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• Closing a Healthcare Gap: Medicare Finally Covers Hepatitis B Testing in At-risk Seniors

  … immigrants, which included all ages, found 9.6 percent of them were chronically infected. Today, the most vulnerable Americans are infected at a rate 10-times the national average, yet until now the government didn’t cover the cost of screening them. Medicare did cover testing if there were signs of liver damage from other medical tests, but in the case of late-stage hepatitis B infections, a diagnosis often comes too late for treatment. Screening seniors for hepatitis B has a life-saving ripple effect across generations. When hepatitis B is diagnosed in a grandparent, there is an opportunity to educate, test and vaccinate their children and grandchildren who are also at risk. Under the new guidelines, which also apply to disabled people covered by Medicare Part B, Medicare will reimburse primary care providers when they screen people at risk of hepatitis B, including: People born in regions with high hepatitis B rates, including Asia, Africa, the Middle East, the Caribbean, Eastern Europe, and some areas of South and Central America. Second-generation residents who were not vaccinated at birth and whose parents come from high-risk regions, such as sub-Saharan Africa and central and Southeast Asia HIV-positive persons, injecting drug users, men who have sex with men, and Family and household members of people with chronic hepatitis B. This expanded coverage will go far to screen seniors, but gaps remain. Under the proposed guidelines, only primary care providers can order testing, but many specialists including oncologists, rheumatologists and gastroenterologists see patients at risk for hepatitis B. The expanded coverage should include them and also pharmacists. Additionally, both providers and the public need to know more about hepatitis B. Today, the majority of people infected with hepatitis B don’t know they’re infected. Patients often don’t share their true stories of activities that may put them at risk of hepatitis B, especially if it includes

  http://www.hepb.org/blog/closing-healthcare-gap-medicare-finally-covers-hepatitis-b-testing-risk-seniors/
• In Rural Villages Across India, an Everyday Hero Works to Eradicate Hepatitis B

  Villagers in India attend an education class to learn how to prevent hepatitis B. By Christine Kukka India has one of the highest hepatitis B infection rates in the world. An estimated 40 percent of all hepatitis B deaths worldwide occur in India each year, and about 3 percent of its 1.25 billion residents – about 40 million — are chronically infected. This liver disease wrecks medical and emotional havoc in India. People diagnosed with hepatitis B struggle to attend schools, advance professionally, and even marry due to the ignorance and stigma surrounding this infection. Like many countries, India’s government is struggling to find resources to screen, immunize, and treat the millions of people affected by hepatitis B. But some people, including Surender Kumar and Sandeep Godara of New Delhi, are not waiting for the government to eradicate hepatitis B. The two men have created a nonprofit organization called Rann Bhoomi Foundation and enlisted support from various organizations and pharmaceutical companies to raise awareness about hepatitis B in some of the poorest slums and rural regions of India. Increasingly, advocates like Kumar and their grassroots army of volunteers and staff are needed to combat hepatitis B globally.Government initiatives to screen people for hepatitis B, immunize those at risk, and infected people into treatment have been woefully under-funded. Public health campaigns need resources, vaccines, and the ability to screen people—especially pregnant women to make sure their newborns are immediately immunized at birth–to prevent a new generation of hepatitis B infections. These campaigns need medical supplies and staff, but they also require knowledge about hepatitis B, compassion and an understanding of local customs to be effective. “I found out in 2010 that I was infected,” Kumar, a 34-year-old human resources executive, explained. His brother had tried to donate blood at work and was told he was infected. He told his

  http://www.hepb.org/blog/rural-villages-across-india-everyday-hero-works-eradicate-hepatitis-b/
• Is a Cure for Hepatitis B Coming? Experts Say Yes

  … and developing ways to test new drugs. Hepatitis B Foundation President Timothy Block “With our Drexel University colleagues, we are among the first, if not the only group, to identify a small molecule that inhibits hepatitis B virus cccDNA formation,” Block noted. This is significant because inhibition of cccDNA is considered essential in achieving a complete cure. Block is confident that a drug that can accomplish this will be developed. In 2015, the Blumberg Institute licensed several of its discoveries to Arbutus Biopharma, the first company solely dedicated to hepatitis B drug discovery, and signed a three-year research agreement to work on novel approaches to developing a cure. “This unique partnership will allow us to move our discoveries more rapidly from the lab to the clinic,” Block explained. Adding to its drug arsenal, Blumberg researchers have used computer modeling to design and produce targeted drugs against hepatitis B and liver cancer. In another innovative approach, researchers are screening plant and fungal extracts from its Natural Products Collection, donated by Merck & Co. in 2011, and have already discovered two potential drugs that are active against hepatitis B. Getting close to the finish line “There has never been more optimism than right now that a cure is within reach,” said Block. “This is the goal of the Hepatitis B Foundation, so we are all very excited.” Blumberg researchers are building on recent discoveries that have heightened the momentum around finding a cure for hepatitis B and liver cancer: new screening methods to search for effective drugs; new ways to treat hepatitis B using different approaches to shut down the virus; a new blood biomarker that aids in the early detection of liver cancer; and a promising drug that selectively kills liver cancer cells in animal studies. “The years that we all have spent working towards a cure for hepatitis B have laid the groundwork for this final phase,” said Block.

  http://www.hepb.org/blog/is-a-cure-for-hepatitis-b-coming-experts-say-yes/
• Celebrate Asian-Pacific American Heritage Month, And Get Tested for Hepatitis B

  … Vietnamese-American men are over 10 times more likely to have liver cancer due to undiagnosed and untreated hepatitis B than their white counterparts. So why don't doctors automatically screen Asian-American patients for hepatitis B? Is it a waylaid attempt at political correctness? Or does ordering a test for hepatitis B carry with it an unspoken judgment or suspicion of drug use or suspect sexual practices that are often linked to ethnic or racial stereotypes? It is a fine line doctors straddle here. It is racist to test a patient for a sexually transmitted disease simply because of sexual stereotypes attached that patient's race or ethnicity. It is not racist to test because the patient belongs to an ethnic group or race with a high rate of a treatable, preventable illness. One doctor, writing in The New York Times several years ago, admitted, "I always take note of my patient's race. So do many of my colleagues. We do it because certain diseases and treatment responses cluster by ethnicity. Recognizing these patterns can help us diagnose disease more efficiently and prescribe medications more effectively. When it comes to practicing medicine, stereotyping often works." In the case of hepatitis B, doctors should allow race and ethnicity to guide their screening decisions because many Asian-American patients are slipping through the health care system's cracks. Failure to identify a hepatitis B leads to new infections and new liver cancers. Treating hepatitis B can be challenging for healthcare providers. Diagnosing a patient with viral hepatitis often leads to complicated treatment decisions, painful disclosures, and immunization of family members. And, sometimes, patients just don't want to know, but they need to. Patients and doctors alike need to know that ethnicity can impact an individual’s health. For example, a recent study  found that Asian-Americans are disproportionately more likely to develop type 2 diabetes, even when they’re young and not

  http://www.hepb.org/blog/celebrate-asian-pacific-american-heritage-month-and-get-screened-for-hepatitis-b/
• Is Your Family Getting Together for the Holidays? Time to Discover Your Medical History

  … 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? And what strain or genotype of the hepatitis B virus (HBV) is our family infected with? Certain HBV genotypes respond better to interferon treatment than others, and some genotypes cause liver damage earlier than others. We can find out what genotypes we have through lab tests, but the regions our parents and grandparents immigrated from can also indicate which genotype we have. 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/is-your-family-getting-together-for-the-holidays-time-to-discover-your-medical-history/
• Pediatric outbreaks of hepatitis

  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 (liver inflammation, or “hepatitis”) after becoming ill. These children do not have evidence of any hepatitis viruses, including hepatitis A, B, C, D or E. Instead, scientists are investigating the possibility of an adenovirus, a common childhood virus that can cause gastroenteritis and cold symptoms, as a cause. Adenoviruses have been known to cause acute hepatitis in children who are immune compromised, but they do not commonly cause hepatitis in otherwise healthy children. As clinicians and researchers continue to investigate, they will learn more about this acute hepatitis outbreak. We will keep this page updated with new information as it becomes available. To learn what is happening in your state, you can contact your state or local health department–most have information on their websites or hotlines to speak to a public health professional. If you are outside the U.S., your health minister or the WHO are good resources for more information. 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 (in the U.S.). Resources for additional information: 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 World Health Organization has posted useful information, "Multi-country: Acute, severe hepatitis of unknown origin in children," 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.

  https://www.hepb.org/news-and-events/news-2/pediatric-outbreaks-of-hepatitis/
• Resources

  The Hepatitis B Foundation, in collaboration with the Centers for Disease Control and Prevention (CDC), is excited to announce the release of the first nationally available hepatitis B educational resources for African populations! These materials are part of a train-the-trainer-based model, and include a suite of resources, including a downloadable presentation on hepatitis B for educators, a printable flipchart for direct community education, and supporting fact sheets and other materials. These resources were created to address the unmet need for increased awareness and testing among African communities in the United States, who are disproportionately affected by hepatitis B.     

  https://www.hepb.org/research-and-programs/chipo/resources/
• Janet and Kurt's Story

  Kurt and Janet had tried to adopt for 5 years when they received a placement of a baby whose mother was hepatitis B positive. Unsure of what that meant for them and the baby they hoped to adopt, they contacted the Hepatitis B Foundation. Through the Foundation, they learned how their daughter could be protected from the disease with a birth dose of the hepatitis B vaccine.  

  https://www.hepb.org/research-and-programs/patient-story-telling-project/janet-and-kurts-story/
• Hepatitis B and School

  As more states require the hepatitis B vaccine for school entry, parents are increasingly asking whether they need to inform the school of their child's diagnosis. This is a gray area where parents must use their personal discretion since there is no perfect answer. Disclosing Your Child's Diagnosis If you decide to disclose your child's hepatitis B, remain calm, provide literature to reinforce the facts, and give the school a letter from your child's doctor stating that s/he is healthy and poses no risk to the other children if appropriate precautions are maintained. Most states require hepatitis B vaccination prior to school entry, so this reduces any potential risk to other students. We recommend the following when disclosing your child's hepatitis B to school officials: Stress the importance of confidentiality and universal precautions to protect your child from social discrimination. Remind school officials that hepatitis B is transmitted through exposure to blood; it is not transmitted casually. Explain that hepatitis B is not the only blood-borne disease that puts children at risk. Consider saying "Treat my child as you should treat every child - with care. You know what risk my child poses, but you don't know the risk that other children might present."  Americans with Disabilities Act The Americans with Disabilities Act (1991) is a federal law that may protect against discrimination related to chronic hepatitis B. Many states have clauses written into their AIDS disclosure laws, which may also protect persons with hepatitis B. State Hepatitis B Vaccine Laws A list of the Hepatitis B Prevention Mandates for all states is published by the Immunization Action Coalition. This site will help you find out each state's laws regarding hepatitis B vaccine requirements for daycare, elementary school, and middle school.  

  https://www.hepb.org/treatment-and-management/children-with-hepatitis-b/hepatitis-b-and-school/
• Acute vs. Chronic Hepatitis B

  A hepatitis B infection can result in either an acute infection or a chronic infection. When a person is first infected with the hepatitis B virus, it is called an "acute infection" (or a new infection). Most healthy adults that are infected do not have any symptoms and are able to get rid of the virus without any problems. Some adults are unable to get rid of the virus after six months and they are diagnosed as having a "chronic infection." A simple blood test can diagnose an acute or chronic hepatitis B infection. The risk of developing a chronic hepatitis B infection is directly related to the age at which a person is first exposed to the hepatitis B virus. The younger a person is when they are first infected, the greater the risk of developing a chronic hepatitis B infection: More than 90% of infants that are infected will develop a chronic hepatitis B infection Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection 5-10% of healthy adults 19 years and older who are infected will develop a chronic hepatitis B infection (that is, 90% will recover from an exposure) Most pregnant women do not know whether they are infected with hepatitis B and can unknowingly pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is so high, both the World Health Organization and the U.S. Centers for Disease Control and Prevention recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. The recommendation for hepatitis B vaccination of babies and children is so important because they are at the greatest risk of developing a chronic infection if they are not protected against the hepatitis B virus as soon as possible.    Acute Hepatitis B Infection An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. A simple blood test can let a person know if the hepatitis B virus is in their blood or if they have successfully gotten rid of the virus. The doctor should periodically test your blood over the six-month period to monitor the health of your liver and check progress towards recovery. In a person who has recovered from an acute hepatitis B infection, a blood test taken six-months after initial diagnosis will show that there is no more hepatitis B virus in your blood. Being diagnosed with acute hepatitis B can be difficult. As you move through the initial six-month period, there are tips and strategies to help. Until your health care provider confirms that the blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact) get tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should also start the hepatitis B vaccine series.    Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 90 days or 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. If treatment for an acute hepatitis B infection is required, a person may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during a new infection is to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about your prescriptions, over-the-counter medications and ask any other questions you may have during this time. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver.   Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. Acute hepatitis B infections have few, if any, lasting effects. However, recovery from an acute infection means that while the virus is no longer in your blood, it is still living in the liver in an inactive state. You cannot infect anyone else, and you are not considered to be infected. However, the virus that is in your liver can be re-activated in the future if you take medications that suppress the immune system. This can be dangerous for the liver. Therefore, it is important that you tell all of your health care providers that you had a past hepatitis B infection. This way, if you need immune-suppressing medication, your provider can take precautions to prevent the hepatitis B virus from re-activating. This simple fact sheet can help you better understand this. You can print this fact sheet and bring it to your health care provider’s office. Chronic Hepatitis B Infection People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. The risk of developing a chronic hepatitis B infection is also directly related to the age at which one first becomes exposed to the hepatitis B virus: 90% of infected newborns and babies  will develop a chronic hepatitis B infection Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. There are effective drug therapies that can control and even stop the hepatitis B virus from further damaging a liver. There are also promising new drugs in the research pipeline that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risks. Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver through blood tests or diagnostic imaging Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer. It is important to understand that not everyone is a candidate for treatment, but everyone with chronic HBV benefits from regular monitoring  Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life Avoid or limit alcohol and smoking since both cause a lot of stress to your liver Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver To learn more about other ways to protect your liver and your health click here. 

  https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/acute-vs-chronic/