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• Pa DOH Highlights the Importance of Viral Hepatitis Awareness, Need for Expansion of Syringe Services

  June 7, 2022 [From the Pa DOH] Today the Pennsylvania Department of Health joined advocates and residents with lived experiences to highlight the importance of viral hepatitis awareness along with the success of syringe services programs. "Viral hepatitis is significantly reduced by having access to syringe service programs," Dr. Wendy Braund, DOH Deputy Secretary of Health Preparedness and Community Protection said during the awareness event news conference in the Capitol building. "The success of existing programs is evidence that residents across the state can help stop the spread of viral hepatitis if more syringe service programs are available." Nationwide, syringe services programs are associated with a significant reduction in injection-related Hepatitis C. "According to the Centers for Disease Control and Prevention, individuals who participate in syringe service programs are five times more likely to enter drug treatment," Dr. Braund said, noting that DOH leaders were in Bethlehem and Pittsburgh last week to discuss syringe services with elected officials and members of the local heroin and opioid task forces who are eager to provide this service to residents in their region." To support those efforts, the Department of Health worked in partnership with the Pennsylvania Viral Hepatitis Eliminating Planning Committee and the Viral Hepatitis Interagency Workgroup to create the Pennsylvania viral hepatitis elimination plan. The plan is intended to achieve short-term and long-term goals, including: Creating and enhance prevention and education initiatives Expanding the availability of co-located viral hepatitis and harm reduction services and programs across the state Increasing testing and linkage to care and treatment Continuing surveillance of those diagnosed with Hepatitis B and C "Forty-percent of Pennsylvanians living with Hepatitis C are unaware of their infection," Dr. Stacey Trooskin, Chief Medical Officer of Philadelphia FIGHT said. "We can eliminate Hepatitis C from Pennsylvania but we must scale up testing, access to curative treatment and harm reduction services like syringe service programs as evidenced by the success we've seen in Philadelphia." The Wolf Administration worked closely with members of the General Assembly to develop Senate Bill 926 and House Bill 2264, which would allow organizations to engage in this work. Currently, there are more than 400 syringe service programs currently operating in 40 states, the District of Columbia and Puerto Rico."There are vaccines available to prevent hepatitis A and B and medicines to treat hepatitis B and C," said Dr. Chari Cohen, Senior Vice President, of the Hepatitis B Foundation. "Bringing this awareness to all regions of the state, combined with syringe service programs is critical as we work towards eliminating viral hepatitis in Pennsylvania."Currently, there are 166 organizations signed on to support syringe service programs, including several organizations joining the event today: The Allegheny Health Network Philadelphia Fight Community Health Centers Hepatitis B Foundation Clean Slate Recovery Centers Pennsylvania Harm Reduction Network Armstrong-Indiana-Clarion Drug and Alcohol Commission, INC Pennsylvania Association of County Drug and Alcohol Administrators Gaudenzia Pennsylvania Medical Society "Without syringe service programs, there is a good chance that I would not be standing here speaking with you today," said Kate Favata, Community Relations Liaison for Clean Slate Recovery Centers. "I am proof that not only do these programs work, but they help people lead impactful and full lives. "Some people who need these programs are currently not able to access them, and that needs to change."  Dr. Chari A. Cohen, the Foundation's senior vice president, speaking at the June 7 event in the Capitol Building. Dr. Wendy Braund, deputy secretary of health preparedness and community protection, Penna. DOH, started off the event. To view a recording of the event and read more, please click here.

  https://www.hepb.org/news-and-events/news-2/pa-doh-highlights-the-importance-of-viral-hepatitis-awareness-need-for-expansion-of-syringe-services/
• Hepatitis B Foundation and Hep B United Statement on the Federal Government's Rollback of Critical Health Care Protections

   Doylestown, Pa., June 16, 2020 – The U.S. Department of Health and Human Services (HHS) finalized a rule on June 12 that rolls back critical nondiscrimination protections provided under Section 1557 of the Affordable Care Act (ACA). Section 1557, also referred to as the Health Care Rights Law, was enacted as part of the ACA in 2010 to protect patients from health care discrimination based on race, color, national origin, disability, age and sex. The Trump administration’s final rule makes significant changes to weaken Section 1557 by removing protections against discrimination based on gender identity and sexual orientation. The rule also removes requirements for health plans and other federally funded entities to notify Limited English Proficient (LEP) individuals of their right to language access services, such as health care interpreters and translated materials containing critical health care information.  ”All people should be able to access the health care they need without fear of being turned away, shamed or treated unfairly,” said Kate Moraras, deputy director of public health at the Hepatitis B Foundation and director of Hep B United. “We denounce the Trump administration’s decision to roll back important civil rights protections provided under Section 1557, and we are gravely concerned about the detrimental impacts this rule will have on marginalized communities. It intentionally limits access to health care for LGBTQ people and people with limited English skills, jeopardizing the lives of people already vulnerable to discrimination and seriously endangering individuals with chronic conditions such as hepatitis B.” Without access to appropriate monitoring, care and treatment when necessary, Moraras said, approximately one in four people with chronic hepatitis B will die prematurely of liver cancer, liver failure, or cirrhosis. LGBTQ and LEP communities are among those at highest risk of hepatitis B infection. For example:  Nationally, men who have sex with men (MSM) are at heightened risk for hepatitis B and C; nearly 20% of new hepatitis B cases are among MSM.  Asian American, Pacific Islander and African communities are disproportionately affected, with these communities comprising up to 80% of all chronic hepatitis B infections across the country.  Among those chronically infected with hepatitis B, an estimated 70% are non-U.S.-born and face unique barriers in accessing health care services, including language access barriers.  The Hepatitis B Foundation and Hep B United stand firmly against the Trump administration’s final rule on Section 1557. Allowing providers, insurance companies, hospitals and other health care entities to discriminate against patients – for example, to refuse to test or provide treatment to a patient based on a provider or staff member’s personal beliefs – is unacceptable. This rule will only further exacerbate hepatitis B-related health disparities and reverse progress that has been made to eliminate the disease.  For more information regarding our concerns about this rule and how it could impact people living with or at risk of hepatitis, read our comment letter.  About the Hepatitis B Foundation: 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, the Hepatitis B Foundation is based in Doylestown, Pa. 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. To donate, contact Jean Holmes at 215-489-4900 or jean.holmes@hepb.org. About Hep B United: Hep B United is a national coalition co-chaired by the Hepatitis B Foundation and the Association of Asian Pacific Community Health Organizations dedicated to reducing the health disparities associated with hepatitis B by increasing awareness, screening, vaccination, and linkage to care for high-risk communities across the United States. To learn more, visit www.hepbunited.org. 

  https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-and-hep-b-united-statement-on-the-trump-administrations-rollback-of-critical-health-care-protections/
• Hepatitis B Foundation Commends New Rx Outreach Program to Provide Access to Affordable Hepatitis B Medication

  DOYLESTOWN, PA (June 25, 2019): The Hepatitis B Foundation commends Rx Outreach, a nonprofit online pharmacy, for expanding their service to provide medications to help more than 2 million Americans who are chronically infected with hepatitis B. Through Rx Outreach’s online pharmacy, people will now have access to tenofovir disoproxil fumarate (TDF) and entecavir, two front-line medications used to treat hepatitis B, at prices significantly lower than retail. The Hepatitis B Foundation is proud to partner with Rx Outreach’s nonprofit pharmacy to identify the most commonly prescribed hepatitis B medications, and refer patients struggling with medication costs. The two nonprofits have partnered to improve health outcomes for people with hepatitis B, under the shared belief that everyone deserves access to affordable health services. “Rx Outreach is proud to work with the Hepatitis B Foundation,” said Darryl Munden, President of Rx Outreach. “We know that countless chronically ill people in the United States have to choose between food and medication. This partnership aligns with our core strategies and belief that everyone deserves access to affordable medications." Known for their exceptional attention to improving the quality of life for those affected by hepatitis B worldwide through education and patient advocacy as well as their focus on finding a cure through research, the Hepatitis B Foundation is a global leader in the field. They are recognized for making great strides for this mostly overlooked and underfunded disease. “The Hepatitis B Foundation is pleased to direct people to a low-cost resource for two of the most commonly prescribed medications for chronic hepatitis B,” said Chari Cohen, DrPH, MPH, Senior Vice President of the Hepatitis B Foundation.  “Nearly 20% of our phone calls in the first three months of this year were directly related to the rising cost of medicines. By partnering with Rx Outreach, Hepatitis B Foundation is improving access to life-saving treatment for people living with hepatitis B – and helping all stakeholders -  family, friends, healthcare providers, community stakeholders, faith-based communities, and national organizations -- to create informative change within the field.”    Tenofovir disoproxil fumarate (TDF), generic Viread ®, retails for $838.85 for a 30-day supply but is available from Rx Outreach for $25 for up to 30 tablets. Entecavir, generic Baraclude ®, has an average monthly retail price of $981.66, but is available from Rx Outreach for $45 for up to 30 tablets.  Individuals who meet the eligibility requirements will qualify for Rx Outreach’s affordable pricing regardless of their health insurance status or prescription coverage. To learn more about this partnership, visit www.hepb.org/blog  To order medications from Rx Outreach, visit www.rxoutreach.org/hepb The Hepatitis B Foundation does not financially benefit from this partnership.   About Rx Outreach  Rx Outreach is the nation's largest, nonprofit, fully licensed, mail order pharmacy and Patient Assistance Program (PAP). It offers more than 1,000 medication strengths at affordable prices. Missioned to provide affordable medication to the underserved, Rx Outreach partners with hundreds of clinics and organizations across the U.S. to provide a crucial health safety net for those who battle both illness and poverty. Since 2010, Rx Outreach has saved people in need more than $662 million on their prescription medications compared to retail costs. To learn more, go to www.rxoutreach.org/hepb. Follow Rx Outreach on Twitter  https://twitter.com/RxOutreach, on Facebook https://www.facebook.com/RxOutreach and on LinkedIn https://www.linkedin.com/company/rx-outreach/ About The Hepatitis B Foundation    The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure and improving the quality of life for those affected by Hepatitis B worldwide. Their commitment includes funding focused research, promoting disease awareness, supporting immunization and treatment initiatives, and serving as the primary source of information for patients and their families, the medical and scientific community, and the general public. To learn more, go to www.hepb.org, read our blog at www.hepb.org/blog, follow us on Twitter @HepBFoundation, find us on Facebook at http://www.facebook.com/hepbfoundation or call 215-489-4900.

  https://www.hepb.org/news-and-events/news-2/rxoutreach/
• Discriminatory Practices in Hepatitis B Treatment Drug Tiering in the United States

  When the Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA), was passed in 2010, it included consumer protections against discrimination from health insurance companies. Through the Essential Health Benefits (EHB) requirement of the ACA and the non-discrimination provision (Section 1557), federal law states that it is illegal for companies to include a benefit design in their insurance plans that discriminate against individuals based upon their age, disability, gender, health conditions, and numerous other factors that will have the effect of discouraging the enrollment of individuals with significant health needs. Despite the provisions of the Affordable Care Act, insurance companies across the United States are participating in a discriminatory practice called adverse drug tiering. Adverse drug tiering happens when health insurance companies use tactics such as placing all or most medications that treat a specific condition on the pricing highest tiers or implement high cost-shares for treatment. Oftentimes, individuals with pre-existing chronic conditions like hepatitis B are forced to bear the burden of adverse drug tiering. Other tactics used are coinsurance-based cost-sharing designs and making patients regularly seek physician approval - called prior authorization- to access medications for hepatitis B. All of these methods are designed to place the majority of medication costs upon the consumer and/or discourage individuals with pre-existing conditions from enrolling in a health plan. Under the ACA, adverse drug tiering practices are discriminatory and illegal. What we are doing The Hepatitis B Foundation is currently in the process of analyzing access to hepatitis B treatments in health insurance plans participating in federally-facilitated marketplaces for several states. Once a sufficient number of analyses are complete, the Hepatitis B Foundation will work with partners to take strategic actions against discriminatory insurers in order to hold them accountable and to establish a national precedent that affordable hepatitis B treatment is a right. Without affordable options, chronic hepatitis B patients may stop taking medication, which increases their risk of developing cirrhosis or liver cancer. It also discourages people who may be at risk from getting tested and into care. Our methodology is based upon a similar analysis of HIV/AIDS medications. In 2014, the AIDS Institute analyzed health insurance plans in the federal insurance marketplace for 12 states and found many of the same issues that we are observing with hepatitis B treatment today. The AIDS Institute and the National Health Law Program filed a joint complaint on both a state and federal level to encourage insurers to change their policies. The case gained national attention and brought awareness to the issue. What to Do if You are Facing Discrimination Drug access discrimination comes in many forms including, but not limited to: Generic drugs on pricing tiers 3 and above Placing most or all hepatitis B treatments on the highest tiers Requiring coinsurance rates instead of copays for most or all hepatitis B treatments Mandatory physician's approval (prior authorization) for first-line or generic treatments A combination of any of the above markers of discrimination Click here to view Health Insurance Costs Impacting Shoppers Living with Hepatitis B - a comprehensive report that details our findings from analyzing 2019 and 2020 silver-level health insurance plans for potential discriminatory tiering of hepatitis B treatments. The report contains a list of things to consider when choosing health insurance plans, trends that may drive up the cost of treatment, and an overview of health insurance companies that displayed discriminatory practices. If you believe that your insurance company is discriminating against chronic hepatitis B patients, you can contact the Hepatitis B Foundation and file a complaint with your state’s Bureau of Insurance and the U.S. Department of Health and Human Services' Office of Civil Rights. States are the regulatory body for health insurance companies, so it is important to make them aware of the issue. You can use the information on our site to help advocate for yourself, report your experience with discrimination on the Hepatitis B Foundation's Discrimination Registry, or contact the Hepatitis B Foundation at discrimination@hepb.org or 215-489-4900 if you need additional assistance. 

  https://www.hepb.org/resources-and-support/know-your-rights/us-access-to-medicine/

• Mga Pagsusuri sa Dugo para sa Hepatitis B  Mayroon bang pagsusuri sa dugo para sa hepatitis B?Mayroong simpleng pagsusuri sa dugo para sa hepatitis B na maaaring ipagawa ng iyong doktor o klinika ng kalusugan na tinatawag na “grupo ng pagsusuri ng dugo para sa hepatitis B”. Ang sampol ng dugo na ito ay maaaring kunin sa tanggapan ng iyong doktor. May 3 karaniwang mga pagsusuri na bumubuo sa grupo ng pagsusuri sa dugo na ito. Minsan, maaaring suriin muli ng doktor ang iyong dugo anim na buwan pagkatapos ng iyong unang bisita upang kumpirmahin ang kalagayan ng iyong hepatitis B. Kung sa tingin mo ay kamakailan ka lang nahawa ng hepatitis B, maaaring abutin nang 9 na linggo bago matuklasan ang virus sa iyong dugo.Maaaring nakakalitong unawain ang iyong mga resulta ng pagsusuri sa dugo para sa hepatitis B, kaya gusto mong siguruhin ang iyong dayagnosis – nahawa ka ba ng hepatitis B, gumaling ka ba mula sa hepatitis B na impeksyon, o mayroon ka bang talamak na hepatitis B na impeksyon? Dagdag pa, makatutulong kung humingi ka ng nakasulat na kopya ng iyong mga pagsusuri sa dugo para lubos mong maunawaan kung aling mga pagsusuri ang positibo o negatibo. Ano ang tatlong pagsusuri na bumubuo ng "grupo ng pagsusuri sa dugo para sa hepatitis B"? Ang grupo ng pagsusuri sa dugo para sa hepatitis B ay nangangailangan lamang ng isang sampol ng dugo ngunit kasama rito ang tatlong mga pagsusuri na kinakailangan upang gumawa ng panghuling dayagnosis: HBsAg (hepatitis B surface antigen)  HBsAb o anti-HBs (hepatitis B surface antibody)  HBcAb o anti-HBc (hepatitis B core antibody) Ano ang hepatitis B surface antigen (HBsAg)? Ang resultang "positibo" o “reaktibo” sa HBsAg na pagsusuri ay nangangahulugan na ang tao ay nahawa sa hepatitis B na virus, na maaaring "malubha" o "talamak" na impeksyon. Ang mga taong nahawahan ay maaaring maipasa ang virus sa iba sa pamamagitan ng kanilang dugo. Ano ang hepatitis B surface antibody (HBsAb or anti-HBs)?Ang resultang "positibo" o “reaktibo” HBsAb (o anti-HBs) na pagsusuri ay nagpapahiwatig na ang tao ay matagumpay na tumugon sa bakuna sa hepatitis B o gumaling mula sa malubhang impeksyon ng hepatitis B. Ang resultang ito (kasama ng negatibong resulta sa HbsAg) ay nangangahulugan na ikaw ay hindi tatablan ng (protektado mula sa) hepatitis B na impeksyon sa hinaharap. Ano ang hepatitis B core antibody (HBcAb)?Ang HBcAb ay isang antibody na bahagi ng virus - hindi ito nagbibigay ng proteksyon. Ang resultang "positibo" o "reaktibo" sa HBcAb (o anti-HBc) na pagsusuri ay nagpapahiwatig ng impeksyon sa nakaraan o kasalukuyan. Ang interpretasyon ng resulta ng pagsusuring ito ay nagdedepende sa mga resulta ng dalawang iba pang mga pagsusuri. Ang paglitaw nito kasama ng nagpoprotektang panlabas na antibody (positibong HBsAb o anti-HBs) ay nagpapahiwatig ng naunang impeksyon at paggaling. Para sa mga taong may talamak na impeksyon, lumilitaw ito kasama ng virus (positibong HBsAg). Hepatitis B Blood Tests Is there a blood test for hepatitis B?There is a simple hepatitis B blood test that your doctor or health clinic can order called the “hepatitis B blood panel”. This blood sample can be taken in the doctor’s office. There are 3 common tests that make up this blood panel. Sometimes the doctor may ask to check your blood again six months after your first visit to confirm your hepatitis B status. If you think you have been recently infected with hepatitis B, it can take up to 9 weeks before the virus will be detected in your blood.Understanding your hepatitis B blood test results can be confusing, so you want to be sure about your diagnosis – are you infected with hepatitis B, have you recovered from a hepatitis B infection, or do you have a chronic hepatitis B infection? In addition, it is helpful if you request a written copy of your blood tests so that you fully understand which tests are positive or negative. What three tests make up the "hepatitis B blood panel"? The hepatitis B blood panel requires only one blood sample but includes three tests that are needed to make a final diagnosis: HBsAg (hepatitis B surface antigen) HBsAb or anti-HBs (hepatitis B surface antibody) HBcAb or anti-HBc (hepatitis B core antibody) What is the hepatitis B surface antigen (HBsAg)? A "positive" or “reactive” HBsAg test result means that the person is infected with the hepatitis B virus, which can be an "acute" or a "chronic" infection. Infected people can pass the virus on to others through their blood. What is the hepatitis B surface antibody (HBsAb or anti-HBs)?A "positive" or “reactive” HBsAb (or anti-HBs) test result indicates that a person has either successfully responded to the hepatitis B vaccine or has recovered from an acute hepatitis B infection. This result (along with a negative HbsAg result) means that you are immune to (protected from) a future hepatitis B infection. What is the hepatitis B core antibody (HBcAb)?The HBcAb is an antibody that is part of the virus- it does not provide protection. A "positive" or "reactive" HBcAb (or anti-HBc) test result indicates a past or present infection. The interpretation of this test result depends on the results of the other two tests. Its appearance with the protective surface antibody (positive HBsAb or anti-HBs) indicates prior infection and recovery. For chronically infected persons, it will usually appear with the virus (positive HBsAg).  

  https://www.hepb.org/languages/tagalog/bloodtests/
• Raw Shellfish Warning for those with Hepatitis B

  Summer is here, and it’s time for a smorgasbord of your favorite, fresh seafood.  All good, but if you have hepatitis B, you’re going to want to take precautions to ensure you don’t get sick, or even die, from the seafood that you eat. There are a couple of variations on what is considered shellfish, but basically it includes oysters, clams, mussels, shrimp, crab, and lobster.  Oysters and clams are the only shellfish eaten raw, so they present the greatest danger.  Raw oysters are the main culprit, although all raw or undercooked shellfish from warm coastal waters, especially during the summer months, are a risk.  It's difficult to ensure the origin of your seafood, despite labeling requirements, and whether or not it was frozen, or partially unfrozen at some time.  As a result, it's best to treat all seafood equally.  And of course it's not the shellfish itself, but rather a microbe called Vibrio vulnificus.  In fact this hearty microbe may exist in warm, salt-water directly, and care should be taken to avoid exposure of open wounds to potentially contaminated water. V. vulnificus is very virulent with a 50% mortality rate.  The microbe may enter the blood stream via an open wound, or the GI tract where it may cause sepsis.  This is especially perilous for people that are immunocompromised, or have liver damage due to chronic infections such as viral hepatitis - specifically hepatitis B.  Symptoms may include fever, chills, vomiting, diarrhea, and abdominal pain.  It is very serious, and may lead to septic shock and death.  Septic infections are carry a high mortality rate of 50% in individuals without liver disease.  Those that are immunocompromised or suffer from liver disease are 80 to 200 times more likely to develop septicemia from V. vulnificus than those without liver disease.  Those are pretty serious odds. Please keep in mind that this is not to be confused with basic food poisoning from "bad seafood".  There are no visible signs of

  http://www.hepb.org/blog/raw-shellfish-warning-for-those-with-hepatitis-b/
• 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/
• Got Hepatitis B? Share Your Favorite Liver Specialist with the HBV Community

  Do you have a favorite liver specialist that you’d like to share with the Hepatitis B Foundation and friends living with HBV?  Friends with HBV live all over the globe, and we are interested in liver specialists with Hepatitis B treating experience from all over.  Pediatric patients are a special sub-population with special treating needs, too.  We’d love to hear from all of you!  Here’s what we’re looking for… The Hepatitis B Foundation maintains a database of liver specialists that have experience treating patients with HBV.  Based on your recommendations, we would love to extend an invitation to your liver specialist to participate in our directory of liver specialists.  If your liver specialist replies, we will add his/her name to the list. We’ve had some wonderful, new HBV friends on facebook from Africa and other continents, and we would encourage all of you to send us your liver specialist’s contact information.  Our international database is a little sparse, so we really need your input!  This would also include parents of children with HBV that are living abroad.  So, if you’ve got experience with a treating specialist that you’d like to share, you can be sure others will benefit from your advice. Here is what the Hepatitis B Foundation needs to know: Residing country Adult or pediatric specialist Liver specialist’s name and contact information  - including name, address, telephone number and email address (if available) Anything else you’d like to share! Email this important information to directory@hepb.org .  Please keep in mind that the information you provide is offered as a courtesy to others in the HBV community.  Your name will not be associated, and the addition of your physician does not make you responsible in any way.  This is not a physician referral service, but rather an opportunity for those living with HBV to share resources.  (Please note the disclaimer.) Thanks to all who participate.  The entire HBV

  http://www.hepb.org/blog/got-hepatitis-b-share-your-favorite-liver-specialist-with-the-hbv-community/
• Mosquito Repellent and Hepatitis B

  Summer has arrived and so have your annoying neighborhood mosquitoes, who show up uninvited to every party.  Everyone's first impulse is to spray on the DEET, an effective, insect repellent, to keep them away. If you have hepatitis B, and are working hard to "love your liver", you might be wondering what affect DEET will have on your liver.   Your liver is an amazing organ responsible for filtering just about everything we inhale, ingest or absorb through the skin.  DEET is an effective, but strong chemical, that when applied to the skin, or accidentally inhaled while spraying, or ingested due to poor hand washing, may be found in the blood stream up to 12 hours later.  It's your liver's job to ensure this toxin is filtered from your system.   An over-taxed liver can be problematic for anyone, but placing additional burdens on your liver when you have HBV can contribute to liver damage over time. Here are a couple of things to consider.  Mosquitoes and other flying, or biting insects are vectors for numerous diseases that can make us very sick.   (Please keep in mind that mosquitoes are NOT vectors for hepatitis B.)  As a result we have to consider other options, or weigh the risks vs. the benefits of spraying on a dose of DEET.  If you do decide that DEET is the best protection against mosquitoes, consider limiting your exposure by applying it to your clothing, rather than directly to the skin.  When you're back inside and out of mosquito territory, wash it off.  Don't wear it to bed. A natural alternative to chemically produced repellents is citronella, which has been registered for use in the U.S. since 1948.  It is made by steam distillation of certain grasses, and is considered a biopesticide, a naturally occurring substance that controls by non-toxic means. Citronella can be purchased in various outdoor candles and natural, registered products such as Burt's Bee's Herbal Insect Repellent, or Avon Skin So Soft.  Citronella and other remedies can

  http://www.hepb.org/blog/mosquitos-repellents-and-hepatitis-b/
• Choosing a Liver Specialist to Treat Your HBV

  Got HepB?  Which doctor is right for you?  Do you need a hepatologist, gastroenterologist (GI doctor), or an infectious disease doctor?  Is the patient an adult or child?  If you’re new to HBV, these specialty doctors are likely foreign to your doctor line-up, and weeding through the specialty titles and training can be confusing.   However, if you have HBV, it’s essential that you find a knowledgeable liver specialist to monitor and potentially treat your hepatitis B. A hepatologist is a doctor that specializes in diseases associated with the liver.  Hepatology is a sub-specialty of gastroenterology.  This is an obvious choice for patients with HBV, but it may be difficult to find a hepatologist in your vicinity. A gastroenterologist, or GI doctor, specializes in the function and disorders of the GI tract, which includes the esophagus, stomach, pancreas, intestines and the liver.  This covers a very broad spectrum of functions and diseases.  The key is to find a GI doctor that has experience treating patients with liver disease - specifically, viral hepatitis, and hepatitis B.  If your GI candidate spends much of his week performing endoscopies, he is likely not a good choice for a liver specialist. Because hepatitis B is an infectious disease, it would seem logical that an infectious disease specialist would be the best choice.  However, this is not usually the case with hepatitis B, or viral hepatitis, but rather HIV and other infectious diseases.  Your best bet will most likely be a hepatologist or a GI doctor. If the patient is a child, it is imperative that the child see a pediatric liver specialist.  Some of the best and brightest, cutting edge doctors are both pediatric hepatologists and GI docs.  Children with HBV are monitored and treated much differently than adults.  The labs look different, and the treatment protocols also differ.  You need a pediatric specialist. Ultimately, the key is finding a liver specialist that has

  http://www.hepb.org/blog/choosing-a-liver-specialist-to-treat-your-hbv/