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• The Annual Hepatitis B Check-up: Facing Mortality and a Missing History

  Image by worradmu, courtesy of FreeDigitalPhotos.net. For more than 20 years, I have accompanied my daughter to her annual hepatitis B check-up with her liver specialist. She is 22 and does not need me to come, but I always go out of habit and love. After the appointment, we sit eating lunch and I talk about how lucky she is that her liver has been healthy and her viral load undetectable for many years. Recently, she started testing negative for the hepatitis B surface antigen (HBsAg). However, she has never developed hepatitis B surface antibodies. Her immune system has cleaned house, but has lacked the power to produce enough surface antibodies to show up on lab tests and declare her free of infection. For the second year in a row, her doctor gave her a hepatitis B vaccine shot, an experiment to see if the injection of HBsAg would spur her immune system to generate enough surface antibodies to register in a lab test. “I don’t want to keep seeing you every year,” the doctor tells her with a smile. But it is my daughter who never wants to return to this sterile and colorless clinic. These annual visits are reminders of her mortality and the unknown period of her life when she became infected. My daughter was born in China. At three months of age, the orphanage tested her for hepatitis B, and she tested negative. One month later, my husband and I traveled to China and we became a family. I don’t know exactly when she became infected, but I remain profoundly thankful it takes several months for a blood test to identify a hepatitis B infection. If more time had passed and her infection had been diagnosed while in China, she may have been considered “unadoptable” and our family as we know it would never have happened. “So how do you think I got infected?” she asks me during lunch. We have discussed this before, but every year her questions and knowledge about hepatitis B become more sophisticated. But make no mistake, her question is less about

  http://www.hepb.org/blog/the-annual-hepatitis-b-check-up-facing-mortality-and-a-missing-history/
• Do You Have to Tell Your Employer About Your Hepatitis B?

  Image courtesy of Ambro at FreeDigitalPhotos.net “Do I have to tell my new employer about my hepatitis B?” After years of cautiously completing medical forms for schools, camps and college, my daughter’s question took me by surprise. It shouldn’t have. Many jobs—even when they don’t involve direct medical care—require a physical exam and confirmation of hepatitis B immunization. There may be a safe and effective vaccine and new treatments for hepatitis B, but ignorance and stigma remain stubbornly entrenched in many HR departments. So here is what every job applicant, employee and employer should know about hepatitis B and employment. During the application process or job interview, can an employer ask about my health?No. The Americans with Disabilities Act (ADA) strictly limits what can be asked during an interview. According to federal law, an employer can’t ask if you have a disability (such as hepatitis B) or require you to undergo a medical exam before offering you a job. They CAN ask if you can perform the job (can you lift 50 pounds if you're applying for a warehouse job) or how you would perform a job, but they can’t ask about your health. Can an employer require a medical exam or ask medical questions after an offer is made? Yes. After the offer is made, employers can require you to answer certain medical questions (such as immunization coverage) and undergo a medical exam—as long as everyone who performs that job has to undergo the same exam. If the medical exam reveals a disability that prevents you from doing the job, even after a “reasonable accommodation” is made, then the employer can withdraw the job offer. Can an employer withdraw a job offer after they learn I have hepatitis B? No, because the majority of people with hepatitis B are healthy, productive and able to perform their jobs. Unless you have severe liver disease, hepatitis B does not impair your ability to be a teacher, nurse, doctor or home health aide. If your

  http://www.hepb.org/blog/do-you-have-to-tell-your-employer-about-your-hepatitis-b/
• Know Your Rights: What College Students with Hep B Need to Know About Health Forms and Disclosure

  … indicates that your admission or participation in certain college activities is in jeopardy, stay cool. Send them a copy of the Department of Justice letter and suggest they contact their legal counsel for appropriate advice. Call the Hepatitis B Foundation at 215-489-4900 or email the foundation at info@hepb.org if more assistance is needed. Then why do colleges ask about hepatitis B immunization? Schools cannot ask about your hepatitis B status during the application process, but once you are accepted, the school’s clinic can. Many colleges have clinics that provide basic medical care to students. Just like a doctor, the clinic wants to know about any important health information. The health form you fill out becomes part of the clinic’s medical record and should be treated confidentially under HIPAA. Why do nursing and medical programs and some colleges ask for proof of a successful hepatitis B vaccination? Health care providers are at high risk of infection of bloodborne infections, such as hepatitis B, due to their close contact with blood and body fluids. To protect them, colleges may require students to be immunized and then provide follow-up blood test results that show students have enough protective antibodies to prevent infection. Colleges cannot refuse to admit hepatitis B-infected students because they do not pose a risk to either patients or coworkers. The only risk someone with hepatitis B poses is if they have a high viral load and perform certain surgical procedures. However, no medical or nursing student performs that type of surgery as part of his or her training. Remember, you won’t be the only person at your school with a bloodborne infection. The vast majority of people with hepatitis B or C don’t know they’re infected. Because of these unknown infections, all schools and employers are required to treat everyone as if they have a bloodborne infection and use standard precautions with everyone. Links to helpful resources: The U.S.

  http://www.hepb.org/blog/know-your-rights-what-college-students-with-hep-b-need-to-know-about-health-forms-and-disclosure/
• HBV Journal Review - May 2015

  HBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
 latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored: New Treatments Targeting Hepatitis B Start Clinical Trials Soon Experts Urge Doctors to Screen Pregnant Women for Both Hepatitis B and High Viral Loads Using Antivirals Early in a Pregnancy Reduces Infection of Newborns Some Pregnant Women in U.S. Still Not Getting Screened for HBV and STIs High Viral Loads in Men Increase the Amount of HBV DNA in Their Sperm Despite Vaccine, Rural States See Rise in Hepatitis B Due to Heroin Use More Than Half of Young Drug Users Are Not Vaccinated Against Hepatitis A and B Shorter Vaccination Schedule Works to Prevent Infection Among Drug Users Generic Entecavir Could Treat All Patients Worldwide for $36 a Year Reformulated Tenofovir Appears Better at Fighting Infection in Liver Cells Another Report Calls for Doctors to Screen All Patients for HBV Before Starting Chemotherapy Study Confirms Aflatoxins Increase Liver Cancer in Hepatitis B Patients May1, 2015 Volume 12, No 5 by Christine M. Kukka New Treatments Targeting Hepatitis B Start Clinical Trials Soon A Pennsylvania firm will soon start clinical trials of a unique drug called birinapant that helps liver cells infected with the hepatitis B virus (HBV) self-destruct, according to two reports published in the April edition of the Proceedings of the National Academy of Sciences. The treatment, which employs tiny molecules to force the infected liver cells to die while leaving normal liver cells intact, has eradicated hepatitis B infection in mice, according to TetraLogic Pharmaceuticals Corp. officials and their partner researchers at the University of Melbourne in Australia. The current treatment evolved from cancer research that developed ways to make abnormal cancer cells

  http://www.hepb.org/blog/hbv-journal-review-may-2015/
• Hepatitis on the Hill - HBV Personal Perspective and Action Alert

  75 hepatitis B and C advocates join together for Hepatitis on the Hill! On March 9-10 I participated in “Hepatitis on the Hill” in Washington, DC. The event was organized by Hep B United (HBU), the National Viral Hepatitis Roundtable (NVHR) and the Hepatitis Appropriations Partnership (HAP), and brought together both hepatitis B and C advocates. This was an incredible opportunity to work together, network, and advocate on the Hill. I have been a hepatitis B patient advocate for nearly two decades, and although I do not consider myself politically savvy, I understand the importance of getting out there in front of my legislators to educate staff about hepatitis B, and let them know how HBV impacts their constituents. Unfortunately, many constituents are unaware of their status or are reluctant or unable to speak up about hepatitis B due to the associated stigma and cultural or language barriers. This year is one of the best opportunities we have to raise the profile of viral hepatitis, as a result of the President’s proposed FY16 budget to increase the CDC, Division of Viral Hepatitis’ budget to $62.8 million. This budget increase should ensure there are resources and funding available to implement needed programs, including strengthening state capacity and increasing public health networks to detect new infections and improve access to viral hepatitis testing and linkage to care and treatment. The need for national hepatitis B surveillance data is critical. It’s a vicious cycle – you can’t get the funding to support programs without the numbers, yet you need funding to support an appropriate surveillance system. Hepatitis B desperately needs a national surveillance system that is culturally and linguistically appropriate to ensure those disproportionately impacted by hepatitis B are counted. Once we have identified those that are chronically infected through screening programs, we need to ensure there is linkage to care, and the infrastructure to

  http://www.hepb.org/blog/hepatitis-on-the-hill-hbv-personal-perspective-and-action-alert/
• 300 Million Reasons Movement

  There are currently almost 300 million people living with chronic hepatitis B globally. These are real people and their lives and quality of life are important. 300 Million Reasons is a movement to improve awareness about hepatitis B and liver cancer worldwide, to promote engagement of key stakeholders, and to empower people impacted by hepatitis B to become vocal advocates.  300 Million Reasons is a movement launched by the Hepatitis B Foundation with the goal of giving partners around the world access to important tools to help spread the word about hepatitis B. What can I do to join the movement today? The first step is to access our free social media toolkit. These images are designed to raise awareness about, stop stigma around, promote testing for, and explain different aspects of hepatitis B. Please feel free to download, post, and share widely! Different sizes are available for Facebook/Instagram and Twitter.   Just admitting that there are 300 million reasons to care about hepatitis B makes you part of the movement. Now we just need your help spreading the word. Start with the toolkit, keep it up in conversation in friends, and join the Hepatitis B Foundation in our programs to help make a difference. Work with the Hepatitis B Foundation to make a difference today. 300 Million Reasons to B Informed Get Tested. Hepatitis B Can Be Prevented, Treated, and Managed.   The Hepatitis B Foundation was founded 30 years ago to help people living with hepatitis B. There was almost no information out there for these struggling families at the time. We started out by taking phone calls and now serve people living with hepatitis B through thousands of consults a year, in depth online resources, and research and education to find a cure. Start learning more about hepatitis B here. 300 Million Reasons to B Connected You are not alone! Together, we can foster a collaborative and connected global community united around all things hepatitis B.  The B Connected branch of the 300 Million Reasons movement involves increasing access to clinical trials, expanding global connections to support people living with hepatitis B around the world, establishing international peer mentoring programs, creating a social network for people impacted by hepatitis B, and creating further opportunities for community engagement.  300 Million Reasons to B the Voice Your voice matters! Share your story to empower those with hepatitis B and inspire progress.  The B the Voice branch of the 300 Million Reasons movement is centered largely around international storytelling and elevating the voices of those living with hepatitis B around the world. True change happens with the human element. Stories of discrimination, stigma, screening, diagnosis, treatment, supporting community and family members, personal and larger-scale successes, setbacks and victories - all are important to share and learn about in order to raise awareness, inspire change, and eventually find a cure. Check out our blog post to read more about our B the Voice initiative!  Do you have a story to share? We would love to read it! Use this link to B the Voice of hepatitis B! 300 Million Reasons to B the Change Stand up, speak out! Get involved in putting hepatitis B in the spotlight and moving the cause forward.  The B the Change branch of the 300 Million Reasons movement is focused on patient activism and using this as a tool to advance the cause of increasing knowledge about and support for hepatitis B among legislators and policy-makers. B the Change provides advocacy opportunities, resources, and training for people living with hepatitis B, national and international community ambassadors, and key partners/stakeholders. With knowledge can come action - let’s build a strong grassroots network to spread the word and B the Change to create a world that is Hep B-free.  Are you interested in hepatitis B advocacy? Sign up to join our Action Center and stay tuned for even more ways to get involved and B the Change!        

  https://www.hepb.org/research-and-programs/300-million-reasons-campaign/
• Hep B United Philadelphia

  Hep B United Philadelphia (HBUP) is a local community-owned coalition that was created to increase hepatitis B testing and vaccination in Philadelphia through public awareness and education. Led by the Hepatitis B Foundation, we currently have over 70 coalition partners including the Philadelphia Department of Public Health, university health systems, social service providers, health care professionals, nonprofit advocates, community organizations, and providers of human services to Philadelphia's Asian American, Pacific Islander, and African immigrant communities. We also have the support of the Pennsylvania Governor’s Commission on Asian American Affairs, and the Mayor’s Advisory Commission on Asian American Affairs. We are an active member of the national Hep B United coalition. Since 2008, we have reached over 10,000 Philadelphians, provided in‐person education for over 7,500; offered free hepatitis B screening to 4,000; administered over 500 free doses of the hepatitis B vaccine; and found medical homes for 85% of infected individuals in our program! Hep B United Philadelphia is now one of the largest hepatitis B coalitions in the U.S. Our community program for culturally competent hepatitis B screening, vaccination and linkage to care is helping to identify best practices for cities around the U.S Contact us to learn how you can join as a partner to unite against hepatitis B! Read Hep B United Philadelphia's 2022 Annual Report here. 

  https://www.hepb.org/research-and-programs/hep-b-united-philadelphia/
• New Two-Dose HBV Vaccine Recommended by ACIP

  Hepatitis B Foundation Leaders Expect Use of HEPLISAV-B to Increase Immunization Rates in U.S. DOYLESTOWN, PA (February 22, 2018): The Advisory Committee on Immunization Practices’ (ACIP) voted February 21, 2018, to unanimously recommend HEPLISAV-B™ for use among individuals age 18 years and older to prevent hepatitis B infection (HBV). The Hepatitis B Foundation welcomes the use of the new vaccine, which is expected to increase immunization rates for adults in the United States. HEPLISAV-B™ was approved for use by the FDA on July 28, 2017. It is the first new hepatitis B vaccine in more than 25 years, and the only two dose vaccine for the prevention of infection. Previous vaccines for hepatitis B require three doses over the course of six months to protect against this deadly liver infection, and vaccination initiatives have shown that as few as 13% of people who receive the first dose of the vaccine complete the final dose. According to Kate Moraras, Senior Program Director of the Hepatitis B Foundation, who provided public testimony at this morning’s ACIP meeting, “Vaccination is a critical tool towards eliminating hepatitis B, but in the U.S. only 25% of adults are vaccinated. Having a new 2-dose vaccine can help to greatly increase vaccine coverage, especially among those at high-risk for infection, such as people with diabetes and HIV-infected individuals.” More than 257 million people worldwide and up to 2.2 million in the United States are chronically infected with hepatitis B, a virus that can lead to cirrhosis and liver cancer in up to 25% of those infected. Hepatitis B is associated with significant health disparities in the U.S., disproportionately affecting Asian American, Pacific Islander, and African communities. In addition, the number of reported cases of acute HBV infection across the country is rising along with the increased use of opioids and injection drugs. Binh Ly, a hepatitis B advocate from Washington. D.C., also provided testimony at the ACIP meeting, stating that “the availability of a two-dose vaccine over 1 month instead of being given as 3 doses over 6 months is a critical tool to protect many more Americans - this is one less barrier for vulnerable and at-risk communities to receive necessary protection.” ACIP is a committee of medical and public health experts who develop recommendations to guide the use of vaccines and develop vaccine schedules for the U.S. ACIP’s new HEPLISAV-B™ recommendation will now be sent to the Director of the Centers for Disease Control and Prevention (CDC) for approval. Once approved, the recommendation will be published in an upcoming CDC Morbidity and Mortality Weekly Report (MMWR) and will represent an official CDC recommendation for hepatitis B vaccination in the U.S. About the Hepatitis B Foundation The Hepatitis B Foundation is 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. 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. # # #  

  https://www.hepb.org/news-and-events/news-2/new-two-dose-hbv-vaccine-recommended-by-acip/
• Hepatitis B and Liver Cancer Clinical Trials

  NOTE: This section contains only hepatitis B-related liver cancer (HCC) clinical trials, or trials that list both hepatocellular carcinoma and hepatitis B as part of the description. If you are looking for the most up-to-date liver cancer trials, please click here and search for hepatocellular carcinoma and set filters for a more comprehensive list. *CHB=Chronic hepatitis B, Liver cancer=hepatocellular carcinoma or HCC A Study of Molecular Genetic Factors for Liver Cancer in the Greater Baltimore Area – U.S.Patients between the age of 18 & 90 who have been diagnosed with HCC or have a high risk of developing HCC due to chronic hepatitis B or C. Contact: Dr. Dean L. Mann at 410-328-5512, dmann001@umaryland.edu or Dr. Xin Wang at 301-496-2099 or xw3u@nih.gov and refer to identifier – NCT00913757  (Study ID # 999909149, 09-C-N149) Pembrolizumab (Keytruda) in Advanced Hepatocellular Carcinoma – U.S.This is a phase II trial of Pembrolizumab (Keytruda) in patients with advanced, unresectable hepatocellular carcinoma. Contact Dr. Lynn Feun at 305-243-6606 or lfeun@med.miami.edu and refer to identifier NCT02658019. (Study ID # 20151049)  Navitoclax and Sorafenib Tosylate in Treating Patients with Relapse or Refectory Solid Tumors – U.S.This phase I trial studies the side effects and the best dose of navitoclax when given together with sorafenib tosylate in treating patients with solid tumors that have returned (relapsed) or do not respond to treatment (refractory). Navitoclas and sorafenib tosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. For study contact information in each state, region, or country, please go to the study’s description page and find the study location nearest you. The study’s sponsor is The National Cancer Institute (NCI). Refer to the study identifier – NCT02143401. (Study ID # NCI-2014-01043) An Immuno-therapy Study to Evaluate the Effectiveness, Safety, and Tolerability of Nivolumab or Nivolumab in Combination With Other Agents in Patients with Advanced Liver Cancer (CheckMate040) – U.S. and InternationalThis is a three phased study designed to establish the safety of nivolumab at different dose levels for each of the three cohorts (uninfected hepatocellular carcinoma (HCC), hepatitis C virus (HCV)-infected HCC subjects, and hepatitis B virus (HBV)-infected subjects), generate additional clinical data at specified doses for each of the 3 cohorts, and compare the efficacy of nivolumab and sorafenib in the treatment of Advanced HCC. For study contact information in each state, region, or country, please go to the study’s description page and find the study location nearest you. The study’s sponsor is Bristol-Myers Squibb. Refer to identifier NCT01658878. (Study ID # CA209-040, 2012-001514-42)  A Study of Nivolumab Compared to Sorafenib as a Primary Treatment in Patients With Advanced Hepatocellular Carcinoma - US and InternationalThe purpose of this study is to determine if nivolumab or sorafenib is more effective in the treatment of Advanced Hepatocellular Carcinoma. For study contact information in each state, region or country, please go to the study’s description page and find the study location nearest you. The study’s sponsor is Bristol-Myers Squibb. Refer to the study identifier -- NCT02576509. (Study ID # CA209-459) A Basic-clinical Translational Research in Hepatitis B Virus (HBV)-Specific Antigen Peptides and HepG2 Cell Lysate Co-activated Dendritic Cells Combined with Transarterial Chemoembolization (TACE) in HBV-related HCC Treatment (BTRHBVAPHCLCDCCTCHBVHCCT) - ChinaResearchers want to put forward a new scientific therapy called “Activated Dendritic-cells Combined Cyclophosphamide” (ADCC) combine with TACE for patients with advanced hepatocellular carcinoma to prolong their survival time. Contact: Yanling Huang at +8615626459901 or hyanlin3@mail2.sysu.edu.cn or Yuehua Huang at +8613318818899 and refer to identifier NCT03086564. (Study ID # huyangyuehuateam).  Adjuvant Entecavir for Postoperative HBV-HCC -- ChinaThis study aims to compare the effect of antiviral therapy with entecavir and lamivudine for hepatitis B virus-related liver cancer (hepatocellular carcinoma) after radical hepatectomy. Included patients will randomly divide into two groups. Contact Jian-Hong Zhong at zhongjianhong66@163.com or 86-771-5330855 and refer to identifier NCT02650271 (Study ID AEVT-HCC).  Follow-up Strategy of Chronic Hepatitis B for Early Detection and Diagnosis of Hepatocellular Carcinoma: A Randomized Control Trial – ChinaThe aim of this study is to establish an all-round and convenient follow-up strategy of CHB for early detection and diagnosis of Hepatocellular Carcinoma (HCC), by investigating whether different surveillance time intervals and surveillance methods are beneficial for chronic hepatitis B and cirrhotic patients with different risk of HCC. Contact: Zhongzhen Su at Sun Yat-Sen University at 0086-020-85252010 or sp9313@126.com and refer to identifier NCT02817685. (Study ID # SYSU2016) Oral Vitamin D Treatment for the Prevention of Hepatocellular Carcinoma (VDHCC) – China (Not yet recruiting)The purpose of this study is to determine whether vitamin D is effective in the prevention of hepatocellular carcinoma in those patients with chronic hepatitis B. Contact: Yutian Chong at ytchongkyzy@126.com and refer to identifier NCT02779465. (Study ID # SYSU-CYT-VD5010) Study of Liver Resection With Versus Without Hepatic Inflow Occlusion for the HBV-related HCC (OHx-NOHx) – ChinaThe study aims to compare the perioperative and long-term outcomes of liver resection for HBV-related HCC with versus without hepatic inflow occlusion. Contact Dr. Shichun Lu at +86 10 68160801 or sclu_301@163.com and refer to identifier NCT02563158. (Study ID # JFJZYY-GD-15-01) TCR-Redirected T Cell Infusions to Prevent Hepatocellular Carcinoma Recurrence Post Liver Transplantation - ChinaThis study plans to recruit 10 subjects with Hepatitis B virus (HBV) related HCC after liver transplantation. The objective of the study is to assess the safety, tolerability and effectiveness of the HBV specific T cell receptor (HBV/TCR) redirected T cell in the target population. Contact Dr. Lietao Li at (65) 6224 6157 or clinicaltrials@liontcr.com and refer to NCT02686372. (Study ID # LTCR-HCC-I-1) TCR-Redirected T Cell Infusions to Treat Recurrent Hepatocellular Carcinoma Post Liver Transplantation - ChinaThis study plans to recruit 10 patients with Hepatitis B virus (HBV) related HCC who underwent liver transplantation and are confirmed to have recurrent HCC. The objective of the study is to assess the safety, tolerability and effectiveness of the HBV specific T cell receptor (HBV/TCR) redirected T cell in the target population. Contact Dr. Lietao Li at (65) 6224 6157 or clinicaltrials@liontcr.com and refer to NCT02719782. (Study ID # LTCR-HCC-I-2)  The Investigation of Peginterferon Alfa-2a on the RFS of the Subjects with HCC Who Have Been Treated by Resection – ChinaThe current study is a prospective, randomized, open, multi-center investigation. The aim of current study is to investigate whether the Recurrence-free Survival Rate (RFS) of the hepatitis B related -hepatocellular carcinoma subjects who have been treated by resection can be improved by peginterferon alfa-2a. Contact: Lunxiu Qin at 52887172 or qinlx@fudan.edu.cn or Huliang Jia at jbl-1@163.com and refer to NCT03253250. (Study ID # PEG-HCC)  Thymalfasin Adjuvant Therapy in Hepatitis B Virus (HBV)-Related Hepatocellular Carcinoma (HCC) After Curative Resection – China (Not yet recruiting)Efficacy and safety of Thymalfasin adjuvant therapy in HBV-related HCC after curative resection. To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. This study’s sponsor is Jia fan and SciClone Pharmaceuticals. Refer to identifier NCT02281266. (Study ID # ZDX-2014-05) Yang Yin Fu Zheng Therapy in HBV Associated Hepatocellular Carcinoma (YYFZTIHBVHCC) – ChinaThe purpose of this study is to observe the efficacy of routine medical care combined with Yang Yin Fu Zheng therapy for patients belong to HBV-HCC. Contact Zhiyun Yang at +861343969688 or 13439696988@163.com and refer to NCT02927626. (Study ID # BeijingDH) The Role of the Vitamin D Receptor Gene Polymorphisms in Hepatocarcinogenesis – EgyptVitamin D levels may influence cancer development.  Vitamin D receptor (VDR gene polymorphisms) have also been investigated as impacting chronic hepatitis B, primary biliary cirrhosis and autoimmune hepatitis. A significant association of VDR (ApaI) polymorphism with the development of HCC (liver cancer) in chronic HCV infection may help to identify those who are at high risk of developing HCC. Contact: Sherief Abd-elsalam at 00201095159522 or email sheriefabdelsalam@yahoo.com and refer to identifier NCT02461979. Sonazoid Enhanced Liver Cancer Trial For Early Detection – Japan Use of contrast enhanced ultrasound (US) using Sonazoid vs. conventional B-mode US for early HCC detection.  Contact: Masatoshi Kudo at +81 72-366-0221 ext. 3149 or m-kudo@med.kindai.ac.jp, or Dr. KazuomiUeshima at +81-72-366-0221 ext. 3525, kaz-ues@med.kindai.ac.jp and refer to identifier – NCT00822991 (Study ID # JLOG08001, UMIN000001612) Boramae Hospital Liver Cirrhosis Patient Cohort Study - KoreaThe goal of this study is to describe the natural history of a large number of patients with liver cirrhosis prospectively followed, and to identify predictors of the occurrence of hepatocellular carcinoma. Contact Sae Kyung Joo at 821089619285 or joo.sammy@gmail.com and refer to identifier NCT01943318. (Study ID # BRM_LC_Cohort) Prompt or Watchful Monitoring for Hepatitis B Virus Related Hepatocellular Carcinoma Without Elevated Viral Load (POWER) – Korea (Not yet recruiting)This trial will investigate and determine the efficacy of the nucleos(t)ide analogue (NUC) treatment with Tenofovir disoproxil fumarate (Viread®) as measured by the cumulative incidence rate of hepatocellular carcinoma (HCC) at 3 year after curative treatment with radiofrequency ablation (RFA) or surgical resection (SR) in chronic hepatitis B virus (HBV) infected patients with low viral load. Contact: Seung Woon Paik at 82-2-3410-3409 or sw.paik@samsung.com or Dong Hyun Sinn at 82-2-3410-3012 or dh.sinn@samsung.com and refer to NCT02308319. (Study ID # 2014-09-149) Stereotactic Body Radiotherapy (SBRT) for UnresectableHepatocellular Carcinoma (SBRT for HCC) – KoreaThis study evaluates the effectiveness and adverse event of SBRT in the patients who had solitary 3 cm or less size HCC without extrahepatic lesion and vascular involvement. Contact HeeChul Park at 82-2-3410-2612 or hee.ro.park@samsung.com and refer to identifier NCT01910909. (Study ID # 2013-06-005-001) Transarterial Radioembolization Versus Chemoembolization for the Treatment of Hepatocellular Carcinoma – Saudi Arabia This randomized controlled trial is designed to prospectively compare TACE and 90Y for treatment of patients with unresectable (BCLC intermediate stage) HCC. Contact Mohamed I Al Sebayel at +966114647272 ext 24818 or msebayel@kfshrc.edu.sa and refer to identifier NCT02729506. (Study ID # 2131 134) The Safety and Maximum Tolerated Dose of Axitinib in Combination With Radiotherapy for HCC – TaiwanThis is a phase I clinical trial evaluating the safety and MTD of axitinib in combination with RT for advanced HCC. Contact Dr. Yu-Min Li at +886-28332211 ext 2031 or M001063@ms.skh.org.tw and refer to identifier NCT02814461. (Study ID # 20150704M) HBV-host cfDNA as Minimal Residual Tumor Marker for HBV-related HCC (Liver Cancer) – TaiwanHBV DNA integration has been found in the chromosomes of about 90% of HBV-related HCC and the integration site is unique to individual HCC. The HBV-host junction DNA fragment from one HCC is therefore a tumor-specific biomarker. Investigators will develop either HBV-specific inverse PCRs or capture-sequencing protocols to identify HBV integrations sites in the tumor chromosomes in patients who have had an HBV-related liver cancer tumor removed surgically. Contact: Pei-Jer Chen, PhD, MD, +886-2-23123456 ext 67072 or email peijerchen@ntu.edu.tw and refer to identifier NCT03020342. (Study ID # 201510056RINA)

  https://www.hepb.org/treatment-and-management/clinical-trials/hepatitis-b-and-liver-cancer-clinical-trials/
• Understanding Your Test Results

  Understanding your hepatitis B blood tests can be confusing. It is important to talk to your health care provider so you understand your test results and your hepatitis B status. Are you infected? Protected? Or at risk? The Hepatitis B Panel of blood tests includes 3 tests and all three results must be known in order to confirm your status. Below is a chart with the most common explanation of the test results, but unusual test results can occur. Please note that this chart is not intended as medical advice, so be sure to talk to your health care provider for a full explanation and obtain a printed copy of your test results. In some cases, a person could be referred to a liver specialist for further evaluation. More Detailed Information About Hepatitis B Blood Tests An acute hepatitis B infection follows a relatively long incubation period - from 60 to 150 days with an average of 90 days. It can take up to six months, however, for a person to get rid of the hepatitis B virus. And it can take up to six months for a hepatitis B blood test to show whether as person has recovered from an acute infection or has become chronically infected . The following graphic from the U.S. Centers for Disease Control and Prevention (CDC) represents the typical course of an acute hepatitis B infection from first exposure to recovery. Source: Centers for Disease Control and Prevention Video According to the CDC, a hepatitis B blood test result (or serologic marker) varies depending on whether the infection is a new acute infection or a chronic infection. HBsAg (hepatitis B surface antigen) is the first serologic marker to appear in a new acute infection, which can be detected as early as 1 week and as late as 9 weeks, with an average of one month after exposure to the hepatitis B virus (HBV).  - HBsAg is detectable for a variable amount of time, along with the HBV DNA, though about 50% of persons will test HBsAg and HBV DNA negative 7 weeks after symptoms. - All persons who spontaneously recover from an infection will test negative for HBsAg and negative for HBV DNA about 15 weeks after the appearance of symptoms. Anti-HBs or HBsAb (hepatitis B surface antibody) – this becomes detectable on a blood test after the disappearance of HBsAg in persons who are able to get rid of the virus and avoid a chronic infection. The presence of anti-HBs following a new acute infection generally indicates recovery and a person is then protected (or “immune”) from re-infection with hepatitis B. Anti-HBc or HBcAb (hepatitis B core antibody) – this blood test remains positive indefinitely as a marker of past HBV infection. HBeAg (hepatitis B e-antigen) is generally detectable in patients with a new acute infection; the presence of HBeAg is associated with higher HBV DNA levels, thus, increased infectiousness. IgM anti-HBc – a positive blood test result indicates a person has a new acute hepatitis B infection.IgM anti-HBc is generally detectable at the time symptoms appear and declines to sub-detectable levels within 6 - 9 months. Note: An acute exacerbation (or liver flare) in a chronic HBV infection can also result in a positive anti-HBc IgM test result. So follow-up testing after 6 months is required. IgG anti-HBc – this blood test remains positive indefinitely as a marker of past HBV infection.

  https://www.hepb.org/prevention-and-diagnosis/diagnosis/understanding-your-test-results/