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  • Family Getting Together for The Holidays? Time to Talk Hepatitis B and Your Family's Health History

    … insight into this. What effect does gender play? Did women experience liver damage or did it only happen to men? The female hormone estrogen is believed to confer some protection against hepatitis B. It may be that men in your family are at highest risk of liver damage and need more frequent monitoring and earlier treatment. Image courtesy of jk1991 at FreeDigitalPhotos.net. There are other factors besides genes that affect a multi-generational experience of hepatitis B. Did our grandparent who developed liver cancer suffer poor nutrition for extended periods in their country of origin that weakened their immune system? Did the uncle who had cirrhosis also smoke, drink or suffer exposure to chemicals at work? Could a grandparent who died of liver disease eat moldy rice or corn that contained aflatoxin, which severely damages the liver? Taken together, all of these factors give us clues to medical conditions that may run in our families, and this knowledge isn’t limited to just hepatitis B. By identifying family patterns of medical problems such as diabetes, heart disease, high blood pressure or breast cancers, healthcare providers can determine if we and our children are at increased risk of a particular condition. Because knowing your family’s health history is such a powerful tool, the Surgeon General created a free website to help everyone create a portrait of their family’s health at My Family Health Portrait. After completing the questions, the website creates a personalized “family health tree” that can be saved to a home computer. From there, families may update the information any time. The tool can be shared with other family members, who can add their health information to the portrait. It’s also important to share this portrait with your doctor. The Surgeon General has declared Thanksgiving to be National Family Health History Day. But whenever your family gathers for a holiday, ask about their medical history. It just might save your life.

    http://www.hepb.org/blog/family-getting-together-thanksgiving-time-talk-hepatitis-b-familys-health-history/
  • Hepatitis B Foundation Expert Timothy Block Predicts Transformational New Therapies for Hepatitis B

    Hepatitis B Foundation President Timothy Block By Christine Kukka For more than 25 years, Timothy Block, Ph.D,, has worked tirelessly to find a cure for hepatitis B, promoting research, writing papers, mentoring students and collaborating with experts around the world to find a cure for the 240 million people living with this deadly liver disease. Today, the cofounder and president of the Hepatitis B Foundation, the Baruch S. Blumberg Institute and the Pennsylvania Biotechnology Center, is optimistic and believes there are new therapies in sight for those living with chronic hepatitis B. An unprecedented number of researchers are scrutinizing every stage of the hepatitis B virus (HBV) replication cycle to find its vulnerabilities and develop drugs to permanently disable it. The cure Block wants would completely eradicate the infection so no one would ever wake up worrying about the risk of liver damage or cancer to themselves or a loved one. This global, active march towards a cure is in stark contrast to 1991 when Block began his solitary quest, after a friend’s devastating hepatitis B infection made him rethink his career and start focusing on the liver disease that infects more than one in three people worldwide. Twenty-five years ago, the only available treatment was conventional interferon, which was largely ineffective. The first antiviral, lamivudine, appeared shortly thereafter. It would be one of several to emerge from HIV’s drug arsenal. Since then, more antivirals designed to disrupt HBV’s replication process have been developed that target the polymerase—the essential enzyme needed for HBV replication. “But they are not cures,” Block explained during a recent webinar. “They’re good at reducing viral load (HBV DNA), but they don’t get rid of the virus, and considerable viral DNA and  hepatitis B surface antigen (HBsAg) remain in liver cells.” Nor do current antivirals get rid of the HBV chromosome called cccDNA that embed in liver

    http://www.hepb.org/blog/cure-within-reach-hepatitis-b-foundation-expert-timothy-block-says-yes/
  • October is Liver Cancer Awareness Month

    Image courtesy of Stuart Miles at FreeDigitalPhotos.net By Christine Kukka In an era of hepatitis B immunization and improved health care, an alarming trend is happening -- liver cancer is increasing and is now the second-leading cause of cancer deaths around the world. This is why it's critical that everyone living with hepatitis B should demand to be screened for liver cancer. There are three key reasons why liver cancer rates remain high: Too few people are tested for hepatitis B, which is why two-thirds of Americans living with hepatitis B don’t know they’re infected. Only 20 percent of doctors follow liver cancer screening guidelines and test at-risk hepatitis B patients for liver cancer. By the time liver cancer is diagnosed, it's often too late for effective treatment. And, screening guidelines themselves are inadequate and fail to use valuable blood tests that help identify liver cancer in its early, treatable stages. Today, the majority of liver cancer cases occur in developing countries, fueled by undiagnosed and untreated hepatitis B. More than 80 percent of these cancers are found in sub-Saharan Africa and Eastern Asia where more than 20 of every 100,000 people will suffer and die from liver cancer. But make no mistake, liver cancer happens in North America and Europe too. Because people aren't effectively screened for hepatitis B and liver cancer, an estimated 10 percent of people with chronic hepatitis B will develop liver cancer in developed countries. Most face a bleak outlook, only 20 percent of people diagnosed with liver cancer survive beyond five years. But you can beat these odds. In celebration of Liver Cancer Awareness Month, we need to insist that our doctors screen us for liver cancer. When diagnosed early, treatment succeeds and survival improves markedly. Medical guidelines that recommend when and how we are tested for liver screening vary dramatically around the world, but most of them are inadequate, according to a recent report.

    http://www.hepb.org/blog/boost-liver-cancer-awareness-reduce-risk-hepatitis-b-related-liver-cancer/
  • Hepatitis B Foundation: Answering Questions and Dispelling Fears One Call or Email at a Time

    … happier stories. Kamischke receives many others where people lose jobs, employment opportunities, relationships and family members due to hepatitis B. But what fuels her commitment to this job is to be able to lift the veil of fear, ignorance and guilt that can accompany a hepatitis B diagnosis. Ultimately, Kamischke says, what she strives to do is assure people that hepatitis B is not a punishment. With insight and education, it can be an opportunity to discover how to love and accept yourself and learn what really matters in relationships and life.

    http://www.hepb.org/blog/hepatitis-b-foundation-answers-questions-dispells-fears-one-email-call-time/
  • A Hero Takes the Fight Against Hepatitis B to Rural Ghana

    … that her babies would be protected against hepatitis B if they immediately received the first dose of the hepatitis B vaccine and HBIG within 12 hours of birth. But things went wrong. She had stopped taking tenofovir. Her midwife gave her an herbal remedy for hepatitis B and told her the vaccine would be enough to protect the baby. It wasn’t, the baby became infected. The mother was devastated. “Her story is not so different from many others' experiences in some parts of Ghana,” he explained. “The unavailability of HBIG and the vaccine is challenging, and even when they are available, very few can afford them.” In Ghana, and many other regions of Africa, the only vaccines available for free are combination (pentavalent) vaccines that contain vaccines for hepatitis B, diphtheria and other diseases. While economical, these combination vaccines cannot be administered until a baby is at least six weeks old, which is too late to prevent mother-to-child infection. To break the infection cycle, a single dose (monovalent) hepatitis B vaccine must be administered within 12 hours of birth. “I believe something can be done about this,” said Owusu-Ansah. "With government support, we need to expand our education campaigns to cover rural areas and take the message of hope to their doorsteps.” For more information about the Hepatitis Foundation of Ghana, visit its website or email theobald2003@yahoo.com.

    http://www.hepb.org/blog/hero-takes-fight-hepatitis-b-rural-ghana/
  • If the currently approved hepatitis B drugs do not provide a cure, then how are they helping?

    Unmanaged hepatitis B infection causes, in the long run, liver damage and significantly increases the risk of liver cancer. The use of antivirals decreases the progression of liver disease and significantly reduces the risk of liver cancer due to the hepatitis B virus. Antivirals work by slowing down or stopping the virus from reproducing. The less virus in the blood and the liver, the less damage being done to the liver. Once the virus is suppressed, inflammation of liver tissue decreases, which is noted by a lowering of liver enzymes (SGPT/ALT and SGOT/AST). With time, the liver may be able to heal, and some damage may be reversed. Antivirals such as tenofovir alafenamide (TAF), tenofovir disoproxil (TDF) and entecavir are effective and safe. However, they work only as long as they are taken. Stopping and starting antivirals should be avoided if possible. Most people take one pill every day for years (just like drugs for hypertension, high cholesterol and high blood sugar). Taking doctor-prescribed antivirals can be lifesaving by keeping the liver in the best health possible until a functional cure is available.

    https://www.hepb.org/what-is-hepatitis-b/faqs/if-the-currently-approved-hepatitis-b-drugs-do-not-provide-a-cure-then-how-are-they-helping/
  • What People Want: The Most Important Outcomes of Future Hepatitis B Treatments

    Future treatment for hepatitis B: Participants were asked to share what they want new potential treatments to achieve, and share their perspectives on how the new hepatitis B medications under development may impact their lives. Findings: Respondents listed the most important outcomes of future hepatitis B treatments: 28% - loss of hepatitis B surface antigen (HBsAg). 25% - having finite treatment (6-12 months). 20% - reducing the risk of liver cancer. 14% - improving quality of daily life (reducing physical, emotional symptoms and stigma). One participant said “So it's my dream someday to be kind of like a business owner too. So, I want to have some kind of treatment that enables me to not really be too cautious in my life.” Take action: Learn about new hepatitis B treatments under development (Drug Watch). Help us advocate for hepatitis B curative research. Engage with scientists at HepBCommunity to share what you want in future hepatitis B treatment.

    https://www.hepb.org/resources-and-support/patient-facing-infographics/what-people-want-the-most-important-outcomes-of-future-hepatitis-b-treatments/
  • Pediatric Hepatitis Outbreaks

    Pediatric hepatitis outbreaks in the U.S, and several European countries over the past few weeks and months have raised new concerns as a number of children have suffered liver damage after becoming ill. These children did not have hepatitis B, but another form of hepatitis, which means another type of the disease that causes liver inflammation.  The U.S. Centers for Disease Control & Prevention (CDC) recently released a useful document, "Proactive Statement: MMWR on children with acute hepatitis and adenovirus infection in Alabama," posted here. The Hepatitis B Foundation suggests a very recent article in Hepatitis magazine, posted here, as a useful summary, with valuable links, though we cannot validate or verify the information it contains. If you have concerns about your child's health, please contact your physician or other health care provider. If it is an emergency, dial 911.

    https://www.hepb.org/news-and-events/news-2/pediatric-hepatitis-outbreaks/
  • B Informed Conference Videos and Information

    The Hepatitis B Foundation was proud to partner with the St. Barnabas Medical Center's Center for Asian Health to offer a free half-day conference on June 8, 2019 for people living with hepatitis B. The conference included an update on current hepatitis B research from Hepatitis B Foundation President, Dr. Timothy Block, and breakout sessions on topics including Advocacy & Storytelling; Finding Affordable Medications; Living with Hepatitis B; and Participating in Clinical Trials.  View Presentation Slides: Hepatitis B: Are We on the Road to Elimination?Su Wang, MD, MPH, Saint Barnabas Medical Center and President-Elect, World Hepatitis Alliance Research Update- What's New in HBV Cure Development Tim Block, PhD, President, Hepatitis B Foundation Patients Driving Change: Storytelling and AdvocacyJason Crum; Rhea Racho, MPAff; and Kate Moraras, MPH, Hepatitis B Foundation Navigating Prescriptions, Pharmacies and Insurance: Tips for Affordable HBV MedicationsAlyssa Gallipani, Pharm D, BCAP, RWJBarnabas HealthMichaela Jackson, MS, Hepatitis B Foundation HBV Therapeutic Development: The Ins and Outs of Clinical TrialsSean Cunningham, MBA, Janssen The Importance of Asian American Engagement with Clinical TrialsChristine Lee, PharmD, PhD, FDA View Videos:

    https://www.hepb.org/resources-and-support/b-informed-conference-videos-and-information/

  • Pag-iwas at Bakuna  Paano ako mahahawahan ng hepatitis B?Ang hepatitis B ay isang nakakahawang sakit na sanhi ng isang virus na kumakalat sa pamamagitan ng dugo. Nakalista sa ibaba ang pinakakaraniwang mga paraan kung paano naipapasa ang hepatitis B sa iba: Direktang pagkalapat sa nahawahang dugo o nahawahang mga likido ng katawan  Mula sa isang impektadong ina sa kanyang bagong silang na sanggol sa panahon ng pagbubuntis o pagkapanganak  Hindi protektadong pakikipagtalik sa isang impektadong katalik  Pinagbahaginan o muling paggamit na mga karayom (halimbawa, pinagbaha-bahaginan ang mga karayom para sa ilegal na droga o muling paggamit ng mga karayom na hindi isterilisado nang mabuti, acupuncture, mga tatu, o pagbutas sa tainga o katawan  Mga hindi isterilisadong medikal na kagamitan o karayom na maaaring ginamit ng mga doktor, dentista o barbero sa tabing kalsada. Napapasa ba ang hepatitis B nang hindi sinasadya?Hindi, ang hepatitis B ay hindi naipapasa sa pamamagitan ng simpleng pagkakadikit. Hindi mo makukuha ang hepatitis B mula sa hangin, pagyakap, paghawak, pagsinga, pag-ubo, mga upuan sa kubeta, o busol. Hindi mo makukuha ang hepatitis B mula sa pagkain o pag-inom kasama ng isang taong nahawahan o mula sa pagkain ng pagkaing inihanda ng isang taong may hepatitis B. Sino ang malamang na mahawa ng hepatitis B?Bagama’t lahat ay nasa ilang panganib na magkaroon ng hepatitis B, mayroong ilang mga tao na mas malamang mahawa. Ang iyong trabaho, pamumuhay, o sa pamamagitan ng maipanganak lamang sa pamilyang may hepatits B maaaring tumaas ang iyong pagkakaton na mahawa. Narito ang ilang mga pinakakaraniwang “mataas na panganib” na mga grupo -- ngunit mangyaring tandaan na ang listahang ito ay hindi kumpleto: Mga taong kasal sa isang may may hepatitis B o namumuhay nang may malapitang kontak sa isang kasambahay na may hepatitis B. Kasama rito ang mga nasa hustong gulang at mga bata. Mga taong ipinanganak sa mga bansa kung saan karaniwan ang hepatitis B, o may mga magulang na ipinanganak sa mga bansa kung saan karaniwan ang hepatitis B (Asya, mga bahagi ng Aprika at Timog Amerika, Silangang Europa, at Gitnang Silangan). Mga taong nakatira sa o bumibyahe sa mga bansa kung saan napakakaraniwan ang hepatitis B (Asya, mga bahagi ng Aprika at Timog Amerika, Silangang Europa, at Gitnang Silangan). Mga nasa hustong gulang at teenager na aktibo sa pakikipagtalik  Mga lalaking nakikipagtalik sa mga lalaki  Mga sanggol na ipinanganak ng mga impketadong ina  Mga manggagawa sa pangangalagang pangkalusugan at iba pang mga nalalantad sa dugo sa kanilang mga trabaho. Mga nagtatrabaho sa emergency  Mga pasyenteng sumasailalim sa dayalisis sa kidney  Mga residente at kawani ng mga grupong pang-tahanan, mga institusyon, o mga pang-koreksyonal na pasilidad. Mga sinalinan ng dugo bago ang 1992, o mga mas maaga pang nasalinan ng dugong hindi nasuri nang mabuti Mga gumagamit ng droga sa pamamagitan ng iniksyon, sa nakaraan at kasalukuyan  Mga taong nagpapatatu o nagpapabutas sa katawan  Mga taong pumupunta sa mga doktor, dentista o barbero sa tabing kalsada   Ano ang mga rekomendasyon para sa bakuna sa hepatitis B?Ang bakuna sa hepatitis B ay inirerekomenda para sa lahat ng mga sanggol at bata hanggang edad 18 taon ng World Health Organization (WHO) at ng Centers for Disease Control and Prevention (CDC) ng U.S. Inirerekomenda rin ng CDC na magpabakuna ang mga nasa wastong gulang na nasa mga grupong may mataas na panganib. Ang bakuna sa hepatitis B ay ligtas at epektibong bakuna na inirerekomenda para sa lahat ng mga sanggol pagkapanganak at para sa mga bata hanggang 18 taong gulang. Inirerekomenda rin ang bakuna sa hepatitis B para sa mga nasa hustong gulang na may diyabetis at mga may mataas na panganib sa impeksyon dulot ng kanilang mga trabaho, pamumuhay, kalagayan sa paninirahan, o bansa kung saan ipinanganak. Dahil lahat ay nasa ilang panganib, lahat ng mga nasa hustong gulang ay dapat seryosong isaalang-alang ang pagkuha ng bakuna sa hepatitis B para sa pang-habang buhay na proteksyon laban sa isang maiiwasang talamak na sakit sa atay. Ligtas ba ang bakuna sa hepatitis B? Oo, ang bakuna sa hepatitis B ay napakaligtas at epektibo. Sa katotohanan, ito ang unang “bakuna laban sa kanser” dahil maaari nitong protektahan ka mula sa hepatitis B, na sanhi ng 80% ng lahat ng kanser sa atay sa mundo. Nang may higit sa isang bilyong dosis na naibigay sa buong mundo, ipinapakita ng mga medikal at siyentipikong mga pag-aaral na ang bakuna sa hepatitis B ay isa sa mga pinakaligtas na mga bakuna na nagawa na. Makukuha ko ba ang hepatitis B mula sa bakuna?Hindi, ang hepatitis B ay hindi nakukuha mula sa bakuna. Ang bakuna ay ginawa mula sa isang produkto ng sintetikong yeast sa laboratoryo. Ang pinakakaraniwang mga pangalawang epekto ay pamumula at pananakit sa braso kung saan itinurok ang bakuna. Ano ang iskedyul ng bakuna sa hepatitis B?Ang bakuna sa hepatitis B ay makukuha sa tanggapan ng iyong doktor at lokal na kagawaran ng kalusugan o klinika. Tatlong dosis ang pangkaraniwang kinakailangan upang makumpleto ang serye ng bakuna sa hepatitis B, bagama’t mayroong pinabilis na serye ng dalawang dosis para sa mga kabataang edad 11 hanggang 15 taon, at mayroong bagong dalawang-dosis na bakuna na aprubado ng U.S. Food and Drug Administration (FDA) para gamitin sa mga nasa wastong gulang nang 2017. Mahalagang tandaan na ang mga sanggol na ipinanganak ng mga impektadong ina ay dapat na tumanggap ng unang dosis ng bakuna sa hepatitis B sa silid ng panganganak o sa loob ng unang 12 oras ng buhay. Unang Dosis – Sa anumang oras, ngunit ang mga bagong silang ay dapat na tumanggap ng dosis na ito sa silid ng panganganak Pangalawang Dosis – Hindi bababa sa isang buwan (o 28 araw) pagkatapos ng unang dosis Ikatlong Dosis – Anim na buwan pagkatapos ng unang dosis (o hindi bababa sa 2 buwan pagkatapos ng pangalawang dosis) Hindi dapat bababa sa 16 na buwan sa pagitan ng una at pangatlong dosis. Kung ang iyong iskedyul ng bakuna ay naantala, hindi mo kailangang simulan muli ang serye, maaari mong ituloy mula sa kung saan ka tumigil – kahit na may ilang taon nang pagitan sa mga dosis. Upang matiyak na ikaw ay protektado laban sa hepatitis B, humingi ng simpleng pagsusuri sa dugo upang matingnan ang iyong mga “hepatitis B antibody titer” (HBsAb) na magkukumpirma kung ang pagbabakuna ay matagumpay. Ano ang maaari kong gawin upang protektahan ang aking sarili mula sa hepatitis B?Dahil ang hepatitis B ay kumakalat sa pamamagitan ng nahawahang dugo at nahawahang likido ng katawan, mayroong ilang simpleng bagay na iyong magagawa upang protektahan ang iyong sarili mula sa posibleng impeksyon hanggang ang iyong pagbabakuna ay makumpleto: Iwasang humawak ng dugo o anumang mga likido ng katawan nang direkta  Gumamit ng mga condom sa mga katalik  Iwasan ang mga ilegal na droga at maling paggamit ng iniresetang gamot, kasama ang iniksyon ng nasabing mga droga  Iwasan ang paghiram at pagpapahiram ng matutulis na mga gamit katulad ng mga pang-ahit, sipilyo, hikaw, at mga pamputol ng kuko  Siguraduhing gumamit ng isterilisadong mga karayom at kagamitan para sa gamot, dentista, acupuncture, tatu, pagbutas sa tainga at katawan  Magsuot ng guwantes at gumamit ng sariwang solusyon ng bleach at tubig upang linisin ang mga natapong dugo  Masinsinang hugasan ang mga kamay gamit ang sabon at tubig pagkatapos hawakan o linisin ang dugo  Pinakamahalaga, siguruhin na tumanggap ka ng bakuna sa hepatitis B! Prevention and Vaccination  How can I get hepatitis B?Hepatitis B is an infectious disease caused by a virus that is spread through blood. Listed below are the most common ways hepatitis B is passed to others: Direct contact with infected blood or infected bodily fluids  From an infected mother to her newborn baby during pregnancy or delivery  Unprotected sex with an infected partner  Shared or re-used needles (for example, sharing needles for illegal drugs or re-using needles that are not properly sterilized for medicine, acupuncture, tattoos, or ear/body piercing)  Unsterilized medical equipment or needles that may be used by roadside doctors, dentists or barbers   Is hepatitis B transmitted casually?No, hepatitis B is not spread through casual contact. You cannot get hepatitis B from the air, hugging, touching, sneezing, coughing, toilet seats or doorknobs. You cannot get hepatitis B from eating or drinking with someone who is infected or from eating food prepared by someone who has hepatitis B. Who is most likely to become infected with hepatitis B? Although everyone is at some risk for getting hepatitis B, there are some people who are more likely to get infected. Your job, lifestyle, or just being born into a family with hepatitis B can increase your chances of being infected. Here are some of the most common "high risk" groups -- but please remember that this is not a complete list: People who are married to or live in close household contact with someone who has hepatitis B. This includes adults and children. People who were born countries where hepatitis B is common, or whose parents were born in countries where hepatitis B is common (Asia, parts of Africa and South America, Eastern Europe, and the Middle East).  People who live in or travel to countries where hepatitis B is very common (Asia, parts of Africa and South America, Eastern Europe, and the Middle East). Sexually active adults and teenagers  Men who have sex with men  Infants born to infected mothers  Healthcare workers and others who are exposed to blood in their jobs. Emergency personnel  Patients who are on kidney dialysis Residents and staff of group homes, institutions, or correctional facilities. Recipients of blood transfusions before 1992, or more recent recipients of improperly screened blood Injection drug users, past and present  People who get tattoos or body piercing  People who use roadside doctors, dentists or barbers   What are the recommendations for the hepatitis B vaccine? The hepatitis B vaccine is recommended for all infants and children up to age 18 years by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). The CDC also recommends that adults in high-risk groups be vaccinated. 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 with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.   Is the hepatitis B vaccine safe? Yes, the hepatitis B vaccine is very safe and effective. In fact, it is the first “anti-cancer vaccine” because it can protect you from hepatitis B, which is the cause of 80% of all liver cancer in the world. With more than one billion doses given throughout the world, medical and scientific studies have shown the hepatitis B vaccine to be one of the safest vaccines ever made.   What is the hepatitis B vaccine schedule?The hepatitis B vaccine is available at your doctor's office and local health department or clinic. Three doses are generally required to complete the hepatitis B vaccine series, although there is an accelerated two-dose series for adolescents age 11 through 15 years, and there is a new 2-dose vaccine that was approved by the U.S. Food and Drug Administration (FDA) for use in adults in 2017. It is important to remember that babies born to infected mothers must receive the first dose of hepatitis B vaccine in the delivery room or within the first 12 hours of life. 1st Shot - At any given time, but newborns should receive this dose in the delivery room2nd Shot - At least one month (or 28 days) after the 1st shot3rd Shot - Six months after the 1st shot (or at least 2 months after the 2nd shot) There must be at least 16 weeks between the 1st and 3rd shot. If your vaccine schedule has been delayed, you do not need to start the series over, you can continue from where you have left off – even if there have been years between doses. To be certain that you are protected against hepatitis B, ask for a simple blood test to check your “hepatitis B antibody titers” (HBsAb) which will confirm whether the vaccination was successful.   What else can I do to protect myself from hepatitis B? Since hepatitis B is spread through infected blood and infected body fluids, there are several simple things that you can do to protect yourself from possible infection until your vaccination is complete: Avoid touching blood or any bodily fluids directly Use condoms with sexual partners Avoid illegal drugs and prescription drug misuse, including injection of such drugs Avoid sharing sharp objects such as razors, toothbrushes, earrings, and nail clippers Make sure that sterile needles and equipment are used for medicine, the dentist, acupuncture, tattoos, ear and body piercing Wear gloves and use a fresh solution of bleach and water to clean up blood spills  Wash your hands thoroughly with soap and water after touching or cleaning up blood Most importantly, make sure you receive the hepatitis B vaccine! 

    https://www.hepb.org/languages/tagalog/vaccination/