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• August is National Immunization Awareness Month!

  As August wraps up National Immunization Awareness Month (NIAM). This month we raise awareness to highlight the importance of vaccination. In the era of COVID-19, we are shown how effective and protective vaccines are. During NIAM, we encourage you to talk to your doctor, nurse, or healthcare professional to ensure you and your family are protected against serious diseases by getting caught up on routine vaccination, especially the hepatitis B vaccination! What is 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. Two billion people (or 1 in 3) have been infected and about 300 million people are living with a chronic hepatitis B infection. Each year around 820,000 people die from liver disease caused by hepatitis B despite the fact that it is preventable and treatable. In the United States, 2.4 million people are chronically infected with hepatitis B! The hepatitis B virus (HBV) is transmitted through blood and infected bodily fluids. It can be passed to others through direct contact with blood, unprotected sex, unsterilized or contaminated needles, and from an infected woman to her newborn during pregnancy or childbirth. Hepatitis B is a “silent epidemic” because most people do not have symptoms when they are newly infected or chronically infected. Thus, they can unknowingly spread the virus to others and continue the silent spread of hepatitis B. For people who are chronically infected but don’t have any symptoms, their liver is still being silently damaged which can develop into serious liver disease such as cirrhosis or liver cancer. Preventing Hepatitis B   It takes only 2 to 3 shots to protect yourself and your loved ones against hepatitis B for a lifetime. The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living

  http://www.hepb.org/blog/august-national-immunization-awareness-month/
• Liver Cancer Among Men

  June is Men’s Health Month. This month we bring awareness to preventable health problems and encourage early detection and treatment of disease among men and boys. In 2020, The World Health Organization found that liver cancer is the third leading cause of cancer deaths with 830,000 deaths.1 Liver cancer occurs more often in men than in women with it being the 5th most commonly occurring cancer in men and the 9th most commonly occurring cancer in women.2 There are two main types of liver cancers, hepatocellular carcinoma (HCC) which accounts for about 75% of liver cancer cases, and intrahepatic cholangiocarcinoma which accounts for 12-15% of cases. Liver cancer especially impacts Asian countries like Mongolia, Vietnam, Laos, Cambodia, Thailand, and China. Hepatitis B is the leading cause of HCC globally. Of the 300 million individuals living with a chronic hepatitis B diagnosis, about 25% will develop HCC.3 Risk Factors HCC affects men with an incidence 2x-4x higher than women due to differences in behavioral risk factors and biological factors.3 Research has found men were less likely to undergo HCC screening and more likely to smoke.  Additionally, studies have shown alcohol is a major risk factor for HCC. In the United States, HCC associated with alcohol is higher among men than in women at 27.8% and 15.4% respectively.3 Biologically, there is evidence estrogen (a female hormone) decreases IL-6 mediated hepatic inflammation and viral production.3 Studies have demonstrated IL-6 may promote virus survival and/or exacerbation of the disease.4 In the context of hepatitis B, men are at an increased risk for HCC as they do not produce estrogen which would help decrease the risk of IL-6, in turn, promoting viral survival. Prevention The great news is that HCC can be prevented by preventing hepatitis B. There is a safe and effective vaccine that can be completed in either 2 or 3 doses over a span of 3 months. Ask your healthcare provider for the hepatitis B vaccine

  http://www.hepb.org/blog/liver-cancer-among-men/
• World Refugee Day!

  June 20th is World Refugee Day! This day “celebrates the strength and courage of people who have been forced to flee their home country to escape conflict or persecution. World Refugee Day is an occasion to build empathy and understanding for their plight and to recognize their resilience in rebuilding their lives.”1 In 2020, the United Nations Refugee Agency estimates that 80 million people were forcibly displaced. A majority of refugees originate from Syria, Venezuela, Afghanistan, South Sudan, and Myanmar and are mostly resettling in countries like Turkey, Colombia, Pakistan, Uganda, and Germany.1 As individuals who are experiencing forcible displacement begin to resettle, it is important to encourage hepatitis B testing and vaccination, even though hepatitis B might be the last thing on their minds. It is important to keep health, and especially hepatitis B in mind because hepatitis B disproportionately affects people from the World Health Organization’s (WHO) African, Western Pacific, and Asian regions. In South Sudan, hepatitis B accounts for 80% of the viral hepatitis cases. Moreover, Myanmar has a moderate to high burden, with 6.5% of the general population being infected with hepatitis B. It is imperative that testing and vaccination is encouraged in countries like South Sudan and Myanmar and in countries where people are resettling to not only prevent the spread of hepatitis B but also allow people living with hepatitis B who might not know it to live a long and healthy life. Additionally, it is important to note that the continuation of care for people experiencing forcible displacement is halted when resettling in different countries. This interruption can be damaging to individuals’ health, especially those living with hepatitis B as medication must be taken daily, and seeing a liver specialist should happen every 6 months. However, some people who are in the process of resettling might be hesitant to get tested for hepatitis B. This can be due

  http://www.hepb.org/blog/world-refugee-day/
• April 30 is National Adult Hepatitis B Vaccination Awareness Day

  … 60% of healthcare personnel have completed their vaccine series. Get yourself vaccinated for yourself and your loved ones! How to Become Vaccinated for Hepatitis B In the era of COVID, we are reminded how important vaccines are. Make sure you and your loved ones are vaccinated for hepatitis B. If you are not vaccinated, ask your doctor or healthcare provider for the hepatitis B vaccine. This safe and effective vaccine is given in 2 or 3 doses depending on the vaccine: The three-dose vaccine (scheduled at 0, 1 and 6 months): The first dose is administered at any time (newborns should receive their first dose in the delivery room). The second dose is administered one month after the first dose. The third dose is administered 6 months after the first dose. Sometimes committing to a 3-dose shot is hard. Luckily, there is an approved 2-dose hepatitis vaccine, Heplisav-B, for adults in theU.S.. The two-dose vaccine: The first dose is administered at any time. The second and final dose is administered one month after the first dose. More information on the dosing schedule can be found here. -- You can show your support for National Adult Hepatitis B Vaccine Day by using the social media toolkit and hashtag #AdultHepBVaxDay on April 30th and when discussing the hepatitis B vaccine on social media! Graphics are also available to share throughout your networks. Join the Hepatitis B Foundation and other leading hepatitis organizations for a Congressional Briefing on Thursday, April 29th at 3pm ET where a group of panelists will discuss how we can work towards achieving health equity by increasing adult hepatitis B vaccination rates. -- References https://www.cdc.gov/hepatitis/populations/idu.htm https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html Author: Evangeline Wang Contact Information: info@hepb.org

  http://www.hepb.org/blog/april-30-national-adult-hepatitis-b-vaccination-awareness-day/
• Hep B Community - A New Global Online Support Group

  The Hepatitis B Foundation is excited to announce our support of a new global online community support group called Hep B Community. Thomas Tu, PhD, a researcher at Westmead Institute for Medical Research founded this online community to reach a global audience who might need support if they are affected by hepatitis B.  Dr Tu stated that “While hepatitis B remains incurable, it can be managed and treated. But, people with hepatitis B face social stigma and discrimination, discouraging them from seeking medical help that could prevent progression of their illness to serious disease like liver cancer,”. He further explained that this online forum is important for people affected by hepatitis B to feel supported and empowered to take control of their diagnosis.  Westmead Hospital’s Storr Liver Centre and the Hepatitis B Foundation have provided start-up funding and help coordinate the forum with support from the World Hepatitis Alliance. The site is peer-led, volunteer-run and is free to join. Already, more than 200 members from all over the world have joined. Chari Cohen, DrPH, MPH, senior vice president, Hepatitis B Foundation, believes, “The new forum is critically important because people can anonymously seek advice about how to live with hepatitis B, and what they can do to protect their liver and long-term health.” If you are considering joining Hep B Community - do not hesitate! In fact, research has shown that people participating in hepatitis support groups can increase their knowledge, coping, and compliance.1  How Does it Work? The online forum has multiple sections like learning resources, media about hepatitis B, and general discussion.  You can post completely anonymously and a hepatitis B expert or a person living with hepatitis B will respond to your questions. You can also choose your own username and the platform will never show your email, ensuring privacy and confidentiality.  The hepatitis B experts responding to your questions go

  http://www.hepb.org/blog/hep-b-community-new-global-online-support-group/
• 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/