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

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  • Microbiome matters: What your gut says about your liver

    … linked to more lactobacillales and fewer clostridiales, which suggests another kind of imbalance (Zhou et al., 2025). This connection could lead to new treatments that target both bile acids and bacteria.  Your gut microbiome does a lot more than help you digest food. It’s deeply connected to your liver and can influence how hepatitis B develops and changes over time. As scientists learn more, we may see new treatments that focus on fixing the microbiome to protect and promote liver health.    References:  Chen, Y., et al. (2025). Gut microbiota and metabolomic profiles in HBV-related cirrhosis. Journal of Hepatology Research.  Li, X., et al. (2024). Gut mycobiome and liver disease: Emerging insights. Liver International.  Wang, J., et al. (2023). Microbiota diversity across HBV disease stages. Microbiome Medicine.  Zhang, L., et al. (2024). Gut microbiota and chronic liver disease: Mechanisms and interventions. Hepatology Reviews.  Zhou, H., et al. (2025). Microbiota–bile acid crosstalk in HBV-induced cirrhosis. Clinical Gastroenterology.   

    https://www.hepb.org/blog/microbiome-matters-gut-says-liver/
  • CHIPO Member Highlight: Africa Health Research Institute

    … with media outlets (TV/radio), the Department of Health (DoH), schools, the Department of Agriculture (DoA), local municipalities, and South African Police Services (SAPS), amongst others, to educate and raise awareness of these diseases within the populations most affected by them. More specifically, AHRI has recently put hepatitis on its strategic map by establishing the study entitled “Evaluation of Vukuzazi LiVEr disease - Hepatitis B: A study to determine the prevalence and characteristics of chronic hepatitis B virus infection in the Vukuzazi population to inform interventions for diagnosis, treatment and prevention” (EVoLVE). See our website for more details: EVoLVE Hepatitis B Study - Africa Health Research Institute (ahri.org) EVoLVE aims to address the pressing need to develop insights into local population HBV epidemiology (considering vaccination, exposure and infection), to quantify the need for – and potential impact of – antiviral treatment. EVoLVE also aims to enhance local pathways for the assessment and provision of clinical care to people living with HBV infection in South Africa. Data collected as part of an interdisciplinary collaboration between clinical and social scientists, in consultation with communities, will be used to inform responsive and sensitive-to-context interventions specifically targeting those at greatest risk of infection and disease, and provide clinical care, support and education, whilst developing an evidence-based foundation for future studies. EVoLVE has already celebrated a successful collaboration between the clinical and human sciences by involving a Community Advisory Board (CAB) in the inductive development of community understanding and perceptions pertaining to the hepatitis B virus (HBV).  In January 2024, the AHRI EVoLVE Team participated in a community engagement with the AHRI CAB and conducted FibroScan training with AHRI clinical and research teams. (FibroScan is a non-invasive ultrasound that

    http://www.hepb.org/blog/chipo-member-highlight-africa-health-research-institute/
  • Why Access to Birth Dose Remains a Challenge Despite Availability of Vaccine. 

                      Birth dose is the most critical public health tool to prevent the spread of new hepatitis B infections among newborn children. Vaccination at birth provides lifelong protection against hepatitis B and reduces the chances of developing chronic hepatitis B. However, access to birth dose and vaccinations for children remains a challenge in many countries, especially countries low- and middle-income countries with high prevalence of hepatitis B, despite the availability of safe and effective vaccines.   Lack of Knowledge  Many communities are unaware of the hepatitis B virus and how it can cause severe damage to the liver, especially for newborn children. Mothers who deliver children at home or without appropriate medical care are also less likely to get the birth dose for their babies. Lack of knowledge about the spread of the virus and vaccination persists among some medical providers and professionals as well, making it harder for families to get birth dose for their children in a timely manner. Misconceptions about the virus and the vaccine also makes it difficult to get children vaccinated. Educational campaigns should focus on raising awareness about the hepatitis B virus and teaching communities about the role of the birth dose in preventing serious liver disease and death (Freeland et al., 2023). Cost and Transportation  Many families mentioned cost to be a barrier to getting the birth dose for their children. For some mothers, they were unable to deliver at health facilities or lacked safe transportation to get to a health facility to get their children vaccinated. For families who lived in rural areas, finding a nearby health facility was a challenge. This also makes it difficult for mothers to return to the health facilities to get the remaining doses for their children.   Lack of Political Will and Advocacy  While the birth dose is available in many countries with high rates of hepatitis

    http://www.hepb.org/blog/access-birth-dose-remains-challenge-despite-availability-vaccine/
  • Happy NAIRHHA Day!

    Today is NAIRHHA Day! Every September 9th, the Hepatitis B Foundation brings awareness to National African Immigrant and Refugee HIV/AIDS and Hepatitis Awareness Day. Founded by advocates in Massachusetts, Washington D.C., and New York, NAIRHHA Day has been observed annually on September 9th by healthcare professionals, awareness campaigns, and other organizations since 2014. The Multicultural AIDS Coalition (MAC), Hepatitis B Foundation and the Coalition Against Hepatitis for People of African Origin (CHIPO) are working to establish NAIRHHA day as their own federally designated awareness day. Hepatitis B and HIV in African Immigrant Communities  People of African origin are disproportionately affected by hepatitis B infection. Worldwide an estimated 292 million people are infected with chronic hepatitis B. Over 60 million people in Africa have hepatitis B which annually accounts for an estimated 68,870 deaths.1 In fact, in some African communities in the United States, between 5%-15% of people have chronic HBV infection. Unfortunately, due to the silent nature of the disease, lack of disease awareness, and limited health care access, most African community members who have hepatitis B DO NOT KNOW that they are infected. This puts them at much greater risk for premature death from cirrhosis or liver cancer. There is a high burden of HIV/HBV co-infection in African countries because both diseases share similar transmission routes such as mother-to-child, unsafe medical and injection practices, and unscreened blood transfusions.2 Chronic HIV/HBV infection is reported in up to 36% of people who are HIV positive, with the highest prevalence reported in west Africa and southern Africa. The co-infection of HIV and HBV is especially dangerous because it accelerates liver disease such as fibrosis and cirrhosis. In fact, liver-related mortality is twice as high among people with an HIV/ HBV co-infection.2  With approximately 54,000 people with HBV who immigrate to the

    http://www.hepb.org/blog/happy-nairhha-day/
  • My country does not have a clinical trial for hepatitis B. Is it possible to travel to another country to participate?

    Volunteering for a clinical trial is noble and valuable. Participating in a clinical trial can be a great opportunity to benefit from the latest advances, often with medication and expensive tests paid for if accepted into the study. However, it is common that clinical trials are run only in certain countries. This is often because the researcher has permission (or funding) to operate in certain countries, or because this is where the study team is based. In other situations, the country where you live may not have properly equipped and validated laboratories or may not approve the study because of regulatory restrictions. Please keep in mind that participating in a clinical trial usually involves a number of visits to the medical facility to administer treatment or for follow up tests. This makes participating in clinical trials practically impossible for those living outside of a country that is a trial site.   Additionally, countries where clinical trials are conducted, don’t grant entry visas for those willing to participate in clinical trials based only on participation in a clinical trial. Although this may sound disappointing, you should not lose hope, as regulations and research funding opportunities can sometimes change. To search for hepatitis B clinical trials near you, visit our clinical trials webpage. While you wait for an opportunity to participate in a clinical trial, or for a functional cure to be discovered, it is important to ensure your liver and general health are in the best health possible. This includes seeing a knowledgeable doctor about your hepatitis B infection and liver health and maintaining a healthy lifestyle by eating a well-balanced diet and exercising regularly. If treatment with currently available antivirals such as tenofovir and entecavir are advised, please do consider the importance of these treatments on your liver health. Your goal is to keep your liver as healthy as possible for when there is a functional cure available for hepatitis B. Please note that the Hepatitis B Foundation does not fund or conduct clinical trials, but we believe it is important to let the hepatitis B community know about opportunities to participate. We will always continue sending information about new ways to get involved. Find more Frequently Asked Questions here.    Page updated 12/27/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/my-country-does-not-have-a-clinical-trial-for-hepatitis-b-is-it-possible-to-travel-to-another-country-to-participate/
  • If hepatitis B is sexually transmitted, how come my partner isn’t infected?

    This is possible, and not an uncommon scenario. There are several factors that may lead to this situation. Hepatitis B Virus (HBV) viral load of the partner living with hepatitis B may be undetectable. The lower the viral load in the blood of an infected individual, the less infectious they are. The likelihood of transmitting hepatitis B virus increases with higher viral loads (HBV DNA). Please discuss with your doctor the benefits of antivirals in lowering viral load and potentially reducing the risk of transmitting hepatitis B. Type of sexual activity is another important factor. There are sexual activities that are associated with higher risk of hepatitis B transmission than others due to the potential exchange of infected fluids (blood, semen and vaginal fluids). For example, anal sex is considered the highest risk sexual activity followed by vaginal intercourse. Oral sex and deep kissing have been reported to be less risky interactions in transmitting HBV. However, any activity that might involve abrasions or trauma may put a person at higher risk of transmission (consider the idea of bleeding gums or cold sores). If you have multiple partners or your partner is in the process of being vaccinated, condoms and dental dams are always recommended to reduce risk of transmission. Timing of sexual activity may also play a role as sexual activity during the menstrual period poses higher risk of blood contact if the menstruating person is infected. This is why the use of dental dams or condoms is recommended. Your partner’s hepatitis B status. Your partner may have a current hepatitis B infection, resolved a previous infection, or may have been vaccinated in the past as a child. This is why, the hepatitis B three- test panel (HBsAg, HBcAb total and HBsAb) is standard practice for screening to best understand one’s hepatitis B status. Please encourage your partner to consider the hepatitis B vaccine series if their screening reveals that they are susceptible. The hepatitis B vaccine is safe, effective, and provides lifelong protection. You will find more information in the blogs below: If Hepatitis B Is Sexually Transmitted, How Come My Partner Isn't Infected? It’s more complicated than you might think If I Have Hepatitis B, Why Doesn’t My Partner? My partner has been diagnosed with hepatitis B. Can transmission be prevented by vaccination?   Find more Frequently Asked Questions here.    Page updated 12/27/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/if-hepatitis-b-is-sexually-transmitted-how-come-my-partner-isnt-infected/
  • Federal Task Force Recommendation for Hepatitis B Screening Fails to Close Gaps in Diagnosis Rates

    Doylestown, Dec. 16, 2020 – The Hepatitis B Foundation today released the following statement regarding the recent publication of a new statement from the U.S. Preventive Services Task Force (USPSTF) that reinforced its 2014 recommendation to screen only adolescents and adults at increased risk for hepatitis B (HBV) infection with a B grade. Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation and co-chair of Hep B United, a national coalition focused on addressing hepatitis B and liver cancer, said: “We are very disappointed the Task Force came to its decision to continue a risk-based screening recommendation for hepatitis B infection. Screening persons based on risk groups for HBV infection in the U.S. has been ineffective and highly stigmatizing. We estimate over 2 million Americans are living with HBV infection, yet a staggering number – about 65 to 75% – remain undiagnosed.” “Despite having these recommendations in place for nearly a decade, we have seen very limited progress in identifying those with HBV infection and a rise in the incidence of liver cancer rates. Additionally, we have failed to make hepatitis B screening a routine practice within our health care systems, so the burden of implementation has fallen on under-resourced community-based organizations.” “Given the recent rise in acute HBV infections tied to injection drug use and the opioid crisis, we have clearly also missed opportunities to identify and protect those susceptible to infection. It is time to transition to universal testing of all adults for HBV infection, and adequate screening means not only with the hepatitis B surface antigen test as recommended by USPSTF, but with the complete panel of hepatitis B tests ¬– surface antigen, surface antibody and core antibody. Screening with hepatitis B surface antigen alone represents a missed opportunity to identify individuals who need to be vaccinated, as well as those who are at risk of reactivation of their HBV infection.” “We cannot eliminate hepatitis B in the U.S. with risk-based screening guidelines. A universal adult hepatitis B screening strategy will help identify infected individuals and link them with care to reduce deaths due to hepatitis B, vaccinate and provide lifelong protection for susceptible individuals, decrease stigma and discrimination associated with an infectious disease and eliminate hepatitis B in future generations.” 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., with an office in Washington, D.C. 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 established by the Hepatitis B Foundation and the Association of Asian and Pacific Community Health Organizations (AAPCHO) to address the public health challenge of hepatitis B by increasing awareness, screening, vaccination and linkage to care for all Americans, with a particular focus on Asian-American and Pacific Islander populations that are disproportionately impacted. To learn more, visit www.hepbunited.org.

    https://www.hepb.org/news-and-events/news-2/federal-task-force-recommendation-for-hepatitis-b-screening-fails-to-close-gaps-in-diagnosis-rates/

  • ການກວດເລືອດຂອງໄວຣັສ໌ຕັບອັກເສບ ບີ້  ມີການກວດເລືອດຊອກຫາໄວຣັສ໌ຕັບອັກເສບບີ້ ບໍ?ມີການກວດເລືອດໄວຣັສ໌ຕັບອັກເສບບີ້ ທີ່ງ່າຍດາຍ ທີ່ໝໍຂອງທ່ານ ຫຼື ຄລີນິກສຸຂະພາບ ສາມາດສັ່ງໄດ້ເອີ້ນວ່າ “ແຜນກວດເລືອດຫາເຊື້ອໄວຣັສ໌ຕັບອັກເສບບີ້”. ຕົວຢ່າງເລືອດນີ້ສາມາດເອົາໄດ້ຈາກຫ້ອງການຂອງທ່ານໝໍ. ມີການກວດທົ່ວໄປ 3 ຢ່າງ ທີ່ສາມາດສ້າງແຜນກວດເລືອດນີ້.ບາງຄັ້ງ ທ່ານໝໍອາດຈະຂໍໃຫ້ທ່ານກວດເລືອດອີກຄັ້ງໜຶ່ງໃນໄລຍະຫົກເດືອນຫຼັງຈາກທ່ານເຂົ້າພົບໝໍຄັ້ງທໍາອິດ ເພື່ອຢັ້ງຢືນສະພາບຕັບອັກເສບ ບີ້ ຂອງທ່ານ.ຖ້າທ່ານຄຶດວ່າ ທ່ານໄດ້ຮັບເຊື້ອໄວຣັສ໌ຕັບອັກເສບ ບີ້ ໃນມໍ່ໆມານີ້, ມັນຕ້ອງໃຊ້ເວລາປະມານ 9 ອາທິດ ຈຶ່ງຈະສາມາດພົບໄວຣັສໃນເລືອດຂອງທ່ານໄດ້. ການເຂົ້າໃຈໃນຜົນຂອງການກວດເລືອດໄວຣັສ໌ຕັບອັກເສບ ບີ້ ຂອງທ່ານ ອາດຈະມີຄວາມສັບສົນ, ສະນັ້ນ ທ່ານຕ້ອງການໝັ້ນໃຈກ່ຽວກັບການບົ່ງມະຕິພະຍາດຂອງທ່ານ - ທ່ານໄດ້ຮັບເຊື້ອໄວຣັສ໌ຕັບອັກເສບ ບີ້, ທ່ານເຊົາຈາກການຕິດເຊື້ອໄວຣັສ໌ຕັບ ອັກເສບບີ້, ຫຼື ທ່ານຕິດເຊື້ອໄວຣັສ໌ຕັບອັກເສບບີ້ຊໍາເຮື້ອ ຫຼືບໍ່? ນອກຈາກນັ້ນ, ຈະມີປະໂຫຍດຖ້າວ່າທ່ານຂໍເອົາສໍາເນົາເອກະສານທີ່ເປັນລາຍລັກອັກສອນກ່ຽວກັບຜົນຂອງການກວດເລືອດຂອງທ່ານ ເພື່ອໃຫ້ທ່ານເຂົ້າໃຈຢ່າງເລິກເຊິ່ງວ່າ ການກວດເລືອດອັນໃດທີ່ມີຄ່າບວກ ຫຼື ຄ່າລົບ. ມີອັນໃດແດ່ໃນການກວດສາມຢ່າງ ທີ່ສ້າງເປັນ "ແຜນກວດເລືອດໄວຣັສ໌ຕັບອັກເສບບີ້"? ແຜນກວດເລືອດເພື່ອຊອກຫາໄວຣັສ໌ຕັບອັກເສບບີ້ ຕ້ອງການເກັບຕົວຢ່າງເລືອດພຽງແຕ່ຕົວຢ່າງດຽວ ແຕ່ປະກອບດ້ວຍການກວດເລືອດສາມຢ່າງທີ່ມີຄວາມຈໍາເປັນໃນການບົ່ງມະຕິພະຍາດຄັ້ງສຸດທ້າຍ: HBsAg (ສານກະຕຸ້ນການສ້າງສານຕໍ່ຕ້ານລັກສະນະພາຍນອກໄວຣັສ໌ຕັບອັກເສບບີ້)  HBsAb ຫຼື ສານຕໍ່ຕ້ານ-HBs (ສານຕໍ່ຕ້ານໃນຮ່າງກາຍລັກສະນະພາຍນອກຂອງໄວຣັສ໌ຕັບອັກເສບບີ້)  HBcAb ຫຼື ສານຕໍ່ຕ້ານ-HBc (ສານຕໍ່ຕ້ານໃນຮ່າງກາຍຂອງແກນໄວຣັສ໌ຕັບອັກເສບບີ້) ສານກະຕຸ້ນການສ້າງສານຕໍ່ຕ້ານລັກສະນະພາຍນອກໄວຣັສ໌ຕັບອັກເສບບີ້ (HBsAg) ແມ່ນຫຍັງ? ຜົນກວດ HBsAg "ທີ່ເປັນບວກ" ຫຼື “ເປັນລົບ” ມີຄວາມໝາຍວ່າ ບຸກຄົນດັ່ງກ່າວຕິດເຊື້ອໄວຣັສ໌ຕັບອັກເສບບີ້, ຊຶ່ງສາມາດເປັນການຕິດເຊື້ອແບບ "ແບບກະທັນຫັນ" ຫຼື "ຊໍາເຮື້ອ". ຄົນທີ່ຕິດເຊື້ອສາມາດກະຈາຍໄວຣັສ໌ໃຫ້ຄົນອື່ນໂດຍຜ່ານເລືອດຂອງພວກເຂົາ. ສານຕໍ່ຕ້ານໃນຮ່າງກາຍລັກສະນະພາຍນອກຂອງໄວຣັສ໌ຕັບອັກເສບບີ້ (HBsAb ຫຼື ສານຕໍ່ຕ້ານ-HBs) ແມ່ນຫຍັງ?ຜົນກວດ HBsAb (ຫຼື ສານຕໍ່ຕ້ານ-HBs) ທີ່ເປັນບວກ" ຫຼື “ເປັນລົບ” ສະແດງໃຫ້ເຫັນວ່າ ບຸກຄົນດັ່ງກ່າວມີຜົນຕອບຮັບຕໍ່ວັກຊີນໄວຣັສ໌ຕັບອັກເສບບີ້ ໄດ້ເປັນຢ່າງດີ ຫຼື ເຊົາຈາກການຕິດເຊື້ອໄວຣັສ໌ຕັບອັກເສບບີ້ ແບບກະທັນຫັນ. ຜົນໄດ້ຮັບນີ້ (ລວມທັງຜົນ HbsAg ທີ່ເປັນລົບ) ມີຄວາມໝາຍວ່າ ທ່ານມີພູມຕ້ານທານຕໍ່ (ໄດ້ຮັບການປົກປ້ອງຈາກ) ການຕິດເຊື້ອໄວຣັສ໌ຕັບອັກເສບບີ້ ໃນອະນາຄົດ. ສານຕໍ່ຕ້ານແກນໄວຣັສ໌ຕັບອັກເສບບີ້ (hepatitis B core antibody - HBcAb) ແມ່ນມີອັນໃດແດ່)?HBcAb ແມ່ນສານຕໍ່ຕ້ານໃນຮ່າງກາຍທີ່ແມ່ນສ່ວນໜຶ່ງຂອງໄວຣັສ໌ - ມັນບໍ່ໃຫ້ການປ້ອງກັນ. ຜົນກວດ " (ຫຼື ສານຕໍ່ຕ້ານ-HBc) "ທີ່ເປັນບວກ" ຫຼື “ເປັນລົບ” ສະແດງໃຫ້ເຫັນການຕິດເຊື້ອໃນອະດີດ ຫຼື ປັດຈຸບັນ. ການອະທິບາຍຜົນການກວດນີ້ແມ່ນຂຶ້ນກັບຜົນຂອງການກວດອີກສອງຢ່າງ. ການສະແດງໃຫ້ເຫັນດ້ວຍສານຕໍ່ຕ້ານໃນຮ່າງກາຍລັກສະນະພາຍນອກທີ່ໄດ້ຮັບການປ້ອງກັນ (HBsAb ທີ່ເປັນບວກ ຫຼື ສານຕໍ່ຕ້ານ-HBs) ສະແດງໃຫ້ເຫັນກ່ອນຈະມີການຕິດເຊື້ອ ແລະ ກັບຄືນສູ່ສະພາບປົກກະຕິ. ສໍາລັບບຸກຄົນທີ່ໄດ້ຮັບເຊື້ອຊໍາເຮື້ອ, ຈະປະກົດມີໄວຣັສ໌ (HBsAg ທີ່ເປັນບວກ). 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/laotian/bloodtests/
  • Vaccine Non-Responders

    A hepatitis B vaccine “non-responder" refers to a person who does not develop protective surface antibodies after completing two full series of the hepatitis B vaccine and for whom an acute or chronic hepatitis B infection has been ruled out. Although the majority of persons vaccinated against hepatitis B successfully respond to vaccination, an estimated 5-15% of persons may not respond due to older age, obesity, smoking, and other chronic illness. It is also possible that a person who does not respond to the vaccine may already be infected with hepatitis B. Therefore, testing for the presence of the hepatitis B virus (hepatitis B surface antigen or HBsAg) is recommended before diagnosing a person as a "vaccine non-responder." CDC Recommendations for Hepatitis B Vaccine Non-Responders Persons who do not respond to the primary hepatitis B vaccine series (i.e., anti-HBs <10 mIU/mL) should complete a second vaccine series or be evaluated to determine if they are HBsAg-positive. For the second series, a different brand of vaccine should be administered. For adults in the U.S., the second series can be given using a 3-dose vaccine or the 2-dose vaccine. Persons who do not respond to an initial vaccine series have a 30%--50% chance of responding to a second series. Newer vaccines might provide greater seroprotection, which can mean a greater antibody response, especially in adults who may be older, obese or live with type 2 diabetes. If you have not responded to a primary hepatitis B vaccine series, talk to your doctor about whether the Heplislav-B (2-dose) or PreHevbrio (3-dose) vaccine is a better option for you. Revaccinated persons should be retested to check antibody response at the completion of the second vaccine series, 1-2 months following the last dose of the series. Persons exposed to HBsAg-positive blood or body fluids who are known not to have responded to a primary vaccine series should receive a single dose of hepatitis B immunoglobulin (HBIG) and restart the hepatitis B vaccine series with the first dose of the hepatitis B vaccine as soon as possible after exposure. Alternatively, they should receive two doses of HBIG, one dose as soon as possible after exposure, and the second dose 1 month later. The option of administering one dose of HBIG and restarting the vaccine series is preferred for non-responders who did not complete a second 3-dose vaccine series. For persons who previously completed a second vaccine series but failed to respond, two doses of HBIG are preferred. Hepatitis B vaccine “non-responders” who test negative for hepatitis B infection are at risk for being infected and should be counseled regarding how to prevent a hepatitis B infection and to seek immediate medical care to receive a dose of hepatitis B immunoglobulin (HBIG) if they have been exposed to potentially infected blood. Hepatitis B vaccine “non-responders" to vaccination who test positive for hepatitis B infection should be counseled regarding how to prevent transmitting the hepatitis B virus to others and the need for regular medical care and monitoring for their chronic infection. References Schillie S, Harris A, Link-Gelles R, Romero J, Ward J, Nelson N. Recommendations of the Advisory Committee on Immunization Practices for Use of a Hepatitis B Vaccine with a Novel Adjuvant. MMWR Morb Mortal Wkly Rep. 2018;67(15):455-458.  Immunization Action Coalition. Ask the Experts: Hepatitis B. https://www.immunize.org/askexperts/experts_hepb.asp

    https://www.hepb.org/prevention-and-diagnosis/vaccination/vaccine-non-responders/
  • Who's On Your HBV Team?

    No matter where you are with your hepatitis B - chronically infected since birth, or recently learned you are HBV positive, you want to be sure you are surrounded by all of the right people to give you the medical guidance and emotional support you need. Start with your primary care physician (PCP).  You want a doctor that listens to you and is willing to work with your liver specialist.  Your PCP's office may be coordinating your annual or bi-annual lab work for HBV monitoring and is your first line of care . HBV can be complicated when it comes to making decisions about whether or not you need monitoring, treatment, or monitoring for liver cancer (HCC).  There are many phases of HBV, and you want to be sure you are followed through ALL phases.  You need a liver specialist that has experience working with patients infected with HBV.  This doctor is nearly always a Gastroenterologist (GI doc) or a Hepatologist.  If the patient is a child, you need a pediatric GI doctor or hepatologist.  Although well qualified, an infectious disease doctor is not really the best fit because of the involvement of the liver.  Once again, experience with HBV infected patients is crucial.  These specialists are often found at large, or University Hospital centers. Check out this directory of liver specialists in your area.   Keep in mind that living a couple of hours from your liver specialist should be fine.  Visits are typically annual or bi-annual.  Visits may increase depending on treatment you may require.  Lab work can usually be coordinated with your local lab via your PCP. Get to know your local pharmacist.  They are a wonderful source of information on everything from prescribed HBV medications to choosing the best OTC cold medicines, or pain relievers.  I am on a first name basis with my pharmacist, and try to visit when the volume of customers is low, so no one feels rushed. Living with a chronic illness can take its toll on your mental health.  Each

    http://www.hepb.org/blog/whos-on-your-hbv-team/