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  • When Is That Pain Hep B-related and When Is It Something Else?

    Image courtesy of Ohmega1982 at FreeDigitalPhotos.net When people with chronic hepatitis B experience abdominal pain, we often wonder if it’s related to our liver and if our hepatitis B is getting worse. According to experts, hepatitis B rarely causes abdominal pain. Here are some insights to help you understand what might be behind your abdominal pain when you live with chronic hepatitis B. First, it’s not called the silent infection for nothing. When first infected, most children and nearly 70 percent of adults never experience any direct symptoms from hepatitis B. When people do have symptoms, such as aches, nausea and fever, they usually last for only a few days. Only a very small percentage have symptoms that persist long-term. But chronic hepatitis B is different. Most of us have had this infection since childhood and over time it rarely causes us any symptoms. Usually, disease causes pain, it is nature’s way of telling us that a health problem is getting worse. However, with diseases such as chronic hepatitis B, diabetes or high blood pressure, we often don't feel any symptoms until the disease reaches an advanced state. Why doesn’t an infected liver hurt? The working part of the liver that filters toxins from our blood has nerves, but they lack feeling or sensory function. However, the membrane that encases the liver is sensitive. When the liver becomes injured or inflamed, it enlarges and pushes against the membrane, causing a dull pain. When a doctor probes or pushes an enlarged liver that’s pushing against this membrane, it feels tender. This palpable “pushing” against the membrane is why fatty liver disease, for example, causes abdominal pain, while early-stage hepatitis B (with its minimal liver inflammation) does not. The “fatty” liver is enlarged from the fat that’s accumulated and its accompanying inflammation, it has literally outgrown its membrane. Pain or discomfort from an enlarged liver usually occurs in the

    http://www.hepb.org/blog/when-is-that-pain-hep-b-related-and-when-is-it-something-else/
  • Growing Older with Hepatitis B: Why Testing for Liver Damage Still Matters

    Image courtesy of Witthaya Phonsawat at FreeDigitalPhotos.net Around the world, older adults bear the greatest burden of hepatitis B. Born before the childhood vaccination became available, about 4.7 percent of U.S. adults over age 50 have been infected and their chronic hepatitis B rate is nearly two-fold higher than in younger adults. The 50-plus generation has lived with with chronic hepatitis B for decades, and over time their risk of liver damage, cirrhosis, and cancer has steadily increased. That is why it is very important that older adults living with this infection see their physicians regularly and have tests for liver damage and cancer performed as needed. Our immune system and liver weaken with age: With age, our immune system loses its edge. Think chicken pox—that virus stays dormant in the body and emerges as shingles later in life when aging immune systems can no longer keep the virus in check. As our immune systems age and weaken, they may no longer be able to suppress reproduction of the hepatitis B virus and you may notice an increase in your viral load (HBV DNA). Even when there is no notable increase in viral load, you can still experience liver damage, scarring (cirrhosis) and even cancer as you age. This is why getting your alanine aminotransferase (ALT) tested regularly for tell-tale signs of liver damage is essential. When estrogen declines, women may be at greater risk of liver damage: Estrogen appears to confer some protection against liver damage, but as women age and estrogen levels decline, their risk of liver damage increases, which means monitoring may need to occur more frequently. The liver loses its resiliency with age: According to researchers, over time our livers lose some of their ability to regenerate and their blood flow and screening capacity declines, leaving them more vulnerable to inflammation, scarring and cancer from the hepatitis B virus that hijacks liver cells to replicate. Decades of exposure to environmental

    http://www.hepb.org/blog/growing-older-with-hepatitis-b-why-testing-for-liver-damage-still-matters/
  • Hepatitis B Foundation releases white paper calling health care providers into action following new hepatitis B screening and vaccination recommendations

    Addressing the new CDC guidance, the paper is titled, “Call to Action: Eliminating Hepatitis B Virus through Universal Screening and Vaccination for Adults Ages 19-59.” Doylestown, Pa., March 15, 2023 – After the U.S. Centers for Disease Control and Prevention (CDC) last week released new guidance for hepatitis B screening, adding to updated recommendations on vaccination that the CDC put out last spring, the Hepatitis B Foundation sprang into action. The Foundation has produced a white paper with guidance on how health care providers in the U.S. can begin implementing these new universal hepatitis B screening and vaccination (for adults ages 19-59) guidelines. Aligning and implementing these new recommendations will require a concerted national effort with collaboration among numerous stakeholders, such as medical societies, which is why the white paper was developed. The Hepatitis B Screening and Vaccine Advisory Council, which was convened in April 2022 by the Hepatitis B Foundation, developed the white paper. The advisory council’s mission is to improve adult hepatitis B vaccination and screening rates by helping providers successfully implement the new vaccination and screening guidelines in their practice.  Advisory council members included federal agencies, national medical societies, community health centers, public health organizations, health department representation and leading hepatitis B experts. The advisory council identified key barriers to hepatitis B screening and vaccination in various settings and formulated strategies to optimize the implementation of the new recommendations.  This resource serves as a call to action for providers. It summarizes the key challenges to universal screening and vaccination and suggests potential strategies to optimize the implementation. The paper makes clear that it is imperative we have urgent action in three key areas: educating stakeholders, exploring multi-stakeholder collaborations and technology innovations, and addressing vaccine hesitancy. The white paper is intended to be a resource for all providers, as various health care settings will require different strategies for successful implementation. In addition to challenges and implementation strategies for universal screening and vaccination, the white paper includes best practices from groups who have begun implementation and resources for providers to access tools in hepatitis B prevention, diagnosis, management and treatment.  The CDC’s Advisory Council on Immunization Practices recommended the updated vaccination guidelines in November 2021. Universal hepatitis B screening guidelines were recommendation by CDC in March 2023. About Hepatitis B: 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.

    https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-provides/
  • Dr. Yasmin Ibrahim appointed to national Patient Engagement Collaborative

    The panel advises the U.S. Food and Drug Administration as to engaging patients in medical product regulation. Doylestown, Pa. – Jan. 11, 2022 – The U.S. Food and Drug Administration and the Clinical Trials Transformation Initiative (CTTI) has announced eight newly selected representatives for the Patient Engagement Collaborative, including Yasmin Ibrahim, MD, PhD, MBA, of the Hepatitis B Foundation. According to the CTTI, “The group of 16 patients, caregivers, and patient group representatives will meet with the FDA several times a year to discuss topics such as communication, transparency, and the best ways for patients to engage the FDA about medical product regulation.” The eight new representatives, who are expected to serve two-year terms, are: Kim Hindery, Yasmin Ibrahim of the Hepatitis B Foundation, Seth Morgan, Cara O’Neill, Ceciel Rooker, Christina Sisti, Trina Stelly and Lauren Youngborg. Yasmin Ibrahim, MD, PhD, MBA, of the Hepatitis B Foundation Dr. Ibrahim is the Hepatitis B Foundation’s senior program manager for public health. “Yasmin provides strong leadership for the Foundation’s efforts to engage patients in our work and is passionate about incorporating the voices of people living with hepatitis B in everything we do,” Chari A. Cohen, DrPH, MPH, president of the Hepatitis B Foundation said. “It’s a true testament to her efforts that she is being recognized by the FDA and the Clinical Trials Transformation Initiative as a consistent advocate and partner of people living with hepatitis B.” Read more about the Patient Engagement Collaborative here.

    https://www.hepb.org/news-and-events/news-2/dr-yasmin-ibrahim-appointed-to-national-patient-engagement-collaborative/
  • Importance of Hepatitis B Screening

    Importance of Hepatitis B Screening: The majority of respondents found out about their hepatitis B by coincidence, indicating the importance of screening and early diagnosis. Findings: 56% were tested as part of routine testing (blood donation, pre-marital, or pre- employment). 15% were tested because they were either having symptoms. 8% were tested because a family member was diagnosed. 15% were tested because their doctor recommended it. One participant said “You know I'm a relatively healthy person in terms of you know other things. And how did [I] get [hepatitis B], [I] always feel confused and I’m always wondering, I'm a scientist, I want to know why did this happen?” Take action: Please know that: Hepatitis B is one of the most common viruses worldwide. Hepatitis B can be a silent infection, and everyone should be tested. Encourage your friends and family to get tested for hepatitis B. Early diagnosis is key to a long, healthy life! Share your hepatitis B story. Personal stories are the best way to improve awareness and promote testing for hepatitis B.

    https://www.hepb.org/resources-and-support/patient-facing-infographics/importance-of-hepatitis-b-screening/
  • Hepatitis B Foundation Expands Hepatitis B Prevention Policy Initiatives

    Doylestown, Pa., May 6, 2020 – The Hepatitis B Foundation has launched a new Hepatitis B Prevention Policy Program aimed at increasing adult hepatitis B vaccination rates in the U.S. The program will build and expand the Foundation’s policy and advocacy initiatives and increase engagement with federal and state public health agency partners to improve hepatitis B prevention and vaccination infrastructure and strategies. The program also will expand the Foundation’s engagement with Members of Congress. In the U.S., more than 2 million people are living with chronic hepatitis B and many more are at risk for becoming infected with this virus, which is a leading cause of liver cancer and deaths worldwide. Despite the tools available to prevent and eliminate hepatitis B, including safe and effective hepatitis B vaccines, only about 25% of adults in the U.S. have been vaccinated. The new program’s objectives are to: Foster public discussion about hepatitis B to improve awareness and knowledge about transmission and prevention, reduce hepatitis B‐related stigma and promote hepatitis B vaccination at all levels (community, health system, etc.). Engage with public health leaders, professional associations, clinical partners, patients and high‐risk communities to promote effective hepatitis B prevention and vaccination strategies and implement policies and programs to improve adult hepatitis B vaccination coverage rates. Expand grassroots advocacy efforts and engage hepatitis B patients and state-level advocates and provide training and education. Develop sustainable systems for improving hepatitis B prevention through public policy focused on grassroots engagement and collaboration with federal and state public health leaders. The new program’s manager will be Michaela Jackson, who has been on the Hepatitis B Foundation’s public health team since 2018. Since her promotion, Jackson has been leading policy development and research into federal and state hepatitis B prevention, including vaccine-related policies and programs. A Philadelphia resident, Jackson earned a Master of Science degree in science communication from Drexel University in 2018. Since then she has been coordinating the Hepatitis B Foundation’s coalition in Philadelphia, including raising awareness and increasing hepatitis B testing within the city's high-risk communities and supporting state policy development and advocacy efforts to promote a Pennsylvania viral hepatitis elimination plan.

    https://www.hepb.org/news-and-events/news-2/httpshepatitis-b-foundation-expands-hepatitis-b-prevention-policy-initiatives/
  • What You Need to Know About Fatty Liver Disease and Liver Cancer

    Join the Hepatitis B Foundation, Monday, April 22 at 1 pm EST, 10 am PST, for the final webinar of the 3-Part Liver Cancer Webinar Series, “Liver Cancer and Fatty Liver Disease: What You Need to Know”, presented by liver disease expert, Kenneth Rothstein, MD. There is an upsurge in fatty liver disease in the U.S. and around the world as a result of poor diet, consumption of alcohol, and sedentary lifestyle. Fatty Liver Disease occurs when fat makes up more than 5% -10% of the weight of your liver, which can be a result of either alcoholic, or non-alcoholic fatty liver disease (NAFLD). This accumulation of fat can cause inflammation and permanent scarring of the liver, which may lead to serious complications including liver failure, and liver cancer. Learn about fatty liver, which is largely preventable. Liver cancer is the third leading cause of cancer-related deaths and the seventh most common cancer worldwide. Learn how to prevent liver cancer, along with screening, surveillance and treatments for liver cancer. Dr. Rothstein is the Associate professor in the Department of Medicine, and chief of the Division of Gastroenterology and Hepatology at Drexel University College of Medicine. He also serves as medical director of Abdominal Transplantation at Hahnemann University Hospital. 
Dr. Rothstein is a leading expert in the field of hepatology, with over 20 years of experience. He specializes in the treatment of liver disease and liver transplantation, particularly treating the complications of cirrhosis, including liver cancer. He is also a recognized expert on new treatments for hepatitis B and C. “Fatty Liver Disease and Liver Cancer: What You Need to Know” webinar details: Presented by: Dr. Kenneth Rothstein Date: Monday, April 22, 2013 Time: 1 pm EST, 10 am PST Click here to register Did you miss the previous webinars of the series? Feel free to download them and listen at your leisure: Download the March 6th Webinar and listen to Hepatitis B and Liver

    http://www.hepb.org/blog/what-you-need-to-know-about-fatty-liver-disease-and-liver-cancer/
  • Welcome to our Liver Cancer Connect Program

      Find Clinical Trials Near Me! Check out this video with a liver cancer survivor on Closing the Care Gap! [embed width="483" height="273" class="leftAlone" thumbnail="https://i.ytimg.com/vi/W184RAyXHpU/hqdefault.jpg?r"]http://www.youtube.com/watch?v=W184RAyXHpU[/embed] This panel discussion features someone with lived experience of liver cancer and his wife in conversation with researchers and patient advocates. The discussion highlights what is missing in order to improve the lives of people diagnosed with HCC. Check it out today! [embed width="497" height="373" class="leftAlone" thumbnail="https://i.ytimg.com/vi/2sumSuuMc6Q/hqdefault.jpg?r"]http://www.youtube.com/watch?v=2sumSuuMc6Q&t=2s[/embed] Watch our latest webinar! In it, panelists discuss conclusions & insights from a recent project to identify & close disparities in hepatitis B & liver cancer knowledge and screening rates among highly impacted communities around the US. Check it out today! Check out a special episode from the 2022 HBV Meeting in Paris!  Ed Tate, Director of Communications and Marketing at the Hepatitis B Foundation was able to interview Dr. Mathias Heikenwalder to talk about updates on liver cancer research. Liver Cancer Connect is a dedicated program of the Hepatitis B Foundation that was created to provide individuals and families with the information and support they need when facing the challenge of primary liver cancer. Although this is a serious diagnosis, there is good reason to have hope because of the many advances made in the early detection, management and treatment of liver cancer. In the News BAIAP2L2 is a Novel Prognostic Biomarker Related to Migration and Invasion of HCC and Associated with Cuprotosis Advancing the Care of Advanced HCC – A Hepatologist’s Perspective After FDA rejection, Gilead's Hepcludex looks set for full EU nod Evidence Grows for Avoiding Biopsy in Hepatocellular Carcinoma Novel Use of Artificial Intelligence Shows Promise to Improve HCC Detection Molecular and Clinical Features of Hepatocellular Carcinoma in Patients with HBV-HDV Infection Genentech’s Tecentriq Plus Avastin Reduced the Risk of Cancer Returning in People With Certain Types of Adjuvant Liver Cancer in a Phase III Study Generic Drugs in Oncology (Recent Lancet article)  A Novel Online Calculator Based on Serum Biomarkers to Detect Hepatocellular Carcinoma among Patients with Hepatitis B New 3D ultrasound may improve accuracy of liver cancer treatment 4 Liver Cancer Treatment Advances The Cancer Experience Registry is an online survey that allows people facing cancer to share their experiences, identify the issues that impact their life, and help them understand their experiences. Minimally-invasive surgical options for liver cancer and liver tumors, and other options from the multidisciplinary team from Johns Hopkins (Video) Review of insights into the success and failure of systemic therapy for liver cancer REACH-B Score for Hepatocellular Carcinoma About Herbs, Botanicals, and Other Products (from Memorial Sloan Kettering Cancer Center) Pan Tumor Clinical Trial Is Actively Recruiting to Investigate the Effects of Nivolumab When Given Under the Skin With or Without rHuPH20. Learn more!  FDA approves a combination of the immunotherapy drugs durvalumab (Imfinzi®) plus the experimental drug tremelimumab for people with unresectable hepatocellular cancer, the most common type of liver cancer AstraZeneca’s immunotherapy tremelimumab has secured its first FDA approval and is to be sold under the brand name Imjudo Antiviral therapy improves survival among elderly patients after hepatectomy for hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) Cabozantinib plus atezolizumab in advanced hepatocellular carcinoma and the role of adjuvant antiviral therapy Case 3: Novel Frontline Combination Strategies for Unresectable HCC (Video) Assessing the Risk of HCC for Hepatitis B Treatments Study Uncovers New Treatment Approaches for Liver Cancer Patients NUS Scientists Discover New Clues to Liver Cancer Progression What Gastroenterologists Need to Know About New Guidelines on Systemic HCC Therapy Bringing Early Cancer Detection to the Masses Researchers Identify a New tsRNA in Blood to Improve Liver Cancer Diagnosis New strategies and the partnerships needed to bring early detection of cancer to everyone Importance of screening for hepatocellular carcinoma in hepatitis B virus: Patient and physician sharing session, a podcast with Ming-Lung Yu, MD, PhD The American Society for Radiation Oncology (ASTRO) issues clinical guidelines on the use of radiation therapy to treat adult patients with primary liver cancers using external beam radiation therapy (EBRT). Dr. Gish talks about the importance of liver cancer surveillance and the blood work and imaging involved in regular monitoring - all in less than 2 minutes (Video) Listen to this episode of B Heppy with Dr. Rothstein about the relationship between liver cancer & hep B (Podcast) National Comprehensive Cancer Network (NCCN) releases an update to its guideline for hepatobiliary cancers NCCN Guidelines for Patients Liver Cancer Immunotherapy for advanced HCC: Experts answer clinician questions Current and Future Immunotherapy Approaches for HCC: Evidence, Guidance, and Resources (Podcast) Insights into the success and failure of systemic therapy for hepatocellular carcinoma What Cancer Survivors Should Know About Their Mental Health EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma Get Connected

    https://www.hepb.org/research-and-programs/liver/
  • Cleaning Up and Staying Safe at College

    Whether you have hepatitis B or not, you will want to follow some simple clean-up rules now that you are living in a more public environment and away from home. (Take a look at the previous blog - Off to College with HBV.) Regardless of your living arrangements - dorm room, quad, or apartment, you will want to set a couple of ground rules, and be prepared for maintenance, and possible emergency spot cleaning. Bathrooms are a breeding ground for a plethora of bacteria and viruses. They are the site of all kinds of planned and unplanned, natural and unnatural biological and human functions that produce blood, bodily fluids, and all kinds of other body by-products.  They are shared spaces where very private things occur. They are shared spaces where there's a whole other microbial world living off of all the human activities that occur in the bathroom. That is why bathrooms should be cleaned properly and regularly.  It's good practice and keeps everyone healthy. Standard or universal precautions are  prevention methods that should be integrated into everyone's life.  The whole goal is to prevent contact with an infectious agent such as HIV, HCV and HBV, assuming all possible blood or bodily fluids may be contaminated. They remind you to provide a barrier between you and any potentially contaminated blood or body fluid, whether it is in an emergency situation with a bleeding person, or the cleanup of blood or bodily fluids. It's yet another reminder to "wash your hands", and basically use common sense.  In the case of HBV or other infectious diseases (HCV, HIV), blood in particular may contain high concentrations of virus which could be transmitted to others through mucous membranes, orifices, or microscopic cuts in the skin.  HBV is a tenacious virus and can live outside the body for seven days. Fortunately, HBV is vaccine preventable. If you live in a dorm, with shared, floor bathrooms, they should be cleaned and maintained by the janitorial staff. However,

    http://www.hepb.org/blog/cleaning-up-hbv-in-college/
  • Fun, Fireworks, and Alcohol Consumption Over the 4th of July Holiday

    Are you gearing up for the 4th of July, holiday?  Planning on a couple of days of fun, sun, fireworks, and holiday picnics and parties?  If you're living with hepatitis B, you will want to be sure to abstain, or at a minimum, keep your alcohol consumption extremely restricted.  Some of the statistics out there linking alcohol consumption to liver disease are sobering (no pun intended), even for those that do not suffer from liver disease due to viral hepatitis.  If you have HBV, drinking just doesn't mix with love N' your liver. So just how much alcohol is too much?  Like everything else, alcohol tolerances vary with the individual, so the amount will vary.  Some people, with or without HBV, may be more prone to liver disease due to contributing factors such as fatty liver disease, hemochromatosis, autoimmune hepatitis,  or hepatoxicity - exposure to certain drugs or environmental and chemical toxins causing liver scarring .   Remember that the liver is basically a very quiet, essential, non-complaining organ. If you have HBV, you know your tolerance for alcohol is going to be nil.  Drinking will contribute to liver disease. For healthy women who do not have hep B, 20 grams of alcohol, per day and for men without HBV,  60 grams of alcohol per day is risky business and may very well contribute to liver disease.  This equates to 60 ml. of sixty-proof liquor, or 200 ml. of wine (12% alcohol), and 500 ml of beer (5% alcohol).  A visual always works best for me: Ouch... Even if you do not have HBV, you are risking your liver health when you drink casually, on a daily basis.  For women, this basically equates to one mixed drink, glass of wine or beer per day, while the limit for men may be three alcoholic drinks per day. If you've got HBV, perhaps it's time to eliminate alcohol from the party scene and replace it with a thirst-quenching, non-alcoholic beverage.  If not, you might consider one drink for the holiday weekend, and abstain for very l-o-n-g

    http://www.hepb.org/blog/fun-fireworks-and-alcohol-consumption-over-the-holiday-weekend/