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  • Expert Calls for Viral Load Testing in All Pregnant Women with Hepatitis B

    Dr. Ravi Jhaveri, an infectious disease specialist at the University of North Carolina at Chapel Hill School of Medicine, talks to parents. Today, all pregnant women are routinely screened for hepatitis B, but a growing number of doctors say this single test doesn't go far enough to protect the health of women and children. In a commentary published in the medical journal Pediatrics,  infectious disease specialist Dr. Ravi Jhaveri calls for a mandatory second test in pregnant women infected with hepatitis B. This test would measure the amount of hepatitis B virus (HBV) in her body (called viral load). When women have high viral loads, their newborns can become infected even if they are immunized at birth and treated with HBIG (hepatitis B antibodies) to prevent infection. Dr. Jhaveri, a pediatric infectious disease specialist and associate professor at the University of North Carolina at Chapel Hill School of Medicine, knows this first-hand. He has patients who became infected despite vaccination and HBIG treatment because of their mothers' high viral loads. Infection occurs when newborns are exposed to these mothers' highly infectious blood during delivery. In the past, when anguished parents asked Dr. Jhaveri why their children became infected, he could offer no explanation or treatment to lower the risk. "But now we can," he told the Hepatitis B Foundation. Doctors now have potent, antiviral drugs that safely lower viral load in pregnant women and reduce the risk of mother-to-child infection to nearly zero. Before immunizations, nearly all infants born to infected women developed chronic hepatitis B. Today, immunization within 12 hours of birth and use of HBIG reduces mother-to-child infection by 95 percent. But despite those prevention efforts, infection still occurs in 3-5 percent of infants born to women who: Test positive for the hepatitis B "e" antigen (HBeAg), which is present when viral load is high, And have viral loads (HBV DNA) that exceed 20,000

    http://www.hepb.org/blog/expert-calls-for-viral-load-testing-in-all-pregnant-women-with-hepatitis-b/
  • HBV Journal Review - June 2015

    … hepatitis C patients, HBV patients: Had higher levels of alpha-fetoprotein (AFP), found through a blood test, which indicates the presence of tumors Had liver cancer tumors that grew and spread more quickly Had larger tumors And often had portal thrombosis–a blockage of the vessel that delivers blood to the liver from the intestines. However, hepatitis C patients with liver cancer had higher rates of cirrhosis, histories of alcohol and cigarette use and more diabetes than hepatitis B patients. The average survival rate for hepatitis B patients was 9.3 months after liver cancer diagnosis, compared to 10.9-month survival for hepatitis C patients. According to a related editorial published in the medical journal Oncology, about 700,000 patients are diagnosed with liver cancer each year worldwide; more than two-thirds of new cases result from HBV infection. Knowing HBV-related liver cancer is more aggressive can lead to different or accelerated treatment plans when patients are first diagnosed, the study's experts suggest. “This study provides more evidence that future clinical trials should stratify patients by hepatitis type to help identify better drugs and create personalized treatment modalities,” researcher Ahmed Kaseb explained. Source: http://newswise.com/articles/variations-in -liver-cancer-attributable-to-hepatitis-virus-variations Experts: Treat Cirrhotic Patients, Even if Viral Load Is Low Should "healthy" patients who have cirrhosis with low viral load and no signs of liver damage be treated? Absolutely, according to experts writing in the May issue of the medical journal Hepatology. Continue reading this review and the remainder of the June review here

    http://www.hepb.org/blog/hbv-journal-review-june-2015/
  • Highlights of the New WHO Chronic Hepatitis B Guidelines

    Have you had an opportunity to take a look at the new World Health Organization (WHO) guidelines for the treatment of those with chronic hepatitis B? Guidelines developed by other medical organizations including AASLD, EASL, and APASL were focused mainly on the prevention, care and treatment of hepatitis B for those living in higher income countries. The new WHO guidelines were developed with low-and-middle-income countries (LMICs) in mind, though they are certainly applicable in high-income countries as well. These new WHO guidelines have it all: epidemiology and the global burden, virology, natural history of the virus, transmission, screening and prevention, diagnosis and treatment along with monitoring of both HBV infection and liver cancer. Although it may initially appear daunting, you'll find the guidelines well organized, and thorough, with dark-blue boxed "Recommendations" and  light-blue boxed "Rationales for Recommendations". WHO recommendations even broach the topics of availability and cost. The guidelines provide a framework for the development or strengthening of hepatitis B treatment programs. Target audiences include ministry of health policy makers in LMICs, non-governmental agencies and health care professionals organizing screening and treatment services, along with clinicians managing patients with chronic hepatitis B. They are also very helpful for those living with chronic hepatitis B interested in taking a more informed, active role in their care. The WHO guidelines prioritize treatment for those with clinical evidence of compensated or decompensated cirrhosis. This determination is made based on the APRI (AST to platelet ratio index) score acquired through inexpensive, non-invasive means and include AST and platelet count blood tests.  ALT levels, HBeAg status, HBV DNA levels (if available), age and other factors are also taken into account when determining who should or should not be considered for treatment. (Please note the following

    http://www.hepb.org/blog/highlights-of-the-new-who-chronic-hepatitis-b-guidelines/
  • The Fifty Shades of "Gray" of Hepatitis B Transmission - Part 2

    You can’t neatly package and control everything, but you can use good judgment and not over react when thinking about hepatitis B transmission. Hep B is not casually transmitted, but you know yourself, and both infected and uninfected individuals can take simple precautions. If you don’t have hepatitis B and you are sexually active, make sure you are vaccinated. If you have hep B, encourage your partners to get vaccinated. If you're not in a monogamous relationship and/or one partner has not completed the hepatitis B vaccine series, use a condom! (Click here if you're looking for Part 1) Back to the questions I hear often about "adult" hepatitis B transmission: Can I have sex with my partner(s) and not transmit hepatitis B? Your partner is at risk if he or she is not vaccinated. At a minimum, you should be practicing safe sex by using a condom. There is a double whammy of both infected sexual fluids, along with direct contact with mucous membranes of either male or female genitalia. Anal sex presents a higher risk than vaginal sex, but both are risky. Is oral sex safe for my partner if I have HBV? There are no studies or confirmed reports of transmission as a result of oral sex. However, you should consider the following: how high is your viral load? Are you or your partner having oral problems - bleeding gums, mouth sores, or anything that might increase the likelihood of infection through direct contact with blood? This sexual activity would likely be of limited risk, but use good judgment before engaging. To ensure you're safe, use a condom or dam. What about French kissing? Once again, there are no data or confirmed reports of hepatitis B transmission through French kissing. Just use good judgment and consider the viral load and the oral health of you and your partner. What is the risk if someone’s “hand” comes in contact with “sexual fluids”? It is not uncommon to get questions about a hand that has come in contact with sexual fluids. As you can

    http://www.hepb.org/blog/the-fifty-shades-of-gray-of-hepatitis-b-transmission-part-2/
  • HBV Journal Review March 2015

    HBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
 latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored: Cholesterol and Type 2 Diabetes Drugs Markedly Lower Cancer Risk in Hepatitis B Patients Hepatitis B Increases Risk of Stomach Cancer Unsafe Injections Caused 1.7 Million HBV Infections Worldwide in 2010 New Guidelines Require Doctors to Screen for Hepatitis B Before Starting Chemotherapy Computer Reminders Effective at Prompting Doctors to Screen for HBV Before Starting Chemotherapy Study Finds Getting Frequent Cancer Screenings Saves Lives Use of Radio Waves to Destroy Small Liver Tumors as Effective as Surgery Interferon Increases Thyroid Disease in Hepatitis B and C Patients Smoking Impairs Recovery from Hepatitis B and the Effectiveness of Immunization Hepatitis B Immunization Coverage Declined 2.1% in 2013 March 1, 2015 Volume 12, No 3 by Christine M. Kukka Cholesterol and Type 2 Diabetes Drugs Markedly Lower Cancer Risk in Hepatitis B Patients A large, ground-breaking study that followed 71,824 patients infected with the hepatitis B virus (HBV) from 2000 to 2008 found that those who took medium to high doses of metformin and/or statins had substantially lower rates of liver and other cancers. The study, conducted by Taiwanese researchers and published in the February issue of the journal Medicine, examined the impact of: Statins: Drugs taken to reduce triglycerides and cholesterol in the blood And metformin: A drug used to treat patients in the early stages of type 2 diabetes. There have been some studies that suggest statins reduce liver cancer risk in hepatitis B patients, however this large study that spanned eight years found a definite decrease in cancers in patients who took these drugs, especially at higher doses. While the exact mechanisms

    http://www.hepb.org/blog/hbv-journal-review-march-2015/
  • Barbara Testoni, PhD

    Inserm U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL) - France Barbara Testoni is a PI in the “Viral Hepatitis” team at CRCL – INSERM U1052 in Lyon. Her research interests mainly include the investigation of the epigenetic mechanisms at the basis of host and viral gene regulation during HBV infection, with particular focus on the transcriptional regulation of the HBV minichromosome. She is also involved in translational studies, to the aim of understanding the relationships between HBV persistence and intrahepatic innate immunity perturbations and to characterizing new serum biomarkers for intrahepatic cccDNA activity. Read the journal picks of the month from our Emerging Scholars Scientific and Medical Advisory Board here.  

    https://www.hepb.org/news-and-events/reports/emerging-scholars-scientific-and-medical-advisors/barbara-testoni-phd/
  • Emerging Scholars Scientific and Medical Advisors

    Read the journal picks of the month from our Emerging Scholars Scientific and Medical Advisory Board here. Meet this Hepatitis B Foundation Emerging Scholars Scientific and Medical Advisory Board below. Click on the blue names for more information. We are still in the process of adding some of our Board Members complete details. Please check back for more information.  Lena Allweiss, PhD University Medical Center Hamburg-Eppendorf Peter Block, MD, MSc Yale Medicine Julie Dang, PhD, MPH University of California, Davis Rachel Wen-Juei Jeng, MD Chang Gung University Mohsin Khan, MSc, PhD National Institutes of Health  Nina Le Bert, PhD Duke Singapore     Angel Yen-Chun Liu, MD Chang Gung University, Taiwan  Julie Lucifora, PhD (HDR)  INSERM, France    Udara Perera, DrPH National Quality Forum  Ed Pham, MD, PhD  Stanford University  Tung-Hung Su, MD, PhD National Taiwan UniversityHospital, Taipei, Taiwan  Barbara Testoni, PhD INSERM, France   Thomas Tu, PhD Westmead Institute, Sydney   Eloi Verrier, PhD (HDR)  University of Strasbourg   Yuchen Xia, MS, Ph.D. Wuhan University   Huan Yan, MD, PhD State Key Laboratory of Virology, Wuhan University   Mukhlid Yousif, PhD  University of Witwatersran          

    https://www.hepb.org/news-and-events/reports/emerging-scholars-scientific-and-medical-advisors/
  • What treatments (medicines) are available for chronic hepatitis B?

    First line treatments include antiviral therapies such as tenofovir (TDF), entecavir and Vemlidy (TAF) which are taken once daily. These antivirals are not a cure for chronic hepatitis B, but they work to suppress or control the virus while you are taking them. When the virus is suppressed, liver disease progression is slowed or even stopped, and the liver is often able to heal with time. It is important to see a knowledgeable doctor to determine if you are a good candidate for treatment since treatment is a commitment, and is taken for at least a year, usually for many years or even for life - or until there is a cure found for this disease. U.S. residents seeking help with medication costs can find resources here.  Find more Frequently Asked Questions here.    Page updated 02/09/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/what-treatments-medicines-are-available-for-chronic-hepatitis-b/
  • Cinder's Story

    Cinder and her husband grew up on a small island in Micronesia, where there is stigma against seeing doctors. Even after they moved to Hawaii and her husband became an advocate for their community, he didn’t want to receive treatment for his hepatitis B. When he became seriously ill, Cinder cared for him every day for two years at the medical center. After he passed away, Cinder took up his mantle in their community by interpreting, volunteering at the church, enrolling people in health insurance, educating others about hepatitis B. Cinder's story is available in English and Chuukese.   English   Chuukese

    https://www.hepb.org/research-and-programs/patient-story-telling-project/cinders-story/
  • Randy's Story

    The excitement in Randy’s family over his son Cody’s acceptance to the U.S. Naval Academy turned to disappointment when they learned that Cody has a hepatitis B infection. Even though monitoring and treatment have advanced considerably, the U.S. military does not admit people living with the virus. Randy hopes this policy can be changed, and he continues to support Cody in moving on and embracing a hopeful future.  

    https://www.hepb.org/research-and-programs/patient-story-telling-project/randys-story/