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  • Sunshine, Vitamin D, and Hepatitis B

                    When you hear vitamin D you most notably think of the sun, or perhaps milk, or the small plastic bottles labeled with a bolded “D3” on store shelves. If you've ever been challenged by a trivia question asking what vitamin D does, you most likely know to say it helps build strong bones. In addition, vitamin D is a vital element that serves the immune, nervous and gastrointestinal systems, among our most important organs.   What you may not know about are the multiple functions vitamin D has in the body to regulate and maintain optimal health, especially for those living with chronic conditions such as hepatitis B.     The sun is the best source of vitamin D, and while everyone needs it, people living with hepatitis B need to pay extra attention to the summertime sun. Too much of a good thing can lead to harmful consequences, so it's best to be aware of some precautions. Key considerations before spending time in the sun are hydrating with water, applying sunscreen to minimize risks of sunburn and skin cancer, and understanding the impact of exposure to sunlight on your body.     Being in the sun typically makes you thirsty. Drinking water instead of beverages with high sugars such as soda, sport and energy drinks, is better for the body and doesn't leave behind any fats or byproducts that impede healthy liver function. Physicians from Mass General Brigham Hospital in Boston analyzed data from nearly 1000,000 woman and found that there may be a link between sugary drinks and liver disease (more here). The process of breaking down sugars leads to a build-up of unusable material that saturates the liver, inhibiting normal cells from growing and further exacerbating an already vulnerable liver. On average, the recommended daily water intake for women is around two liters, and for men, about three liters. While those are general guidelines, you may need more while in the hot sun. In addition to simply

    https://www.hepb.org/blog/sunshine-vitamin-d-hepatitis-b/
  • What is the Difference Between hepatitis B and Fatty Liver Disease?

    Many people have trouble understanding the relationship between chronic hepatitis B (HBV) infection and Non-Alcoholic Fatty Liver Disease (NAFLD). While research studies are ongoing and the association between hepatitis B and NAFLD is indeed complex, a chronic hepatitis B infection does not cause NAFLD. It is important to understand both diseases independently of one another before studying the correlation between the two.   Hepatitis B and fatty liver disease both can damage the liver. This is why it is important to understand the role of the liver in maintaining overall health and well-being. The liver is an essential organ in your body and is responsible for supporting digestion and regulating nutrients. It plays a crucial role in removing toxic substances from your body.   Worldwide, almost 300 million people are living with hepatitis B. Hepatitis B is transmitted through direct contact with infected blood, unprotected sex with an infected individual, use of contaminated medical or injection equipment, and most commonly, from an infected mother to her newborn during childbirth. A chronic (lasting longer than six months) hepatitis B infection can damage the liver and may progress to more serious conditions like cirrhosis, fibrosis, and even liver cancer. While hepatitis B is a major public health problem, it can be prevented through a safe and effective vaccine. And even though hepatitis B is a serious disease, most people live healthy and productive lives with effective management and treatment.   NAFLD is caused by the excess accumulation of fat in the liver not related to  alcohol use. Over time, this may lead to inflammation or swelling and liver damage. There are two types of NAFLD: 1). Non-Alcoholic Fatty Liver (NAFL) or Simple Fatty Liver and 2) Non-Alcoholic Steatohepatitis (NASH). Someone who has NAFL has fat buildup in their liver. Someone who has NASH also has liver damage and liver inflammation, which can lead to cirrhosis, liver cancer, and may

    http://www.hepb.org/blog/difference-hepatitis-b-fatty-liver-disease/
  • Four Things Fathers Affected by Hepatitis B Can Do for Themselves and Their Families

    Image courtesy of photostock at FreeDigitalPhotos.net Father’s Day, June 21, is a day to celebrate the contributions men make in their children’s lives. It’s also a good day for fathers to acknowledge how valuable they are to their families and how important it is to take care of their health. Living with chronic hepatitis B can be challenging. Here are some things dads can do to take care of themselves or family members infected with hepatitis B. 1. Get outside and soak in some sunlight and some vitamin D. People with hepatitis B who have vitamin D deficiencies have higher rates of liver damage, cirrhosis and cancer. A healthy diet provides vitamin D, but 80 percent of our vitamin D comes from 15 minutes of exposure to sunlight two to three times a week. So get outside and walk, garden, exercise and soak in some healthy sunlight. 2. Relieve your stress. Having a chronic infection is stressful. Stress can weaken your immune system, which needs to stay strong to fight hepatitis B. Here are some ways to reduce stress. Physical exercise: Get off the couch and move. Walk, play a game with your kids, mow the lawn or go to a park and shoot hoops or practice tai chi. Every type of physical activity strengthens your immune system, balances blood sugar levels, provides energy and reduces stress. Try yoga:  Yoga is a gentle way to slowly stretch your muscles, which reduces stress as it improves your posture. If you can’t get to a yoga class, buy a video and follow along, or do stretching exercises on your own. Get a massage: Yes, even men enjoy massages. They reduce stress, improve your mood and increase helpful endorphins. Keep your stress reduction program going! Whatever you find that helps reduce stress, keep at it, don’t quit after a few days or weeks. Stress will never totally go away, so give yourself permission to enjoy exercise or other relaxation practices to bring some tranquility to your life. 3. Get regular check-ups: You may worry about your

    http://www.hepb.org/blog/four-things-fathers-affected-by-hepatitis-b-can-do-for-themselves-and-their-families/
  • Hepatitis B Foundation, Baruch S. Blumberg Institute and Pennsylvania Biotechnology Center Announce New Director of Communications and Marketing

    Doylestown, April 8, 2020 − The Hepatitis B Foundation, a global nonprofit, recently appointed Edward F. Tate III, a Newtown resident, as director of communications and marketing. Along with leading the foundation’s communications and marketing, Tate also will handle those functions for the Baruch S. Blumberg Institute and the Pennsylvania Biotechnology Center (PABC). The Hepatitis B Foundation created both the world-renowned Blumberg Institute and the PABC to expand its research toward a cure goal. The PABC now is among the nation’s best life sciences incubators, according to a 2018 study from the International Business Innovation Association. The Blumberg Institute has become one of the nation’s leading centers for translational research, particularly for hepatitis B and liver cancer. All three organizations are innovative and integrated nonprofits that share a campus in Doylestown. “Ed is a welcome addition to the Hepatitis B Foundation, Baruch S. Blumberg Institute and Pennsylvania Biotechnology Center, especially during this challenging time, when clear communication is critical,” said Timothy M. Block, Ph.D., President and CEO of all three nonprofit organizations. “His experience and expertise will help us strengthen and grow our local and national communications.” Tate comes to the foundation from a pharmaceutical and medical technology trade association. Previously he was director of communications for Rutgers University’s Office of Research and Economic Development, executive vice president of a Philadelphia-area public relations agency and director of media relations for Educational Testing Service in Princeton. 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/hepatitis-b-foundation-baruch-s-blumberg-institute-and-pennsylvania-biotechnology-center-announce-new-director-of-communications-and-marketing/

  • እርግዝና እና ሄፓታይተስ ቢ ነፍሰጡር ከሆንኩ የሄፓታይተስ ቢ ምርመራ ማድረግ አለብኝ? አዎ! ሁሉም ነፍሰ ጡር እናቶች የሄፓታይተስ ቢ ምርመራ ማድረግ አለባቸው!  ነፍሰ ጡር ከሆንሽ ዶክተርሽ የሄፓታይተስ ቢ ምርመራ እንዳደረገልሽ አርግጠኛ ሁኚበፊት ልጅሽ ከመወለዱ፡፡ እነዚህ ምርመራዎች ለነፍሰጡር እናቶች በጣም አስፈላጊ የሆኑት ለምንድን ነው? የሄፓታይተስ ቢ ምርመራ ውጤትሽ ፖዘቲቭ ሆኖ ነፍሰጡር ከሆንሽ፤ ቫይረሱ በእርግዝና እና በወሊድ ግዜ አዲስ ወደሚወለደው ህፃን ይተላለፋል፡፡ ሄፓታይተስ ቢ እንዳለብሽ ዶክተሩ ካወቀ በማዋለጃ ክፍል ውስጥ ወደ ልጅሽ እንዳይተላለፍ ተገቢ የሆነ ህክምና ሊያደርግልሽ ይገባል፡፡ ተገቢውን ሂደት መከተል ካልተቻለ ልጅሽ ስር በሰደደው ሄፓታይተስ ቢ የመያዝ እድሉ እስከ 95% ነው፡፡ በሄፓታይተስ ቢ መያዝ በእርግዝናዬ ላይ ተፅዕኖ ያመጣል? በእርግዝና ወቅት የሄፓታይተስ ቢ ኢንፌክሽን በአንቺና እና ባልተወለደው ልጅሽ ላይ ምንም ችግር ማስከተል የለበትም፡፡  አንቺ በሄፓታይተስ ቢ ስለመያዝሽ ዶክተርሽ ሊውቅ ይገባል፤ ይህን ተከትሎም ዶክተሩ በጤናሽ ላይ በሚያደርገው ክትትል ልጁ ከተወለደ በኋላ እንዳይያዝ ለማድረግ ያስችላል፡፡ እኔ ነፍሰጡር ብሆንና ሄፓታይተስ ቢ ቢኖርብኝ፣ እንዴት ነው ልጄን መጠበቅ የምችለው? የሄፓታይተስ ቢ ውጤትህ ፖዘቲቭ ከሆነ ዶክተርህ ለሄፓታይተስ ቢ e-antigen (HBeAg) ምርመራ የሚያደርግልህ ይሆናል፤ ከዚህ በተጨማሪም ፖዘቲቭ ሆነህ የሄፓታይተስ ቢ ቫይራል ሎድ ብለድ ቴስት (HBV DNA quantification) ምርመራም የሚደረግልህ ይሆናል፡፡ አንዳንድ ጊዜ የላቦራቶሪ ውጤት ከፍተኛ የቫይራል ሎድ መኖሩን ያሳያል፡፡ ሀኪምዎ በመጨረሻዎቹ ሶስት ወራት አካባቢ በአፍ የሚሰጥ የአንቲቫይራል መድሀኒት እንዲጠቀሙ ይመክራል፤ ይህም በወሊድ ግዜ አዲስ የሚወለደው ህፃን እንዳይያዝ ያደርገዋል፡፡  ሄፓታይተስ ቢ እንዳለብዎ ከታወቀ፣ አዲስ የተወለደው ልጅዎ በማዋለጃ ክፍል ውስጥ እንዳለ ወዲያውኑ ሁለት ክትባት ሊሰጠው ይገባል፡፡ የመጀመሪያው ክትባት የሄፓታይተስ ቢ ክትባት አንዱ ክትባት ሄፓታይተስ ቢ ኢሚዩኖ ግሎቡሊን (HBIG) በመጀመሪያዎቹ 12 ሰዓታት ውስጥ እነዚህ ሁለቱ መድሀኒቶች በትክክል ቢሰጡ፣ አዲስ የተወለደው ህፃና እድሜ ዘመኑን አብሮት ሊኖር ከሚችለው የሄፓታይተስ ቢ ከ90% በላይ ተጠብቆ የመኖር እድል አለው፡፡ ቀሪዎቹን ከ2-3 የሚደርሱ የሄፓታይተስ ቢ ክትባቶች በመርሀግብሩ መሰረት ልጅዎ ስለመውሰዱ እርግጠኛ መሆን አለብዎት፡፡ ጨቅላ ልጅዎን ሙሉ በሙሉ ከሄፓታይተስ ቢ ለመጠበቅ ሁሉንም ክትባቶች ማስከተብ ያስፈልጋል፡፡ ሄፓታይተስ ቢ ካለባት እናት የተወለደ ልጅ የፖስት ቫክሲኔሽን ሰሮሎጂክ ምርመራ ከ9-12 ወራት ውስጥ በማድረግ ህፃኑ ከሄፓታይተስ ቢ መጠበቁንና አለመያዙን ማረጋገጥ በጣም ጠቃሚ ነው፡፡ ምርመራው HBsAg እና anti-HBs titer ምርመራን ያካትታል፡፡ አዲስ የሚወለደውን ህፃን ለመጠበቅ የሚያስችል ሌላ ሁለተኛ እድል የለም!   ክትባቱ ከዩናይትስቴትስ ውጭ በአብዛኞቹ ሀገሮች ፔንታቫለንት የሚባሉት ክትባቶች 5ቱን በአንድ ክትባት አጣምረው የያዙና አምስት አይነት በሽታዎችን ለመከላከል (ዲፕቴሪያ፣ ፐርቱሲስ፣ ቲታነስ፣ ሂብ እና ሄፓታይተስ ቢ) የሚረዱ ሲሆኑ 6ሳምንት ካለፈው ህፃን ጀምሮ እስከ 1 ዓመት ያሉት ሊወስዱት ይችላሉ፡፡ የመጀመሪያው ክትባት የሚሰጠው በ6 ሳምንት ሲሆን ሁለተኛው እና ሶስተኛው ክትባቶች ደግሞ የሚሰጡት በ10 እና በ14ኛው ሳምንት እድሜ ነው፡፡ ፔንታቫለንት ክትባቶች የሚሰጡት በነፃ ሲሆን ለዚህም ድጋፍ ያደረገው ጋቪ፣ የክትባት ጥምረት፡፡ ጋቪ ያለባቸውን ሀገራት ተመልከት፤ ያለውን ሀብት እና ኢሙዩናይዜሽን ለማየት፦ http://www.gavi.org/country/፡፡ ሄፓታይተስ ቢ ካለባት እናት የተወለደ ህፃን የመጀመሪውን የፐተንታቫለንት ክትባት የሚጠብቅ ከሆነ ከመዘግየትም ባለፈ በወሊድ ወቅት እንዲሁም በመጀመሪያዎቹ ስድስት ወራት ከመያዝ አይድንም፡፡ ሄፓታይተስ ቢ ያለባት ሴት ቫይረሱን ወደልጅዋ በማስተላለፍ ስርለሰደደ በሽታ ታጋልጠዋለች፡፡ አለም አቀፉ የጤና ድርጅት ሁሉም ህፃናት በተወለዱ 24 ሰዓት ውስጥ ሄፓታይተስ ቢ ክትባት መከተብ እንዳለባቸው ይመክራል፡፡ አርቀው ያቅዱ እና በመጀመሪያ ስለሚወሰደው ነጠላ ክትባት መኖርና ዋጋ ይጠይቁ፣ ስለ ክትባቱ መጠን ያስቡ፤ ይህ በጋቪ ድርጅት እንደሚቀርበው ዓይነት በሽታን ለመከላል የሚያስችል አይደለም፡፡ ይህ በተለይም በሄፓታይተስ ቢ ለተያዙ እናቶች ጠቃሚ ነው፡፡   እርስዎ ምናልባት ስለ ሄፓታይተስ ቢ እርግጠኛ መሆን ካልቻሉ ዶክተርዎ የሄፓታይተስ ቢ ምርመራ ሊያደርግልዎት ይገባል፡፡ የፔንታቫላንትን ክትባት ያልወሰዱ ህፃናት፣ የመጀመሪያውን የሞኖቫላንት ሄፓታይተስ ቢ ክትባት ህፃኑ በተወለደ የመጀመሪያዎቹ 12 ሰዓታት ውስጥ የግድ ሊሰጠው የሚገባ ሲሆን ቀሪዎቹ ከ2-3 የሚደርሱት ክትባቶች ደግሞ በተያዘላቸው መርሀ ግብር መሰረት መሰጠት አለባቸው፡፡ የፔንታቫላንትን ክትባትን እየወሰዱ ያሉ ህፃናት፣ ለሄፓታይተስ ቢ የሚሰጠውን የመጀመሪያውን የሞኖቫለንት ክትባት በተወለዱ በ12 ሰዓት ውስጥ ሊሰጣቸው የሚገባ ሲሆን የሄፓታይተስ ሁለተኛ እና ሶስተኛ ክትባት በፔንታቫላንት 1ኛ እና 2ኛ ክትባት ውስጥ የሚካተት ይሆናል፡፡ *ማስታወሻ፦ ሲዲሲ የሄፓታይተስ ቢ የመጀመሪያ ክትባትን እና HBIG በመጀመሪያዎቹ 12 ሰዓታት ውስጥ ሁለቱም ሊሰጡ እንደሚገባ ይመክራል፡፡ HBIG በሁሉም ሀገራት ላይኖር ይችላል፡፡ በእርግዝናዬ ጊዜ ህክምና ያስፈልገኛል? በእርግዝና ወቅት የሄፓታይተስ ቢ ኢንፌክሽን በአንቺና እና ባልተወለደው ልጅሽ ላይ ምንም ችግር ማስከተል የለበትም፡፡ አንቺ በሄፓታይተስ ቢ ስለመያዝሽ ዶክተርሽ ሊውቅ ይገባል፤ ይህን ተከትሎም ዶክተሩ በጤናሽ ላይ በሚያደርገው ክትትል ልጁ ከተወለደ በኋላ እንዳይያዝ ለማድረግ ያስችላል፡፡ የምትኖረው ከአሜሪካ ውጭ ከሆነ እና ሄፓታይተስ ቢ እንዳለብህና እንደሌለብህ እርግጠኛ መሆን ካልቻልክ ዶክተርህን በማናገር የሄፓታይተስ ቢ ምርመራ ማድረግ አለብህ፡፡ ህፃናት ሲወለዱ የተከተቡት የሄፓታይተስ ቢ ክትባትውጤት አለማምጣት እና HBIGበሴቶች ላይ ምናልባትምHBeAg ፖዘቲቭ በሆኑ እና የቫይራል ሎዳቸው በጣም ከፍ ባሉት ላይ ሄፓታይተስ ቢ ወደ ሰውነታችን እንዲተላለፍ ይሆናል፡፡ ሄፓታይተስ ቢ እንዳለባቸው የታወቀላቸው ሁሉም ነፍሰጡር እናቶች ክትትል እንዲደረግላቸው በሄፓታይተስ ቢ ላይ ብቃት ወዳለው የህክምና ባለሙያ መላክ አለባቸው፡፡ ሀኪምዎ እንደ ሄፓታይተስ ቢ e-antigen፣ HBV DNA level፣ እና ጉበት መስራቱን የሚያረጋግጥ ምርመራዎች (ALT) ያሉ ተጨማሪ የላቦራቶሪ ምርመራዎችን ማድረግ አለበት፡፡ የቫይረሱ ሌቭል ከ200,000 IU/mL ወይም 1 million cp/mlከበለጠ የሚያሳየው ሲወለድ የተከተበው ክትባት መጠን እና HBIGጥምረት ዝቅ ማለቱን ነው፡፡ ከወሊድ በፊት የመጀመሪያ የአንቲቫይራል ቴራፒ ከቴኖፎቪር ጋር የቫይራል ሎዱን ለመቀነስ ይመከራሉ፡፡ ቴኖፎቪር ለነፍሰጡር እና ጡት ለሚያጠቡ እናቶች አስተማማኝ መሆኑ ታይቷል፡፡ ምናልባት ቲኖፎቪር ውጤታማ ካልሆነ ዶክተሮቹ ቴልቢቩዲን ወይንም ላሚቩዲንን ሊያዙ ይችላሉ፡፡ የአንቲቫይራል ትሪትመንት ከ 28-32 ሳምንታት ውስጥ ጀምሮ እስከ 3 ወር ያለማቋረጥ ይቀጥላል፡፡ ከእርግዝናዬ በኋላ የህክምና ክትትል ያስፈልገኛል? በእርግዝናዎ ወቅት አንቲቫይራል እንዲወስዱ ከታዘዙ፣ ከ3 እስከ 6 ወር አንድ ጊዜ በALT (SGPT) መታየት አለብዎት፡፡ ይህ የአንቲቫይራል ህክምናውን መቀጠል እንዳለብዎት ለመወሰን ይረዳል፡፡ እባክዎ በውጤትዎ መሰረት የታዘዘልዎትን የአንቲቫይራል መድሀኒት ዶክተርዎ ካላዘዝውት በቀር እንዳያቋርጡ፡፡ ለአብዛኞቹ ሴቶች የክትትል ውጤታቸው ምንም አይነት በሽታ አለመኖሩን ሲያሳይ፤ የእርስዎ ሀኪም፣ ጉበት ስፔሻሊስት ጋር ክትትል እንዲያደርጉ ይመክራሉ፡፡  ሁሌም አዋላጅ ሀኪምዎ እና አዲስ የተወለደው ልጅዎ ሀኪም ስለ እርስዎ የሄፓታይተስ ቢ ደረጃ ማወቃቸው ልጅዎ በቀጣይ ዘመኑ ሄፓታይተስ ቢ እንዳይኖርበት ለማድረግ ክትባት እንዲወስድ ሲያግዝ እርስዎ ደግሞ ተገቢውን የህክምና ክትትል እንዲገኙ ምቹ ሁኔታን ይፈጥራል፡፡  ሄፓታይተስ ቢ ቢኖርብኝ ልጄን ጡት ማጥባት እችላለሁ? ጡት ማጥባት የመያዝ እድልን ይቀንሳል፣ ምንም እንኳን ዝቅ ያለ ቢሆንም፡፡  ከዚህ በተጨማሪም ህጻናት ሲወለዱ ሄፓታይተስ ቢ ን ለመከላከል የሚያግዘውን ክትባት መከተባቸው የሚመከርና በቀጣይ ሊመጣ የሚችልን ማንኛውም አይነት ችግር የመቀነስ እድልን ይፈጥራል፡፡ ለሄፓታይተስ ቢ ተብሎ የሚታዘዘው ቲኖፎቪር ጡት ለሚያጠቡ እናቶች አስተማማኝ ስለመሆኑ የሚያሳይ መረጃ አለ፡፡   Pregnancy and Hepatitis B  Should I be tested for hepatitis B if I am pregnant?Yes, ALL pregnant women should be tested for hepatitis B! If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born. Why are these tests so important for pregnant women?If you test positive for hepatitis B and are pregnant, the virus can be passed on to your newborn baby during your pregnancy or during delivery. If your doctor is aware that you have hepatitis B, he or she can make arrangements to have the proper medications in the delivery room to prevent your baby from being infected. If the proper procedures are not followed, your baby has a 95% chance of developing chronic hepatitis B! Will a hepatitis B infection affect my pregnancy?A hepatitis B infection should not cause any problems for you or your unborn baby during your pregnancy. It is important for your doctor to be aware of your hepatitis B infection so that he or she can monitor your health and so your baby can be protected from an infection after it is born. If I am pregnant and have hepatitis B, how can I protect my baby?If you test positive for hepatitis B, your doctor should also test you for the hepatitis B e-antigen (HBeAg), and if positive, you should have a hepatitis B viral load blood test (HBV DNA quantification). In some cases, the laboratory test results may show a very high viral load. In these cases, your physician may recommend that you take an oral antiviral drug in the third trimester, which is safe to take to reduce the risk of infecting your newborn at birth. If you test positive for hepatitis B, then your newborn must be given two shots immediately in the delivery room: First dose of the hepatitis B vaccine One dose of hepatitis B immune globulin (HBIG) If these two medications are given correctly within the first 12 hours of life, a newborn has more than a 90% chance of being protected against a lifelong hepatitis B infection. You must make sure your baby receives the remaining 2-3 doses of the hepatitis B vaccine according to schedule. All doses must be completed in order for your infant to be fully protected against hepatitis B. It is also important that a baby born to an HBV-positive mother receive post-vaccination serologic testing at 9-12 months to confirm the baby is protected against HBV and is not infected. Tests include the HBsAg and anti-HBs titer test. There is no second chance to protect your newborn baby! Vaccination Outside the United StatesIn many countries, the pentavalent vaccine, a combination 5-in-one vaccine that protects against five diseases (diphtheria, pertussis, tetanus, Hib and hepatitis B) may be given to babies more than 6 weeks of age and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of Gavi, the Vaccine Alliance. Check the Gavi country hub to see the resources and immunizations that may be available: http://www.gavi.org/country/. For babies born to mothers with hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from becoming infected during birth or within the first six weeks of life. A woman who is hepatitis B positive is likely to pass the virus on to her baby, who will then be chronically infected. WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Plan ahead and inquire about the availability and cost of the monovalent (single), birth dose of the vaccine, as it is not a Gavi provided immunization. This is particularly important to women who are positive for hepatitis B. If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B! For babies NOT receiving the pentavalent vaccine, the first dose of the monovalent, HBV vaccine must be given within 12 hours of birth, followed by the remaining 2-3 doses of the hepatitis B vaccine according to schedule. For babies receiving the pentavalent vaccine, the first, monovalent dose of the hepatitis B vaccine is given within 12 hours of birth, and the second and third doses of the HBV vaccine will be included in dose 1 and dose 2 of the pentavalent vaccine. *Note: CDC recommends both the first shot of the HBV vaccine and HBIG within 12 hours of birth. HBIG may not be available in all countries. Do I need treatment during my pregnancy?A hepatitis B infection should not cause any problems for you or your unborn baby during your pregnancy. It is important for your doctor to be aware of your hepatitis B infection so that he or she can monitor your health and so your baby can be protected from an infection after it is born. If you live outside of the U.S. and are unsure of your hepatitis B status, please ask your doctor to test you for hepatitis B. Failure of the birth dose of the HBV vaccine and HBIG may occur in women who are HBeAg positive and have a very high viral load, allowing for the transmission of hepatitis B to your baby.All women who are diagnosed with hepatitis B in pregnancy should be referred for follow up care with a physician skilled at managing hepatitis B infection. Your physician should perform additional laboratory testing, including hepatitis B e-antigen, HBV DNA level, and liver function tests (ALT). A virus level greater than 200,000 IU/mL or 1 million cp/ml indicates a level where the combination of the birth dose of the vaccine and HBIG may fail. First-line, antiviral therapy with tenofovir may be recommended to reduce the viral load prior to birth. Tenofovir has been shown to be safe both during pregnancy and for breastfeeding mothers. In cases where tenofovir is not effective, doctors may prescribe telbivudine or lamivudine. Antiviral treatment begins at 28-32 weeks and continues 3 months postpartum. Do I need treatment after my pregnancy? If you are prescribed antivirals during pregnancy, you should have your ALT (SGPT) monitored every 3 months for 6 months. This will help determine if you should continue antiviral treatment. Please do not discontinue your antiviral medication unless the doctor advises you to, based upon test results. For most women whose follow up testing shows no signs of active disease, your physician will recommend regular monitoring with a liver specialist. In all cases, it is very important that your obstetrician and your newborn’s pediatrician, are aware of your hepatitis B status to ensure that your newborn receives the proper vaccines at birth to prevent a lifelong hepatitis B infection, and that you receive appropriate follow up care. Can I breastfeed my baby if I have hepatitis B?The benefits of breastfeeding outweigh the potential risk of infection, which is minimal. In addition, since it is recommended that all infants be vaccinated against hepatitis B at birth, any potential risk is further reduced. There is data that shows that tenofovir, which may be prescribed to manage hepatitis B, is safe for breastfeeding women.

    https://www.hepb.org/languages/amharic/pregnancy/
  • Fred Beans Family of Dealerships Donates $30,000 to Support the Hepatitis B Foundation's High School Enrichment Programs

    DOYLESTOWN, PA (February 2017) –The Hepatitis B Foundation’s (HBF) High School Science Enrichment Program received a $30,000 donation from the Fred Beans Family of Dealerships to support its research program for outstanding high school students. Between the intensive two-week  summer program, and a year-round after-school opportunity, motivated high school students have an opportunity to work in state-of the-art research labs under the supervision of professional scientists. Fred Beans and Beth Beans Gilbert (center) present the $30,000 donation from the Fred Beans Family of Dealerships in support of the Hepatitis B Foundation’s High School Science Enrichment Program to Dr. Timothy Block, president of the foundation (third from left), and several of the high school students participating in the program “The Hepatitis B Foundation, and its research arm, the Baruch S. Blumberg Institute, are committed to training the next generation of scientists," said Timothy Block, PhD, co-founder and president of both nonprofit organizations. "The generosity of the Fred Beans organization allows us to continue to offer local students the opportunity to learn about research, biotechnology, and entrepreneurship through ‘hands-on’ lab experience and interactive seminars.’ The HBF’s High School Science Enrichment Program is funded through Pennsylvania’s “Educational Improvement Tax Credit” (EITC) program, a state tax credit program that allows businesses to receive tax credits for corporate state tax dollars for donations in support of educational enrichment. Photo Caption: Fred Beans and Beth Beans Gilbert (center) present the $30,000 donation from the Fred Beans Family of Dealerships in support of the Hepatitis B Foundation’s High School Science Enrichment Program to Dr. Timothy Block, president of the foundation  (third from left), and several of the high school students participating in the program.      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/beans/
  • Viral Hepatitis Meetings in D.C.

    Last week was an eventful week for this HBV blogger.  I was fortunate to be able to attend the National Viral Hepatitis Technical Assistance and the National Viral Hepatitis Round Table (NVHR) meetings in Washington D.C. last Tuesday and Wednesday. These meetings were followed by Capitol Hill visits on Thursday by viral hepatitis advocates to their legislative offices. In attendance at the meeting were state viral hepatitis coordinators from around the country, other state health department personnel, government representatives from various agencies and organizations, and numerous viral hepatitis advocates from various non-profit organizations. It was a great opportunity to meet colleagues from all over the country dedicated to combating viral hepatitis in the United States. Please keep in mind that my background is patient oriented, and that I do not have a master’s degree in public health, nor do I have experience working in the public health system.  Keeping up with the political front is challenging as is keeping up with the public health system. I’m still trying to figure it all out. Both have their own language and acronyms. After a couple of days of meetings, I have a great deal of respect for those working in public health at both the federal and state level.  I also have a great deal of respect for those working to push policy on behalf of viral hepatitis. There’s always more to learn, but you can still make an impact by jumping in and getting involved at a number of different levels. A couple of messages were loud and clear at the meeting and you didn’t need to be an expert to understand them. Perhaps the biggest message is that funding for viral hepatitis public health programs is very limited and the burden is well beyond the level of funding.  This comes as no surprise since these are difficult times for both state and federal government programs.  This lack of funding will require that all health departments, government organizations and

    http://www.hepb.org/blog/viral-hepatitis-meetings-in-d-c/
  • Patient Assistance Programs in the U.S.

    If you live in the United States and are struggling to afford your hepatitis B medication, there may be programs available to help you with the cost. Programs generally fall into one of 4 general categories: Manufacturer-Sponsored Patient Assistance Programs; Nonprofit Co-Pay Assistance Programs; Mail-order Discount Pharmacies; and Discount Prescription Cards. Manufacturer-sponsored Patient Assistance Programs Most major pharmaceutical companies offer assistance programs to help individuals afford their medicines. Eligibility requirements vary by company, and the available funding can be depleted before the end of a year. But it is worth checking these medication assistance programs if you need help. Some programs may provide free medications to individuals without insurance, while others may assist with covering co-pays for people with health insurance. Below is a list of the companies, the medications that are covered by their assistance programs, and their contact information.   Company Medicines Covered Contact Information Eligibility Gilead Vemlidy (Tenofovir alafenamide) Hepsera (Adefovir) (Note: Gilead does not offer assistance for Viread)  Gilead website    855-769-7284  Co-Pay Program will offer $5,000/year toward insurance co-pays for Vemlidy for eligible insured patients.   Patient Assistance Program provides free Vemlidy or Hepsera for eligible uninsured patients.     Merck Intron A (interferon alpha)  Merck website    855-257-3932 Patient assistance for individuals without medical insurance who meet income requirements.   GlaxoSmithKline Epivir HBV (lamivudine)  GSK website  1-888-825-5249 Patient assistance for individuals without medical insurance who meet income requirements.   Co-Pay Assistance Programs The following programs offer financial assistance for eligible individuals with prescription insurance who are not able to afford their prescription co-pays. Patient Advocate Foundation Assistance with all hepatitis B medications   Copays.org Eligible individuals must have prescription insurance coverage and have a household income below 400% of the Federal Poverty Guidelines. Program opens and closes throughout the year as funding becomes available.   Prescription Hope  Assistance with all hepatitis B medications  Program website Eligible individuals may be uninsured or underinsured and make around $30,000 per year or have a combined household income of around $50,000. Click here for more information about the program and eligibility.   Eligible individuals can purchase medications including tenofovir, entecavir, Baraclude, Viread and Vemlidy for $50/mo.   Online Discount Pharmacy This online discount mail-order pharmacy is a nonprofit offering two first-line hepatitis B medications at an affordable price for eligible individuals regardless of their prescription coverage. DiRx Health Entecavir     Tenofovir disoproxil fumarate (TDF)  DiRxhealth.com      1-800-FOR-DIRX  (877-367-3479)   No eligibility requirements. Individuals can purchase Entecavir and Tenofovir at discounted prices below. Prices are inclusive of free standard shipping. The discount will show at checkout when using the code HBFSAVE for every order (prices based on use of 1 tablet per day): Entecavir 0.5 mg - $27.00 (30 days) and $68.40 (90 days) Entecavir 1 mg - $32.40 (30 days) and $84.60 (90 days) Tenofovir Disoproxil Fumarate 300 mg – $18.00 (30 days) and $45.90 (90 days) RX Outreach Tenofovir disoproxil fumarate (TDF)   Entecavir  Rxoutreach.org    1-888-796-1234 Eligible individuals must have an income below 400% of Federal Poverty Guidelines. Individuals are eligible whether or not they have prescription insurance. Eligible individuals can purchase tenofovir for $25/mo or entecavir for $45/mo.  Mark Cuban CostPlus Drug Company       Entecavir      Tenofovir disoproxil fumarate (TDF)  CostPlusDrugs.com No eligibility requirements. Individuals can purchase entecavir at the following prices: 0.5 mg – $39.30 (30 days), $75.60 (60 days), $111.90 (90 days) 1 mg – $43.50 (30 days), $84.00 (60 days), $124.50 (90 days) Individuals can purchase Tenofovir (TDF) at the following prices: 300 mg - $18.30 (30 days), $33.60 (60 days), $48.90 (90 Days)  NiceRx Viread (tenofovir disoproxil fumarate, TDF)     Entecavir     Vemlidy (Tenofovir alafenamide, TAF)    NiceRX.com        866-407-0777   Eligible individuals must have an income of less than $65,000 for 1-person household or $90,000 for 2-person in household.   Cannot have any prescription drug coverage (except for Viread – if a person has Medicare Part D, they must have spent at least $600 in medication expenses in the calendar year)   Eligible individuals can purchase medication for $49 per month.   Discount Prescription Cards Prescription drug discount cards allow cardholders to save money on all types of prescription medications. Cards are available online, at no cost, and can be used with or without insurance. At the time of purchase, cardholders simply present their card at a participating pharmacy to instantly receive substantial discounts on their prescription drugs. These cards typically offer the best price on generic medications. The websites also allow individuals to search for the best price on their medication at nearby pharmacies based on zip code. America's Pharmacy 888-495-3181 www.americaspharmacy.com ScriptSave Well Rx   www.wellrx.com GoodRX 855-268-2822 www.Goodrx.com   America’s Drug Card   www.americansdrugcard.com Needymeds   www.needymeds.org   Additional tips for affording your medications: If you can not afford your brand-name medication, talk to your doctor about whether a generic version is available. Generic medications contain the same active ingredients as the brand name version, often at a much lower cost. Discount prescription cards are available online at no cost, and have no eligibility requirements. These are a great option if you are not eligible for other assistance programs. Before changing health insurance, check how much your medication will cost on the new plan. If you find that your insurance company places all hepatitis B medications on the highest pricing tier, then your plan may be discriminating against people with chronic hepatitis B. Learn more about discriminatory drug pricing and how to report it here: https://www.hepb.org/resources-and-support/know-your-rights/us-access-to-medicine/ Serious liver damage can occur if you suddenly stop taking your hepatitis B medication, or if you take it inconsistently. If you can not afford your current medication, talk to your doctor about other options. Do not cut pills, skip doses, or stop medication unless you are under the care of a knowledgeable doctor.   

    https://www.hepb.org/treatment-and-management/patient-assistance-programs-in-the-u-s/

  • Hamilelik ve Hepatit B Hamileysem hepatit B için test yaptırmalı mıyım?Evet, TÜM hamile kadınlar hepatit B için test yaptırmalıdır! Hamileyseniz doktorunuzun sizde bebeğiniz doğmadan önce hepatit B testi yaptırdığından emin olun. Bu testler hamile kadınlarda niye çok önemli?Hepatit B testiniz pozitif çıkarsa ve hamileyseniz virüs hamileliğiniz veya doğum sırasında yenidoğan bebeğinize geçebilir. Doktorunuz sizde hepatit B olduğundan haberdarsa bebeğinizin enfekte olmasını önlemek için doğumhanede uygun ilaçların bulunmasını düzenleyebilir. Uygun işlemler izlenmezse bebeğinizde kronik hepatit B gelişmesi olasılığı %95'tir! Hepatit B enfeksiyonu hamileliğimi etkiler mi?Hepatit B enfeksiyonunun hamilelik sırasında siz veya doğmamış bebeğinizde problem oluşturması beklenmez. Doktorunuzun sağlığınızı izleyebilmesi ve böylece doğduktan sonra bebeğinizin enfeksiyondan korunabilmesi için hepatit B enfeksiyonu durumunuzdan haberdar olması önemlidir. Hamileysem ve hepatit B durumum varsa bebeğimi nasıl koruyabilirim?Hepatit B testiniz pozitif çıkarsa doktorunuz ayrıca sizde hepatit B e-antijeni (HBeAg) testi yaptırmalıdır ve pozitif çıkarsa bir hepatit B viral yük kan testi (HBV DNA miktarı belirleme) yapılmalıdır. Bazı durumlarda laboratuvar testi sonuçları çok yüksek bir viral yük gösterir. Bu durumlarda doktorunuz alması güvenli olan ve doğumda yenidoğan bebeğinizin enfekte olması riskini azaltan ağızdan bir antiviral ilacın üçüncü trimesterde alınmasını önerebilir. Hepatit B testiniz pozitif çıkarsa yenidoğan bebeğinize doğumhanede hemen iki aşı yapılmalıdır:• Hepatit B aşısından bir doz • Hepatit B immünglobulinden (HBIG) bir dozBu iki ilaç yaşamın ilk 12 saatinde doğru olarak verilirse yenidoğan bebeğin ömür boyu hepatit B enfeksiyonuna karşı korunma olasılığı %90'ın üzerindedir. Bebeğinizin kalan 2-3 hepatit B aşısı dozunu çizelgeye göre aldığından emin olmalısınız. Bebeğinizin hepatit B'ye karşı tam korunması için tüm dozlar tamamlanmalıdır. HBV pozitif bir anneye doğan bir bebekte bebeğin HBV'ye karşı korunmuş olduğundan ve enfekte olmadığından emin olmak için aşılamadan 9-12 ay sonra serum ile testler yapılması önemlidir. HBsAg ve anti-HBs titresi testi bu testlere dahildir. Yenidoğan bebeğinizi korumak için ikinci bir şans yoktur! Amerika Birleşik Devletleri Dışında AşılamaÇoğu ülkede 6 haftanın üzerindeki bebeklere 5'i bir yerde olan pentavalan (beşli) aşı kombinasyonu beş hastalığa karşı (difteri, boğmaca, tetanoz, Hib ve hepatit B) koruyacak şekilde 1 yaşa kadar verilebilir. İlk doz bebek 6 haftalıkken verilir ve ikinci ve üçüncü dozlar 10 ve 14 haftalıkken verilir. Pentavalan aşı Gavi yani Aşı Birliği desteğiyle ücretsiz sağlanabilir. Mevcut olabilecek kaynaklar ve bağışıklamaları görmek için Gavi ülke iletişim merkezine bakınız: http://www.gavi.org/country/. Hepatit B durumu olan annelere doğan bebekler için pentavalan aşının ilk dozunu beklemek çok geç olur ve bebeği doğum sırasında veya yaşamın ilk altı haftasında enfekte olmaktan KORUMAZ. Hepatit B pozitif olan bir kadın, virüsü büyük olasılıkla bebeğine geçirecektir ve onda kronik enfeksiyon gelişecektir. DSÖ, TÜM bebeklerde hepatit B aşısının doğumdan sonraki 24 saat içinde yapılmasını önerir. Bu Gavi tarafından sağlanan bir bağışıklama olmadığından aşının doğumda yapılan monovalan (tekli) dozunun mevcudiyetini ve maliyetini önceden sorun ve gerekenleri planlayın. Bu durum özellikle hepatit B için pozitif kadınlar için önemlidir. Hepatit B durumunuzdan emin değilseniz lütfen doktorunuzun size hepatit B testleri yaptırdığından emin olun! Pentavalan aşıyı ALMAYAN bebekler için monovalan HBV aşısının ilk dozu doğumdan sonra 12 saat içinde verilmeli ve sonrasında programa göre hepatit B aşısının diğer 2-3 dozu verilmelidir.Pentavalan aşının yapılacağı bebekler için hepatit B aşısının ilk monovalan dozu doğumdan sonraki 12 saat içinde verilir ve HBV aşısının ikinci ve üçüncü dozları pentavalan aşının doz 1 ve doz 2'sine dahil edilecektir. *Not: CDC hem HBV aşısı hem HBIG için ilk enjeksiyonun doğumda sonraki 12 saatte yapılmasını önerir. HBIG tüm ülkelerde bulunmayabilir. Hamileliğim sırasında tedaviye gerek var mı?Hepatit B enfeksiyonunun hamilelik sırasında siz veya doğmamış bebeğinizde problem oluşturması beklenmez. Doktorunuzun sağlığınızı izleyebilmesi ve böylece doğduktan sonra bebeğinizin enfeksiyondan korunabilmesi için hepatit B enfeksiyonu durumunuzdan haberdar olması önemlidir. ABD dışında yaşıyorsanız ve hepatit B durumunuzdan emin değilseniz lütfen doktorunuzdan size hepatit B testleri yaptırmasını isteyin. HBV aşısı ve HBIG'nin doğumda verilen dozu HBeAg pozitif olan ve çok yüksek viral yük nedeniyle bebeğine hepatit B geçmesi mümkün olan kadınlarda başarısız olabilir. Hamilelikte hepatit B tanısı konan tüm kadınlar hepatit B enfeksiyonunu takip etme konusunda bilgili bir doktor tarafından takip için sevk edilmelidir. Doktorunuz hepatit B e-antijeni, HBV DNA seviyesi ve karaciğer fonksiyon testleri (ALT) dahil ek laboratuvar testleri yapmalıdır. 200.000 IU/mL veya 1 milyon kopya/ml üzerinde bir virüs seviyesi, aşı ve HBIG için doğumda verilen dozların kombinasyonunun başarısız olabileceği seviyeye işaret eder. Doğumdaki viral yükü azaltmak için tenofovir ile birinci basamak antiviral tedavi önerilebilir. Tenofovirin hem hamilelikte hem emziren annelerde güvenli olduğu gösterilmiştir. Tenofovirin etkili olmadığı durumlarda doktorlar telbivudine veya lamivudin yazabilir. Antiviral tedavi hamileliğin 28-32. haftasında başlayıp doğumdan sonra 3 ay sürer. Hamileliğim sonrasında tedaviye gerek var mı? Hamilelik sırasında size bir antiviral yazılırsa ALT (SGPT) seviyenizin 6 ay boyunca 3 ayda bir izlenmesi gerekir. Bu durum antiviral tedaviye devam edip etmeyeceğinizi belirlemeye yardımcı olur. Lütfen test sonuçları temelinde doktorunuz önermedikçe antiviral ilaçları sonlandırmayın. Takip testlerinde aktif hastalık bulgusu görülmeyen çoğu kadında doktor bir karaciğer uzmanının düzenli olarak takibini önerir. Her durumda kadın doğum doktorunuz ve yenidoğan bebeğinizin pediatristinin yenidoğan bebeğinizin ömür boyu hepatit B enfeksiyonunu önlemek üzere doğumda uygun aşıları almasını ve sizin uygun şekilde takip edilmenizi sağlaması için hepatit B durumunuzdan haberdar olması çok önemlidir. Hepatit B durumum varsa bebeğimi emzirebilir miyim?Emzirmenin faydaları, çok düşük olası enfeksiyon riskine ağır basar. Ayrıca tüm bebeklerin doğumda hepatit B'ye karşı aşılanması önerildiğinden herhangi bir olası risk daha da azalır. Hepatit B'nin kontrol altında tutulması için yazılabilen tenofovirin emziren kadınlarda güvenli olduğunu gösteren veriler mevcuttur.   Pregnancy & Hepatitis B Should I be tested for hepatitis B if I am pregnant?Yes, ALL pregnant women should be tested for hepatitis B! If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born. Why are these tests so important for pregnant women?If you test positive for hepatitis B and are pregnant, the virus can be passed on to your newborn baby during your pregnancy or during delivery. If your doctor is aware that you have hepatitis B, he or she can make arrangements to have the proper medications in the delivery room to prevent your baby from being infected. If the proper procedures are not followed, your baby has a 95% chance of developing chronic hepatitis B! Will a hepatitis B infection affect my pregnancy?A hepatitis B infection should not cause any problems for you or your unborn baby during your pregnancy. It is important for your doctor to be aware of your hepatitis B infection so that he or she can monitor your health and so your baby can be protected from an infection after it is born. If I am pregnant and have hepatitis B, how can I protect my baby?If you test positive for hepatitis B, your doctor should also test you for the hepatitis B e-antigen (HBeAg), and if positive, you should have a hepatitis B viral load blood test (HBV DNA quantification). In some cases, the laboratory test results may show a very high viral load. In these cases, your physician may recommend that you take an oral antiviral drug in the third trimester, which is safe to take to reduce the risk of infecting your newborn at birth. If you test positive for hepatitis B, then your newborn must be given two shots immediately in the delivery room:• First dose of the hepatitis B vaccine • One dose of hepatitis B immune globulin (HBIG) If these two medications are given correctly within the first 12 hours of life, a newborn has more than a 90% chance of being protected against a lifelong hepatitis B infection. You must make sure your baby receives the remaining 2-3 doses of the hepatitis B vaccine according to schedule. All doses must be completed in order for your infant to be fully protected against hepatitis B. It is also important that a baby born to an HBV-positive mother receive post-vaccination serologic testing at 9-12 months to confirm the baby is protected against HBV and is not infected. Tests include the HBsAg and anti-HBs titer test. There is no second chance to protect your newborn baby! Vaccination Outside the United StatesIn many countries, the pentavalent vaccine, a combination 5-in-one vaccine that protects against five diseases (diphtheria, pertussis, tetanus, Hib and hepatitis B) may be given to babies more than 6 weeks of age, and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of Gavi, the Vaccine Alliance. Check the Gavi country hub to see the resources and immunizations that may be available: http://www.gavi.org/country/. For babies born to mothers with hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from becoming infected during birth or within the first six weeks of life. A woman who is hepatitis B positive is likely to pass the virus on to her baby, who will then be chronically infected. WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Plan ahead and inquire about the availability and cost of the monovalent (single), birth dose of the vaccine, as it is not a Gavi provided immunization. This is particularly important to women who are positive for hepatitis B. If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B! For babies NOT receiving the pentavalent vaccine, the first dose of the monovalent, HBV vaccine must be given within 12 hours of birth, followed by the remaining 2-3 doses of the hepatitis B vaccine according to schedule. For babies receiving the pentavalent vaccine, the first, monovalent dose of the hepatitis B vaccine is given within 12 hours of birth, and the second and third doses of the HBV vaccine will be included in dose 1 and dose 2 of the pentavalent vaccine. *Note: CDC recommends both the first shot of the HBV vaccine and HBIG within 12 hours of birth. HBIG may not be available in all countries. Do I need treatment during my pregnancy?A hepatitis B infection should not cause any problems for you or your unborn baby during your pregnancy. It is important for your doctor to be aware of your hepatitis B infection so that he or she can monitor your health and so your baby can be protected from an infection after it is born. If you live outside of the U.S. and are unsure of your hepatitis B status, please ask your doctor to test you for hepatitis B. Failure of the birth dose of the HBV vaccine and HBIG may occur in women who are HBeAg positive and have a very high viral load, allowing for the transmission of hepatitis B to your baby. All women who are diagnosed with hepatitis B in pregnancy should be referred for follow up care with a physician skilled at managing hepatitis B infection. Your physician should perform additional laboratory testing, including hepatitis B e-antigen, HBV DNA level, and liver function tests (ALT). A virus level greater than 200,000 IU/mL or 1 million cp/ml indicates a level where the combination of the birth dose of the vaccine and HBIG may fail. First-line, antiviral therapy with tenofovir may be recommended to reduce the viral load prior to birth. Tenofovir has been shown to be safe both during pregnancy and for breastfeeding mothers. In cases where tenofovir is not effective, doctors may prescribe telbivudine or lamivudine. Antiviral treatment begins at 28-32 weeks and continues 3 months postpartum. Do I need treatment after my pregnancy? If you are prescribed antivirals during pregnancy, you should have your ALT (SGPT) monitored every 3 months for 6 months. This will help determine if you should continue antiviral treatment. Please do not discontinue your antiviral medication unless the doctor advises you to, based upon test results. For most women whose follow up testing shows no signs of active disease, your physician will recommend regular monitoring with a liver specialist. In all cases, it is very important that your obstetrician and your newborn’s pediatrician, are aware of your hepatitis B status to ensure that your newborn receives the proper vaccines at birth to prevent a lifelong hepatitis B infection, and that you receive appropriate follow up care. Can I breastfeed my baby if I have hepatitis B?The benefits of breastfeeding outweigh the potential risk of infection, which is minimal. In addition, since it is recommended that all infants be vaccinated against hepatitis B at birth, any potential risk is further reduced. There is data that shows that tenofovir, which may be prescribed to manage hepatitis B, is safe for breastfeeding women.

    https://www.hepb.org/languages/turkish/pregnancy-and-hepatitis-b/
  • Do You Have Hepatitis B?

    Have you been told you may be infected with  hepatitis B?  Did you get a letter following a blood donation, or receive lab results indicating infection?  It's important you relax, educate yourself, and don't let the news scare you.  The next step is to determine if you are infected, and if so, do you have an acute or chronic infection. You'll want to talk with your doctor, and have a hepatitis B blood panel run.  It is essential that you do not ignore the possibility of infection.  That being said, it’s equally important that you not panic. When you get your lab results, ask your doctor to explain them to you.  It’s possible that you are not infected, but if you are, then you will need follow-up testing.  Be sure to ask for copies of your labs for your own records.  The test results are initially confusing, so you will want to refer back to the hard-copy results. It is important to determine if you have an acute or chronic infection, but this may take some time.  If you were infected with HBV as an adult, there is a good chance you are acutely infected.  Fortunately, 90% of infected adults resolve the virus on their own. Recently infected adults may have flu-like symptoms, fatigue, yellowing of the eyes, or they may have no symptoms at all.  The answer is in the lab work.  Your doctor may run an HBc-IgM test, which will tell you if the infection is newly acquired. If it is a new infection, you will be monitored for the next one to six months to see if the HBV infection clears, and to ensure you are safe.  During this time, you are infectious to others, so it is important to practice standard precautions and ensure household members are vaccinated.  It is important to eat properly, rest, and avoid alcohol and tobacco. Talk to your doctor about the use of prescription and OTC drugs.  Hopefully your body will be able to mount an appropriate immune response, and you will be able to rid yourself of the virus.  If you remain surface antigen

    http://www.hepb.org/blog/do-you-have-hepatitis-b/