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  • How to Find a Liver Specialist Who Really Knows Hepatitis B

    Image courtesy of stockimages at FreeDigitalPhotos.net By Christine Kukka If you have chronic hepatitis B or are newly-diagnosed, it’s important to see a liver specialist who has experience with hepatitis B. Having a specialist with hepatitis B expertise on your team not only safeguards your health, it also lessens the stress of having a chronic liver disease. "My specialist gave me all the possible scenarios, but most importantly, he gave me my life back," one hepatitis B patient recalled. When first diagnosed, it’s often a primary health provider (PCP) or for children a pediatrician who gets the test results and calls to break the news. Doctors may run additional blood tests and/or immediately refer you to a liver specialist. They may recommend a specialist who accepts your insurance or practices in the same healthcare system, but you may have to do some research to find the best specialist to treat your hepatitis B. There are two types of specialists who treat liver diseases: A gastroenterologist is an internist who has trained in digestive disorders including the liver, but how much liver expertise a gastroenterologist (GI doctor) has varies based on their training. It’s important to find out if they specialize in liver diseases. A hepatologist is a physician who specializes in the liver. This doctor has the most expertise and should be up-to-date about new treatments and clinical trials. But not all hepatologists have treated hepatitis B. Many will have treated hepatitis C, but not hepatitis B, so you need to ask. Tips for finding a specialist: Are they in the Hepatitis B Foundation directory? The foundation has a Physician Directory of liver specialists who treat hepatitis B around the world. These doctors have voluntarily signed up  for the database. It is not an exhaustive list, there may be hepatitis B specialists in your area who have not yet joined the directory. Call the practice ahead of time and ask questions. How many hepatitis B patients

    http://www.hepb.org/blog/find-liver-specialist-knows-hepatitis-b/
  • Iron Overload Affects More Than the Irish, People with Hepatitis B-Related Liver Damage Need to Be Tested

    Image courtesy of zole4 at FreeDigitalPhotos.net. By Christine Kukka Iron is crucial to our health, but too much iron – called iron overload – can put us at risk of liver damage and other health problems, especially if we have hepatitis B-related liver disease and/or we’re Irish. Irish and hepatitis B are not normally two words you hear in the same sentence, but both populations may need to be careful about how much iron they eat. A liver inflamed or damaged by a chronic hepatitis B infection or other causes doesn’t process or store liver effectively and the excess iron accelerates liver damage and causes a host of other medical problems. If you’re Irish or of northern European ancestry, one in eight of you have a genetic predisposition for hereditary hemochromatosis (HH) – commonly called the Celtic Curse -- that occurs when the body doesn’t process or store iron properly, leading to a four-fold increase in iron absorption. If you’re Irish and have chronic hepatitis B, you may want to celebrate St. Patrick’s Day with a trip to your doctor for a simple blood test for ferritin (iron) and transferrin saturation. If they’re elevated, your doctor may order a gene test to see if you have HH. The relationship between iron overload and hepatitis B has been problematic, or as researchers like to say, “not well defined.” Our liver is the body’s major storage organ for iron. About one-third of the iron we consume is stored in liver cells, which play a major role in recycling iron and synthesizing transferrin (the main transporting protein) and ferritin (the major storage protein) from iron. Image courtesy of Stuart Miles at FreeDigitalPhotos.net. When our livers are damaged or inflamed from hepatitis B, the Celtic Curse, fatty liver or alcohol, they don’t synthesize iron well, leading to excessive iron deposits in the liver which leads to more liver damage, including inflammation, fibrosis and even liver cancer.  In some hepatitis C patients,

    http://www.hepb.org/blog/iron-overload-affects-irish-people-hepatitis-b-related-liver-damage-need-tested/
  • Doctors Get a New Tool to Improve Hepatitis B Treatment and Monitoring

    Photo courtesy of CDC. By Christine Kukka A recently-approved test now allows doctors to measure exactly how much hepatitis B surface antigen (HBsAg) people with chronic hepatitis B have in their blood; so why should patients get this test and how will it help the millions of people around the world infected with hepatitis B? According to experts, including the Hepatitis B Foundation’s Medical Director Robert Gish, knowing a patient’s HBsAg levels gives doctors: A better understanding of what stage of hepatitis B a patient is in; A more accurate assessment of a patient’s liver cancer risk; and Essential information to judge if it’s time to start or stop treatment. And in the future, this test may be critical to finding a cure. Don’t labs already test for HBsAg? HBsAg, the protein that makes up the surface of the virus, is what labs look for in a blood sample to determine if a person is currently infected with hepatitis B. Historically, labs determined only if HBsAg was present or not, which is why patients either tested positive or negative for HBsAg. Recently, countries outside the U.S. began measuring HBsAg quantities in blood samples and late last year became available in the U.S. as a federally-approved (CLIA) lab test from Quest Diagnostics. Hepatitis B Foundation President Timothy Block “The strange thing about HBsAg, is that each hepatitis B virus requires only about 100 HBsAg molecules to provide its envelope protein, but the virus produces about 100- to 1 million-times more HBsAg than is needed, leaving millions of HBsAg circulating in the bloodstream,” explained Timothy Block, president of the Hepatitis B Foundation and the Baruch S. Blumberg Institute, the foundation’s research arm. That over-abundance of HBsAg is why people continue to test positive for HBsAg even if they have an undetectable viral load (HBV DNA). Why is there so much HBsAg? Researchers, including Block, suspect that in addition to covering the virus’ surface,

    http://www.hepb.org/blog/doctors-get-new-tool-improve-hepatitis-b-treatment-monitoring/
  • Ten Things You Should Know About Hepatitis B and Do in 2017

    Image courtesy of krishna arts at FreeDigitalPhotos.net By Christine Kukka It's 2017, and experts around the world continue to study the complex life cycle of the hepatitis B virus in order to find a chink in its armor that will lead to a cure. In 2016, there were successes and disappointments in the research and healthcare arena. Here is what you need to know about hepatitis B in 2017. If you're taking tenofovir, ask your doctor about TAF if you’re experiencing kidney problems or bone loss, especially if you're an older woman. If you’re taking the antiviral tenofovir (Viread) long-term, ask your doctor about replacing it with TAF (Vemlidy). TAF is a reformulated version of tenofovir that delivers the antiviral more effectively to liver cells at a lower dose.  Currently, doctors prescribe either tenofovir or entecavir for liver damage. Entecavir does not cause bone loss, but it doesn't work in people who have developed drug resistance to lamivudine or adefovir. For them, tenofovir is the only option, but it can cause bone loss and kidney problems when used long-term. With the U.S. Food and Drug's recent approval of TAF, consumers can now get tenofovir’s robust antiviral activity at a lower dose. Because it’s brand new, your provider may not know about it, so ask about it to see if it would be better for you. Was medical or recreational marijuana just approved in your state? Exercise caution. Many in the hepatitis C community have used medically-prescribed marijuana to ease side effects from interferon for years, so many assume it's also safe for people with hepatitis B. Unfortunately, there are no studies that conclusively prove its safety. One study  that monitored liver fibrosis in 700 people coinfected with HIV and hepatitis C found, “…no evidence for an association between cannabis (marijuana) smoking and significant liver fibrosis progression in HIV/HCV coinfection." But another study  concluded: “Cell culture and animal model studies support

    http://www.hepb.org/blog/ten-things-know-hepatitis-b-2017/
  • Got Hep B and Worried About the Trump Effect on Your Obamacare? Experts Say No Changes Expected Before 2018

    Image courtesy of num_skyman at FreeDigitalPhotos.net. By Christine Kukka It is time to sign up, re-enroll or change your health insurance plan in the Affordable Care Act’s Health Insurance Marketplace, also known as Obamacare. Millions of Americans – many of them with pre-existing medical conditions such as hepatitis B -- get their much-needed health insurance through this plan. But President-elect Donald Trump has promised to repeal the Affordable Care Act (ACA), which funds the program, and now Republicans will have control of the House and Senate. What should we, who require health insurance to cover our doctor visits, lab tests and costly antiviral treatment to keep our livers healthy, do? Should we sign up for 2017? YES, experts say emphatically. Even if Congress passes legislation to repeal parts of the ACA and Trump signs it into law, these changes are unlikely to go into effect before 2019 because Congress will need time to design a replacement plan and the IRS will need time to create a new tax system to go along with whatever replaces the ACA. So for 2017, if you still need health insurance coverage and the subsidies including premium subsidies and cost-sharing subsidies, they will still available. They will probably change starting in 2018, but for 2017 you can still sign up and receive coverage now. To date, healthcare policy experts predict Republicans will not repeal the program because of the huge number of Americans that use it. And what remains popular about the program is that it requires insurers to take all applicants regardless of their medical condition, which is vital for us with chronic hepatitis B. Image courtesy of graur razvan ionut at FreeDigitalPhotos.net. Right now, the marketplace can only ask our age and whether we smoke when providing coverage. It cannot ask about our hepatitis B or what drugs we take, nor can it impose any caps on our medical expenses. If and when the Trump-Congress changes the program, it can only do so by

    http://www.hepb.org/blog/got-hep-b-worried-trump-effect-obamacare-plan-experts-say-changes-unlikely-2018/
  • I’m living with hepatitis B, what should I do to reduce my risk of developing liver cancer?

    There are several ways you could reduce your risk of liver cancer. First, start by learning about hepatitis B, and what people living with hepatitis B should do regularly to maintain a healthy liver. Make sure to visit your doctor regularly to check your liver enzymes (ALT/AST), viral load (HBV DNA), platelet count and other liver function tests along with an ultrasound (every 6 months or at least annually). Ask your doctor about using simple blood tests to look at your Fibrosis-4 Index (FIB-4) for liver fibrosis. Discuss treatment with antivirals with your doctor.  (First line antivirals include tenofovir (TDF), tenofovir (TAF) and entecavir). These antivirals are effective at suppressing and controlling the virus, reducing liver damage resulting from the inflammatory response to the virus, and lowering the risk of developing liver cancer. Learn here about other important questions to ask your doctor. Make healthy lifestyle choices! You can make lifestyle choices that will put you in control during your journey with hepatitis B. You can support your liver by not drinking alcohol, not smoking and maintaining a healthy weight by eating a well-balanced diet and getting regular exercise. Here is some information on how to maintain a healthy liver. You may want to listen to this podcast about what a person with hepatitis B should eat, and you may find this guide helpful. Also be very careful with other prescription and over-the-counter medications or herbal remedies and supplements. Herbal remedies and supplements are not tested or regulated for purity and safety. Some supplements and herbs can do more harm than good. Join the Hep B Community! There, you will be able to engage online in discussions with scientists, clinicians, and people living with chronic hepatitis B from around the world, exchanging ideas, and experiences and knowledge about hepatitis B. Find more Frequently Asked Questions here.    Page updated 12/27/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/im-living-with-hepatitis-b-what-should-i-do-to-reduce-my-risk-of-developing-liver-cancer/
  • FK's Story

    After overcoming a difficult childhood in Burkina Faso, FK worked hard to move to the United States and eventually, her mother joined her. FK was diagnosed with hepatitis B six months after arriving, so she began educating herself and encouraging family and friends to get screened. Despite the stigma and lack of knowledge around hepatitis B in her community, which has impacted her relationships, FK is working to address these misconceptions and is hopeful for the future.   FK's story is available in English and French. English French

    https://www.hepb.org/research-and-programs/patient-story-telling-project/fks-story/
  • Is the hepatitis B vaccine safe during pregnancy?

    Yes. The hepatitis B vaccine is safe to be administered during pregnancy. Please remember that even if a mother receives the hepatitis B vaccine during pregnancy, her baby will have to be vaccinated after birth. The protective antibodies are not transmitted from the mother to her baby. Therefore, all babies should receive the birth dose of the hepatitis B vaccine. However, this is particularly critical for babies born to mothers living with chronic hepatitis B.  Find more Frequently Asked Questions here.  Page updated 02/09/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/is-the-hepatitis-b-vaccine-safe-during-pregnancy/
  • Can a hepatitis B infection be prevented? How can I protect my loved ones?

    Yes, hepatitis B is preventable through a safe and effective vaccine. The hepatitis B vaccine provides lifelong protection. If you, or someone you love, have been diagnosed with hepatitis B, make sure other household members are screened for hepatitis B, and those who are not infected or vaccinated should receive the hepatitis B vaccine.  Hepatitis B is not spread casually, but is transmitted through direct contact with blood and sexual fluids. This can occur through direct blood-to-blood contact, unprotected sex, unsterile needles, and from an infected woman to her newborn during the delivery process. Other possible routes of infection include sharing any sharp instruments such as razors, nail clippers, toothbrushes or earrings, since small amounts of blood can be exchanged through these items. Also, body piercing and tattooing are potential sources of infection if unsterile needles are used. Please visit our webpage to learn more about hepatitis B transmission, and how to protect your loved ones. Find more Frequently Asked Questions here.  Page updated 05/09/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/can-a-hepatitis-b-infection-be-prevented-how-can-i-protect-my-loved-ones/
  • Hepatitis B Foundation Applauds FDA Approval of New Hepatitis B Vaccine

    FDA Approved HEPLISAV-B, the First New Hepatitis B Vaccine in More than 25 Years DOYLESTOWN, PA (November 10, 2017): Today on World Immunization Day, the Hepatitis B Foundation applauded the U.S. Food and Drug Administration’s (FDA) approval of HEPLISAV-B™, the first new hepatitis B vaccine in more than 25 years and the only two-dose schedule for the prevention of infection in adults. Hepatitis B (HBV) is an extremely infectious virus (100 times more infectious than HIV/AIDS), and it is the most common serious liver infection in the world. More than 257 million people worldwide and up to 2.2 million in the United States are chronically infected with hepatitis B. Each year up to 1 million people die from HBV despite the fact that it is preventable and treatable. “The new two-dose vaccine is a game changer,” said Timothy Block, PhD, president of the Hepatitis B Foundation. “Current vaccines require three doses over 6 months, which makes it hard for some people to get all doses. With the new vaccine, people can be fully protected with two doses, in just one month. As we work towards finding a cure and eliminating hepatitis B in the U.S. and globally, having this new tool in our arsenal will play a critical role in preventing infections.” Hepatitis B is associated with significant health disparities in the U.S., disproportionately affecting Asian American, Pacific Islander, and African communities. Asian Americans and Pacific Islanders make up 50% of the HBV infection burden in the U.S., and have liver cancer rates that are up to 13 times higher than Caucasian populations. In addition, for the first time since 2006, the number of reported cases of acute HBV infection across the country is rising, and increased by 20.7% in 2015 alone. Parts of the country that are hardest hit by the opioid epidemic are now facing a rise in acute HBV infection associated with injection drug use. While the current three-dose HBV vaccine series offers lifelong protection from HBV infection, data from 2013 indicated that only 32.6% of adults aged 19 to 49 years were covered by the vaccine. Coverage is estimated to be even lower among injection drug users. Moving from a three-dose vaccine to a two-dose vaccine can help overcome challenges to vaccine completion, and lead to higher coverage and protection rates, especially for high-risk communities. “It is critical to increase HBV vaccination coverage, particularly among high-risk populations and young adults born prior to 1991, when HBV vaccination for infants became routine,” said Chari Cohen, DrPH, MPH, vice president for public health and programs at the Hepatitis B Foundation and co-chair of the Hep B United coalition. “We are very excited about the new two-dose vaccine and look forward to working with our partners to ensure all communities have access to this life-long protection from hepatitis B and liver cancer.” About the Hepatitis B Foundation The Hepatitis B Foundation is 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. To learn more, go to www.hepb.org, read our blog at hepb.org/blog, follow us on Twitter @HepBFoundation, find us on Facebook at facebook.com/hepbfoundation or call 215-489-4900. # # #    

    https://www.hepb.org/news-and-events/news-2/heplisav-approval/