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  • CHIPO Partner Highlight: Illinois Public Health Association

    The Coalition Against Hepatitis for People of African Origin (CHIPO) is a national community coalition that is co-founded and led by the Hepatitis B Foundation and is composed of organizations and individuals who are interested in addressing the high rates of hepatitis B infection among African communities in the US. Over the past year, CHIPO has grown its membership to include nearly 50 community-based organizations and federal agencies, all of which are working to meet the common goal of raising awareness about hepatitis B among African immigrant communities, and increasing rates of screening, vaccination, and linkage to care. This month, we are excited to highlight the work of one of our newer partners, the Illinois Public Health Association, and their Outreach Coordinator, Monde Nyambe. Please enjoy a recent interview with Monde, as she describes her work, including successes and challenges, and the positive impacts she and IPHA have had throughout the state of Illinois.  Could you please introduce yourself and your organization? Monde: My name is Monde Nyambe, and I am the Outreach Coordinator for the Illinois Public Health Association, which is the oldest and largest public health association in the state of Illinois. I work specifically in the area of addressing hepatitis B among African communities around the state. IPHA has had a hep B grant for some time and the focus has actually primarily been on African communities – it was only in the past fiscal year that AAPI communities have been included in this grant as well. All of IPHA’s hepatitis B efforts do fall under the umbrella of the HIV/STI/viral hepatitis section. I started at the organization as an AmeriCorps member in November of 2020, and then was hired on to connect with African communities in the area, around the topic of hepatitis B. I am very glad to have had a role in really growing IPHA’s initiative and moving the outreach project along from the beginning - during my time here, I have

    http://www.hepb.org/blog/chipo-partner-highlight-illinois-public-health-association/
  • May Hepatitis Awareness Month #justBLoud

    This May, for Hepatitis Awareness Month, we are asking you to #justBLoud for hepatitis B. Currently up to 2.4 million living in the U.S. have chronic hepatitis B, yet no one seems to be talking about it. The average American is unaware about hepatitis B and why our country needs to put more energy into prevention and finding a cure. The louder we are, the more we can help people get screened, vaccinated or treated for this serious disease. You can start getting loud the Hepatitis Awareness Month by making a short video explaining why it’s important for you to #justBLoud about hepatitis B. It can be a personal story or you can take the text right from the below bulleted points.  Be sure make the post public and tag #justBLoud and tag HepBFoundation. You can even make quick Instagram and Facebook stories using the #justBLoud stickers we created, just search “justbloud” in the stickers menu. If you’re camera shy, write down your reason for being loud and share a photo of it online. Talking points for your message may include: #JustBLoud about prevention: Hepatitis B is easily prevented with a safe vaccine. #JustBLoud about transmission: Hepatitis B is transmitted through direct contact with infected blood, not casual contact. Hug someone with hepatitis B today. #JustBLoud about screening: In the U.S. only 25% of people with hepatitis B are aware that they have hepatitis B. Get screened today. #JustBLoud about treatment: Only 50% of people with diagnosed chronic hepatitis B in the U.S. receive appropriate medical care. #JustBLoud about giving: Donating to the Hepatitis B Foundation makes a big impact for people living with hepatitis B. It affects advocacy efforts as well as research to find a cure! Other easy ways to just B Loud this Hepatitis Awareness Month: Share our social media posts this month to help spread the word. Make sure to follow us on Facebook, Instagram, Twitter, LinkedIn, and YouTube. Use one of these as your zoom background to get the

    http://www.hepb.org/blog/may-hepatitis-awareness-month-justbloud/
  • How Do I Share My Status

    Valentine’s Day is February 14th! Today is a day to express your love for family, friends, and your significant other. When you are living with chronic hepatitis B, starting a loving, romantic, relationship and initiating sex can be fraught with stress and difficult disclosures, before an intimate relationship can even begin. To begin, living with hepatitis B only makes up a small part of who you are, it doesn’t define you. As guest blogger Lindsey says, “Having HBV is only a small facet of who you are, and not a reason to give up on a loving relationship. A partner who accepts you as you are and wants the best for you is someone who will not see HBV as a barrier to getting to know you.” Someone who genuinely cares about your wellbeing will understand how vulnerable you needed to be to tell them you are living with hepatitis B and react appropriately. And remember, your partner might also have something to disclose to you! So, you should think about how you would respond to them, as well. Although the most common mode of transmission worldwide is from mother-to-child, hepatitis B can be spread sexually. The hepatitis B virus can be transmitted through sexual fluids like semen and vaginal fluids, in fact, it is 50x-100x more infectious than HIV. It is important to note that hepatitis B is more common than people think, affecting about 300 million people worldwide. Most of the time, people were infected at birth due to exposure to blood from their mother, or at an early age due to an unsafe injection or medical/dental procedures, or even direct contact with blood inadvertently exchanged by an infected caregiver or another child while playing. Since the most common symptoms are no symptoms, most people are completely unaware that they have hepatitis B for decades. How Do I Tell My Partner I Have Hepatitis B? So how do you disclose your status to a partner you’re about to get intimate with? This can be a nerve-wracking situation because you don’t know how

    http://www.hepb.org/blog/how-do-i-share-my-status/
  • Happy National Family History Day!

    It’s National Family History Day on November 25th! Today is the perfect time to sit down and talk to your family about health; it gives your loved ones an opportunity to provide the gift of a healthy future! As hepatitis B rarely has any symptoms, many people do not discover that they are infected until a family member is diagnosed or they develop liver damage or liver cancer.   Approaching the topic and starting the conversation can help to break this cycle of transmission within families and allow your loved ones to protect themselves. If you need some tips on how to start the discussion on family health, you can check out our blog post here!  Your family’s health history tells a powerful story. It guides us on what behaviors to avoid and actions that we can take to prevent developing certain illnesses or diseases. It can also help inform us on how to best navigate the health system. Do I need to be tested for liver cancer? Is the medication that I’m taking actually dangerous to my health?   When a family member is living with or has lived with hepatitis B, family health history can become even more critical to creating a healthy future. Hepatitis B is one of the world’s leading causes of liver cancer, so it is extremely important to be aware of your risk! Although hepatitis B is not genetic or hereditary – it is only spread through direct contact with infected blood or through sexual contact – multiple family members can be infected without knowing. This is because hepatitis B often does not have any symptoms and can be spread from mother to child during childbirth or by sharing sharp objects such as razors, toothbrushes, or body jewelry that may contain small amounts of infected blood. Knowing about a family members’ current or past infection is a signal to get tested for hepatitis B using the 3-panel hepatitis B blood test (HBsAg, HBsAb, HBcAb). Testing is the only way to be sure of your hepatitis B status. The test will let you

    http://www.hepb.org/blog/happy-national-family-history-day/
  • Why Your Family Health History Matters with Acute and Chronic Hep B

    National Family Health History Day is November 28th, and it is the perfect time to sit down and talk to your family about health; it gives your loved ones an opportunity to provide the gift of a healthy future! As hepatitis B rarely has any symptoms, many people do not discover that they are infected until a family member is diagnosed or they develop liver damage or liver cancer.  Approaching the topic and starting the conversation can help to break this cycle of transmission within families, and allow your loved ones to protect themselves. If you need some tips on how to start the discussion on family health, you can check out our blog post here! Your family’s health history tells a powerful story. It guides us on what behaviors to avoid and actions that we can take to prevent developing certain illnesses or diseases. It can also help inform us on how to best navigate the health system. Do I need to be tested for liver cancer? Is the medication that I’m taking actually dangerous to my health?  When a family member is living with or has lived with hepatitis B, family health history can become even more critical to creating a healthy future. Hepatitis B is one of the world’s leading causes of liver cancer, so it is extremely important to be aware of your risk! Although hepatitis B is not genetic or hereditary - it is only spread through direct contact with infected blood or through sexual contact -  multiple family members can be infected without knowing. This is because hepatitis B often does not have any symptoms and can be spread from mother to child during childbirth or by sharing sharp objects such as razors, toothbrushes, or body jewelry that may contain small amounts of infected blood. Knowing about a family members’ current or past infection is a signal to get tested for hepatitis B using the 3-panel hepatitis B blood test (HBsAg, HBsAb, HBcAb). Testing is the only way to be sure of your hepatitis B status. The test will let you know if you have a

    http://www.hepb.org/blog/family-health-history-matters-acute-chronic-hep-b/
  • 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/
  • 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/