos.net By Christine Kukka With the help of antivirals, many patients today have undetectable viral load (HBV DNA), a relatively healthy liver and cleared the hepatitis B "e" antigen (HBeAg). So when can they consider stopping their daily entecavir or tenofovir pill? For years, experts have admitted the endgame of antiviral treatment has been “ill-defined.” While antivirals reduce viral load and the risk of liver damage, they rarely cure people. Recently, after years of observing patients and with the help of better diagnostic tools, experts are getting better at identifying when might be safe to stop. Historically, in addition to reducing viral load to undetectable levels, the goals of antiviral treatment were: Triggering HBeAg seroconversion: About 21 percent of HBeAg-positive patients with liver damage treated with either tenofovir or entecavir for 12 months are able to lose the hepatitis B “e” antigen (HBeAg) and develop the “e” antibody (HBeAb). This HBeAg “seroconversion” indicates the immune system is fighting the infection and slowing viral replication. And reducing liver damage and even clearing the hepatitis B surface antigen (HBsAg): About 1-3 percent of patients treated with antivirals lose HBsAg after years of treatment. This is called a "functional cure." Unfortunately, if you have HBeAg-negative hepatitis B, only 1-2 percent of you will lose HBsAg after five to eight years of antiviral treatment.* If you are among the lucky few who achieve HBeAg seroconversion or clear HBsAg, when is it safe to stop your daily antiviral? Here are the newest guidelines detailing when it may be safe to stop from the 2017 European Association for the Study of the Liver (EASL). Image courtesy of Taoty at FreeDigitalPhotos.net When is it safe to stop antivirals after you’ve achieved HBeAg seroconversion? Stop too early, and HBeAg can reappear. EASL recommend non-cirrhotic patients who experience HBeAg

    http://www.hepb.org/blog/can-hepatitis-b-patients-stop-taking-antivirals-experts-finally-answers/
  • Ten Things Women and Mothers Can Do to Combat Hepatitis B

    Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net. By Christine Kukka Don’t know your hepatitis B status? Get tested. Worldwide an estimated 90 percent of people with chronic hepatitis B don’t know they’re infected.  In the U.S. only 25% are aware of their infection. Unfortunately, many doctors won’t test you for hepatitis B unless you request the test. If you or your parents come from or live in a country with high rates of hepatitis B, or if you’ve been sexually active or have other risk factors , get tested. It could save your life. Get tested for sexually-transmitted infections (STIs). More than half of us will have an STI in our lifetime, and in the U.S. about half of new hepatitis B infections are sexually-transmitted. Many doctors don’t test for STIs. In a national survey of U.S. physicians, fewer than one-third routinely screened patients for STIs. To make matters worse, many women are afraid to talk to doctors about their sexual history and STI risk. Be brave, ask your doctor to test you for STIs and hepatitis B if you think you are at risk. Photo by Amanda Mills of CDC. Get immunized against hepatitis B. Not sure if you’ve been immunized during childhood? Tell your healthcare provider and get tested and immunized. Even if you were vaccinated in the past, getting a second vaccine series won’t harm you. If your partner has hepatitis B, getting vaccinated is critical to protect your health. Get tested first. Practice safe sex until you have received all three shots. About one to two months after your third shot, get tested for the hepatitis B surface antibody (called titers). If you have at least 10 mIU/mL of surface antibodies, you are permanently protected against this serious liver disease. Infected? In Love? Disclose. When you disclose your hepatitis B status before sex – even if it’s safe sex with a condom – you don’t jeopardize your partner’s health or his/her trust in you. Talking about hepatitis B helps

    http://www.hepb.org/blog/ten-things-women-mothers-can-combat-hepatitis-b/
  • Advocate Nadine Shiroma Champions Civil Rights for All Affected by Hepatitis B

    Nadine Shiroma and her grandchild. By Nadine Shiroma I am a retiree and volunteer working to address hepatitis B discrimination, which involves a serious, relatively unknown chronic disease that impacts Asian-American and Pacific Islander American (AAPIA) immigrants and refugees who are often isolated by culture and language, which makes this discrimination especially egregious. As a fifth-generation AAPIA, I’d heard of hepatitis B but was not aware that it leads to cirrhosis or liver cancer or that AAPIAs make up 50 percent of the country’s estimated 2 million hepatitis B cases, but represent less than 5 percent of the U.S. population. These facts came into sharp focus in 2010, when a college senior was devastated to learn she would not be permitted to enroll in a healthcare program due to her chronic hepatitis B. Nothing in the school’s admissions policy or information published by the profession’s national admissions coordinating agency had prepared the student for this. When the student informed me that an older friend with hepatitis B was completing a similar healthcare program at a different institution, I advised her to challenge her school’s exclusion policy. The issue raised many questions that called for research and consultation with hepatitis B specialists and community health and civil rights advocates to find out how and why schools were permitted to have such different hepatitis B policies. I also sought to compare various institutional policies with their respective state licensing laws for providers with hepatitis B. Fortunately, I was referred to an attorney who had an understanding of the disease who challenged the school’s exclusion policy. This led to the school’s implementation of a new, progressive policy for students with chronic hepatitis B. Though gratified with the outcome for this student, I feared other students with hepatitis B would face similar discrimination, because too many medical school policies barring enrollment

    http://www.hepb.org/blog/advocate-nadine-shiroma-champions-civil-rights-affected-hepatitis-b/
  • Eloi Verrier, PhD (HDR)

    CRCN InsermUniversity of Strasbourg Tenured researcher focusing on virus-host molecular interactions in the context of hepatitis B and D virus infections for the development of new therapeutic strategies. Read the journal picks of the month from our Emerging Scholars Scientific and Medical Advisory Board here.  

    https://www.hepb.org/news-and-events/reports/emerging-scholars-scientific-and-medical-advisors/eloi-verrier-phd-hdr/
  • Theobald's Story

    Theobald was not sure how to react when he received a diagnosis of hepatitis B. While trying to learn more about the disease, he found that there were no organizations focused on hepatitis B in his country. He decided to turn his diagnosis into action by creating the Hepatitis Foundation of Ghana to help others.  

    https://www.hepb.org/research-and-programs/patient-story-telling-project/theobalds-story/
  • Storytelling: The lived experience of having hepatitis B

    The Hepatitis B Foundation is dedicated to amplifying the voices of those living with hepatitis B and D and their caretakers. We have two storytelling projects: #justB and B the Voice, which allow real people to share their stories through recorded videos. The goal of both campaigns is to raise the profile of hepatitis B as an urgent health priority by putting a human face on this serious illness. We hope to increase advocacy and awareness, decrease stigma and discrimination, and promote testing, vaccination, linkage to care and life-saving treatment.  Please explore our stories here:  Learn more at HepBStories.org.  Want to learn more? Hepatitis B Patient Education Resources Getting Tested for Hepatitis B Understanding Risks of Hepatitis B Understanding Acute vs. Chronic Hepatitis BPreventing Hepatitis B Treatment of Hepatitis B Read more patient stories Additional Stories

    https://www.hepb.org/research-and-programs/patient-story-telling-project/
  • Protecting Your Baby Through Vaccination

    Infants born to people with hepatitis B must receive accurate doses of hepatitis B vaccine and hepatitis B immune globulin (if recommended and available) to ensure complete protection. In order to protect these infants, medications should be given immediately after birth in the delivery room or within the first 12-24 hours of life*.   * See Testing and Treatment During Pregnancy section for details. Please note that testing of all pregnant people for hepatitis B is a global recommendation.  Infants Born to Mothers Who Have Hepatitis B: Hepatitis B Vaccine Schedules *Please note that the first dose of the hepatitis B vaccine (birth dose) should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective. Protecting Your Baby Infants born to people who have hepatitis B must receive accurate doses of the hepatitis B vaccine and hepatitis B immune globulin (HBIG) at separate injection sites (opposite limbs) to ensure complete protection. In order to protect these infants, at least the hepatitis B vaccine birth dose should be given immediately after birth in the delivery room or within the first 12-24 hours of life. If recommended and available, HBIG should also be given at that time.   *U.S. CDC recommends both the hepatitis B vaccine and HBIG within 12 hours of birth to babies born to mothers that are HBsAg positive and within 24 hours for all other babies. WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies and does not recommend HBIG for babies born to mothers with hepatitis B. 3-Dose Vaccine Series for Infants (Including the "Birth Dose") The World Health Organization (WHO) recommends that infants born to people who have hepatitis B receive the first dose of the hepatitis B vaccine within 24 hours of birth. Ideally a dose of hepatitis B immunoglobulin (HBIG) is also given if recommended and available. These shots must be followed by the additional hepatitis B vaccine doses given on the recommended schedule. In the U.S., infants should follow a 1 month and 6-month schedule for the additional two doses.  4-Dose Combination Vaccine Series for Infants (Pentavalent or Hexavalent) Combination vaccines, such as the pentavalent and hexavalent vaccines, provide protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. Their hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine on the recommended schedule. Important Information about Vaccine and Hepatitis B Immunoglobulin (HBIG) Shot Administration Where recommended and available, the hepatitis B “birth dose” and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information. *Please Note: Although the U.S. CDC states that the medications can be given within the first 12 hours of life and the WHO states vaccine birth dose to be given within 24 hours, there is no second chance to protect an infant once this window of opportunity is missed. Therefore, the Hepatitis B Foundation strongly recommends that health care professionals administer these medications immediately in the delivery room to avoid any delays or mistakes. General Information About Vaccination Outside the U.S. In developing countries the pentavalent vaccine, a combination five-in-one vaccine that protects against five diseases, diphtheria, pertussis, tetanus, Hib and hepatitis B, may be given to babies more than 6 weeks of age, and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of GAVI, the vaccine alliance. Check the GAVI country hub to see the resources and immunizations that may be available: http://www.gavi.org/country/ For babies born to mothers who have hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from mother-to-child (vertical) transmission or from being infected during the first few weeks of life through accidental household exposure from close contacts who may unknowingly be infected (horizontal transmission). Babies born to a mother who has hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth. WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Individual countries may have their own recommendations or no recommendations at all. Plan ahead and inquire about the availability and cost of the monovalent (single), birth dose of the vaccine, as it is not a GAVI provided immunization. This is particularly important to pregnant people who have hepatitis B.   If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B. It is now recommended globally that all pregnant people get tested for hepatitis B! For babies NOT receiving the pentavalent vaccine, the first dose of the monovalent, hepatitis B vaccine must be given within 24 hours of birth, followed by the remaining 2-3 doses of the hepatitis B vaccine according to schedule. For babies receiving the pentavalent vaccine, the first, monovalent dose of the hepatitis B vaccine is given within 24 hours of birth, and the second and third doses of the hepatitis B vaccine will be included in dose 1 and dose 2 of the pentavalent vaccine. Making sure babies get the birth dose of the hepatitis B vaccine is critical to eliminating hepatitis B virus. The Center for Global Hepatitis Elimination published a review of strategies to improve implementation of hepatitis B vaccine birth dose worldwide, especially in limited-resource settings. This can be a useful resource to help organizations improve hepatitis B vaccine birth dose completion around the world. *WHO does not recommend the birth dose of HBIG, which may not be available in all countries. Talk to your doctor if you have questions. Page updated September 2020.    

    https://www.hepb.org/treatment-and-management/pregnancy-and-hbv/protecting-your-baby-through-vaccination/
  • Pregnancy and Hepatitis B

    Babies born to a mother with hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth. It is very important that pregnant people know their hepatitis B status in order to prevent passing the virus on to their newborn baby during delivery. If your doctor is aware that you have hepatitis B, he or she can ensure hep B transmission to your baby is prevented by taking the right steps based on blood tests results and to make arrangements to have the proper medications in the delivery room to prevent your baby from being infected.  ALL pregnant people should be tested for hepatitis B. Testing is especially important for people who fall into high-risk groups such as health care workers, people from ethnic communities or countries where hepatitis B is common, spouses or partners living with an infected person, etc. If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born, ideally as early as possible during the first trimester. If you test positive for hepatitis B infection, then your newborn must be given proper prevention immediately in the delivery room, clinic or bedside: first dose (called "birth dose") of the hepatitis B vaccine one dose of the Hepatitis B Immune Globulin (HBIG).* * Note: HBIG is recommended by U.S. CDC. HBIG is not recommended by WHO and may not be available in all countries. What is most important is to make sure the hepatitis B vaccine birth dose is given as soon as possible! If these two medications are given correctly, a newborn born to a person with hepatitis B has more than a 90% chance of being protected from a hepatitis B infection. You must make sure your baby receives the remaining shots of the vaccine series according to schedule to ensure complete protection. Although the U.S. CDC states that the medications can be given within the first 12 hours of life and the WHO states vaccine birth dose can be given within 24 hours, there is no second chance to protect an infant once this window of opportunity is missed. Therefore, the Hepatitis B Foundation strongly recommends that health care professionals properly administer the birth dose of the hepatitis B vaccine immediately in the delivery room to avoid any delays or mistakes. If you test positive for hepatitis B infection while pregnant, your doctor also should do a hepatitis B viral load blood test (HBV DNA) during your pregnancy. In some cases, the laboratory test results may show a very high viral load. In these cases, your physician may recommend that you take an oral antiviral drug in your third trimester to reduce the risk of infecting your newborn at birth. If the hepatitis B viral load test is not available, WHO recommends that pregnant women are tested for the hepatitis B e-antigen (HBeAg), and if positive, an antiviral is recommended during the last trimester. Regardless of viral load levels or HBeAg status, the hepatitis B vaccine birth dose and completion of the vaccine series is essential to protect your infant from infection with the hepatitis B virus.  Additional Resource Links:  U.S.: Centers for Disease Control and Prevention: Viral Hepatitis, Perinatal Transmission (2022) EU/EEA: Antenatal Screening for HIV, Hepatitis B, Syphilis and Rubella Susceptibility in the EU/EEA (2016) Globally: WHO Prevention of Mother-To-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy (2020) Page updated September 2020.  

    https://www.hepb.org/treatment-and-management/pregnancy-and-hbv/