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• It’s Flu Season: When You Have Hepatitis B, Too Much Tylenol Can Damage Your Liver

  Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net By Christine Kukka Cold season is here and sometimes getting a flu shot and consistently washing our hands aren’t enough to keep colds at bay. If you do get sick, make sure the over-the-counter medication you take doesn’t damage your liver while it’s relieving your aches and pains. Acetaminophen (Tylenol or Paracetamol) is the most popular over-the-counter painkiller in the United States. Americans take 8 billion acetaminophen pills each year for pain reduction, and the drug is also found in cough and congestion medications. When we have hepatitis B, we need to be careful we don’t unintentionally overdose when we take acetaminophen pills to reduce our pain and cough or sinus medications that also contain acetaminophen. The trouble is, dozens of cold and flu medications that promise to suppress our coughs and let us sleep through the night also contain acetaminophen, but it's not emblazoned in large print on their labels. Instead, we need to search carefully for “acetaminophen” listed in its ingredient list on the back of the package. Image courtesy of lobster20 at FreeDigitalPhotos.net How much acetaminophen can adults safely take? Unless we have serious liver damage, such as cirrhosis, doctors say we can safely take the recommended dose of acetaminophen for a very limited period of time without damaging our livers. In fact, doctors routinely recommend this painkiller following a liver biopsy or to reduce interferon’s flu-like side effects. The maximum dose of acetaminophen that adults can safely take over a 24-hour period is four grams, which equals eight extra-strength pills or about 12 regular-strength pills. (An extra-strength pill contains 500 mg and a regular strength pill contains 325 mg). But, if we drink two alcoholic beverages a day, we need to cut that recommended acetaminophen dose in half, that’s how much acetaminophen can affect our livers. If we take too much of this

  http://www.hepb.org/blog/flu-season-hepatitis-b-much-tylenol-can-damage-liver/
• Pajama Gala April 24, 2020

    The April 24 Pajama Gala, which was our first virtual event,was a huge success! More than 250 people from around the world registered for the Gala and participants said they greatly enjoyed the hour-long online experience. Supporters pledged over $22,000 in response to a Mission Moment segment highlighting our work to help students battling discrimination.    Overall, the “Pajama Gala”raised more than $124,000 to  support scientific research and our many programs to assist people living with hepatitis B, their families and their health care providers. The Foundation honored two luminaries during the Gala. John M. Taylor, Ph.D., was presented with the Baruch S. Blumberg Award and Susana Lorenzo-Giguere, Esq., received the Community Commitment Award. To watch a recording of the event, click here. 

  https://www.hepb.org/news-and-events/awards-and-events/crystal-ball-gala/
• Clinical Trials

  Clinical trials are research studies that test new potential treatments to evaluate the safety and effectiveness of each new treatment before being approved. Volunteering for a clinical trial can provide the opportunity to potentially benefit from the latest advances in medical science.  Although participation in a clinical trial can be valuable, there are many clinical trials for hepatocellular carcinoma around the U.S. and the world, and it can be difficult to find the best one for you. The National Library of Medicine manages a large website that can help you find clinical trials around the world. In order to help you easily find clinical trials that may be right for you, the Hepatitis B Foundation has created a step-by-step guide. When searching for a clinical trial for liver cancer, please be sure to use “hepatocellular carcinoma” as your search term.

  https://www.hepb.org/research-and-programs/liver/treating-liver-cancer/clinical-trials/
• Kim's Story

  Kim’s father was forced to escape to the United States from Vietnam, in the wake of the war. He located his family and brought them to Minnesota. Kim shares her love for her father and wonders whether the stigma about hepatitis B in the Vietnamese community prevented him from telling the family and seeking medical care earlier. She celebrates his gentle spirit, and suggests that access to culturally and linguistically appropriate resources could have prevented his death from liver cancer. Kim's story is available in English and Vietnamese.   English   Vietnamese

  https://www.hepb.org/research-and-programs/patient-story-telling-project/kims-story/
• Reflections from Hep B Free Phildelphia's HBV Screening Event - CHOP site

  Last week ended with an exciting city-wide hepatitis B screening event in downtown Philadelphia.  This event was sponsored by the Hepatitis B Foundation and Hep B Free Philly as part of the Hep B Free Philadelphia campaign. Hospitals included Hahnemann University Hospital, Thomas Jefferson University, Children’s Hospital of Philadelphia (CHOP), and Albert Einstein Medical Center.  Naturally each site was a little different and had their unique challenges. Throughout the four sights there were Hepatitis B Foundation and Hep B Free Philly volunteers, and 100 college-student volunteers. Student volunteers were a mix of pre-med and medical students, public health students, tutors in Chinese, Vietnamese, Korean, Spanish and French, and students interested in doing community out-reach. Twenty community –based organizations were also involved in order to reach out to high risk communities throughout the city of Philadelphia.  During this event, 200 at-risk participants were screened for hepatitis B. Those participants that do not have HBV will be invited to receive their free HBV vaccine.  This info will arrive in the mail with their test results.  Those with HBV will be provided with a linkage to care. I thoroughly enjoyed my participation at the CHOP location. Although I was not involved in the planning and set-up process, it was clear that the logistics involved in making this multi-screening event come to fruition was extensive.  Testing sites needed to be secured. Community out-reach needed to be done long in advance in order to reach out to high risk communities. Supplies were purchased and carted (via a red-wagon at the CHOP site!) to the various sites. Phlebotomists were hired for the day. Student volunteers were organized. At CHOP, our French translators were essential in making the screening event work.  It was great to see the students take an active part in the event. Some went off campus and distributed flyers. Others manned the give-away desk.  A

  http://www.hepb.org/blog/reflections-from-hep-b-free-phildelphias-hbv-screening-event-chop-site/

• Bị Viêm Gan Loại B Kinh Niên Tôi có nên xét nghiệm viêm gan B nếu tôi có thai không?Có, TẤT CẢ các phụ nữ có thai nên đi xét nghiệm viêm gan B! Nếu bạn có thai, hãy chắc chắn bác sĩ đã xét nghiệm viêm gan B cho bạn trước khi sinh con. Vì sao các xét nghiệm này lại quan trọng đến thế cho phụ nữ có thai?Nếu bạn dương tính với viêm gan B và đang có thai, siêu vi khuẩn có thể lây cho bé mới sinh trong thai kỳ hoặc trong khi sinh. Nếu bác sĩ biết rằng bạn bị viêm gan B, bác sĩ có thể dàn xếp để có các loại thuốc thích hợp trong phòng sinh nhằm ngăn không cho bé bị nhiễm bệnh. Nếu không làm theo các quy trình thích đáng, bé có nguy cơ 95% bị viêm gan B mạn tính! Bệnh viêm gan B có ảnh hưởng đến việc tôi mang thai không?Bệnh viêm gan B không nên gây ra bất kỳ vấn đề nào cho bạn hoặc thai nhi trong thai kỳ. Điều quan trọng là bác sĩ phải biết bạn bị viêm gan B để có thể theo dõi sức khỏe của bạn và để con bạn có thể được bảo vệ khỏi bị nhiễm bệnh sau khi ra đời. Nếu tôi có thai và bị viêm gan B, làm thế nào để tôi có thể bảo vệ cho bé?Nếu bạn dương tính với viêm gan B, bác sĩ cũng nên xét nghiệm kháng nguyên e viêm gan B (HBeAg) cho bạn, và nếu lại dương tính, bạn nên đi xét nghiệm máu tải siêu vi khuẩn viêm gan B (định lượng DNA HBV). Trong một số trường hợp, kết quả xét nghiệm có thể cho thấy tải siêu vi khuẩn rất cao. Trong các trường hợp này, bác sĩ có thể khuyên bạn dùng thuốc kháng siêu vi khuẩn qua đường uống trong tam cá nguyệt thứ ba, thuốc này an toàn để dùng nhằm giảm nguy cơ nhiễm bệnh cho trẻ mới sinh khi sinh. Nếu bạn dương tính với viêm gan B, thì trẻ mới sinh phải được tiêm hai mũi tiêm ngay tại phòng sinh: Mũi vắc-xin viêm gan B thứ nhấtMột mũi globulin miễn dịch viêm gan B (HBIG) Nếu hai loại thuốc này được cho dùng thích đáng trong vòng 12 giờ sau khi sinh, trẻ mới sinh có cơ hội trên 90% được bảo vệ khỏi bệnh viêm gan B suốt đời. Bạn phải đảm bảo rằng bé sẽ được tiêm 2-3 mũi vắc-xin viêm gan B còn lại theo lịch trình. Tất cả các mũi phải được hoàn tất để trẻ sơ sinh được bảo vệ đầy đủ chống lại viêm gan B. Một điều quan trọng nữa là bé sinh ra từ người mẹ có HBV dương tính phải được xét nghiệm huyết thanh hậu chủng ngừa lúc 9-12 tháng tuổi để xác nhận bé được bảo vệ chống lại HBV và không bị nhiễm bệnh. Các xét nghiệm bao gồm HBsAg và xét nghiệm độ chuẩn anti-HBs.Không có cơ hội thứ hai để bảo vệ bé mới sinh đâu! Chủng ngừa Bên ngoài Hoa KỳỞ nhiều nước, vắc-xin tổng hợp 5 trong 1 bảo vệ chống lại năm loại bệnh (bạch hầu, ho gà, uốn ván, viêm màng não và viêm gan B) có thể được tiêm cho bé trên 6 tuần tuổi, và có thể được tiêm cho đến khi bé đạt 1 tuổi. Mũi thứ nhất được cho dùng lúc 6 tuần tuổi, và mũi thứ hai và thứ ba được cho dùng lúc 10 và 14 tuần tuổi. Vắc-xin 5 trong 1 có thể được cung cấp miễn phí với sự hỗ trợ của Gavi, Liên minh Vắc-xin. Kiểm tra cổng thông tin quốc gia Gavi để xem các nguồn lực và chủng ngừa có thể có sẵn: http://www.gavi.org/country/. Với bé sinh ra từ người mẹ bị viêm gan B, việc chờ đợi mũi vắc-xin 5 trong 1 thứ nhất sẽ là quá muộn và sẽ KHÔNG bảo vệ bé khỏi bị nhiễm bệnh trong khi sinh hoặc trong thời gian sáu tuần sau khi sinh. Người mẹ dương tính với viêm gan B có thể lây siêu vi khuẩn sang con, và sau đó con sẽ nhiễm bệnh mạn tính. WHO khuyến cáo tiêm vắc-xin viêm gan B trong vòng 24 giờ sau khi sinh cho TẤT CẢ trẻ sơ sinh. Hãy lên kế hoạch trước và hỏi xem có sẵn vắc-xin hay không và chi phí của mũi vắc-xin đơn trị được cho dùng khi sinh, vì nó không phải là thuốc chủng ngừa được Gavi cung cấp. Điều này đặc biệt quan trọng với phụ nữ dương tính với viêm gan B. Nếu bạn không chắc chắn về tình trạng viêm gan B của mình, hãy đảm bảo bác sĩ xét nghiệm viêm gan B cho bạn! Với bé KHÔNG được tiêm vắc-xin 5 trong 1, mũi thứ nhất của vắc-xin HBV đơn trị phải được tiêm trong vòng 12 giờ sau khi sinh, tiếp theo là 2-3 mũi vắc-xin viêm gan B còn lại theo lịch trình. Với bé được tiêm vắc-xin 5 trong 1, mũi vắc-xin viêm gan B đơn trị thứ nhất được tiêm trong vòng 12 giờ sau khi sinh, và mũi vắc-xin HBV thứ hai và thứ ba sẽ được bao gồm trong mũi 1 và mũi 2 của vắc-xin 5 trong 1. *Lưu ý: CDC khuyến cáo cho tiêm mũi tiêm đầu tiên của vắc-xin HBV và HBIG trong vòng 12 giờ sau khi sinh. HBIG có thể không có sẵn ở tất cả các nước. Tôi có cần điều trị trong thai kỳ không?Bệnh viêm gan B không nên gây ra bất kỳ vấn đề nào cho bạn hoặc thai nhi trong thai kỳ. Điều quan trọng là bác sĩ phải biết bạn bị viêm gan B để có thể theo dõi sức khỏe của bạn và để con bạn có thể được bảo vệ khỏi bị nhiễm bệnh sau khi ra đời. Nếu bạn sống ở ngoài Hoa Kỳ và không chắc chắn về tình trạng viêm gan B của mình, hãy yêu cầu bác sĩ xét nghiệm viêm gan B cho bạn. Mũi vắc-xin HBV và HBIG được cho dùng khi sinh có thể không có tác dụng ở những phụ nữ có HBeAg dương tính và có tải siêu vi khuẩn rất cao, cho phép truyền viêm gan B sang bé. Tất cả những phụ nữ được chẩn đoán bị viêm gan B trong thai kỳ nên được giới thiệu đến dịch vụ chăm sóc theo dõi với bác sĩ có kỹ năng kiểm soát bệnh viêm gan B. Bác sĩ nên thực hiện thêm xét nghiệm, bao gồm kháng nguyên e viêm gan B, nồng độ DNA HBV và xét nghiệm chức năng gan (ALT). Nồng độ siêu vi khuẩn cao hơn 200.000 IU/mL hoặc 1 triệu cp/ml cho thấy nồng độ mà sự kết hợp giữa mũi vắc-xin và HBIG được cho dùng khi sinh có thể không có tác dụng. Có thể khuyến cáo điều trị kháng siêu vi khuẩn, ưu tiên nhất bằng tenofovir để giảm tải siêu vi khuẩn trước khi sinh. Tenofovir đã được chứng minh là an toàn trong suốt thai kỳ và cho người mẹ cho con bú. Trong trường hợp tenofovir không hiệu quả, bác sĩ có thể kê toa telbivudine hoặc lamivudine. Điều trị kháng siêu vi khuẩn bắt đầu lúc 28-32 tuần thai và tiếp tục trong 3 tháng sau khi sinh. Tôi có cần điều trị sau thai kỳ không? Nếu bạn được kê toa thuốc kháng siêu vi khuẩn trong thai kỳ, bạn nên được theo dõi ALT (SGPT) mỗi 3 tháng trong 6 tháng. Điều này sẽ giúp xác định xem bạn có nên tiếp tục điều trị kháng siêu vi khuẩn không. Xin đừng ngừng thuốc kháng siêu vi khuẩn trừ khi bác sĩ khuyên như vậy, dựa trên kết quả xét nghiệm. Với hầu hết phụ nữ mà xét nghiệm theo dõi không cho thấy dấu hiệu bệnh hoạt động, bác sĩ sẽ khuyên nên thường xuyên theo dõi với bác sĩ chuyên khoa về gan. Trong tất cả các trường hợp, điều quan trọng là bác sĩ sản của bạn và bác sĩ nhi của trẻ mới sinh biết về tình trạng viêm gan B của bạn để đảm bảo trẻ mới sinh của bạn được tiêm vắc-xin thích đáng khi sinh để phòng ngừa nhiễm viêm gan B suốt đời và bạn được chăm sóc theo dõi thích hợp . Tôi có thể cho con bú nếu tôi bị viêm gan B không?Lợi ích của việc nuôi con bằng sữa mẹ lớn hơn nguy cơ tiềm ẩn bị nhiễm bệnh, nguy cơ này cực kỳ thấp. Ngoài ra, vì tất cả trẻ sơ sinh được khuyến cáo chủng ngừa viêm gan B khi sinh, bất kỳ nguy cơ tiềm ẩn nào cũng sẽ được giảm nhiều. Có dữ liệu cho thấy tenofovir, vốn có thể được kê toa để kiểm soát viêm gan B, là an toàn cho phụ nữ cho con bú. 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/vietnamese/living-with-chronic-hepatitis-b/
• Infection Prevention is Everyone's Business...That means YOU!

  … are tired and stressed, and they make occasional errors. It may not be right, but mistakes do happen. This is where the above sign comes into play.  Infection protection is everyone's business.  That includes YOU!  Speak up.  Let your voice be heard.  You see the signs in your doctor's office "Ask me if I've washed my hands".  Why not start there, and ask? Had I read the article, or thought about my endoscopy/colonoscopy, I would have asked about the equipment used for my procedure.  Shame on ME. I'm not going to get a bloodborne pathogen like hepatitis B from shaking my doctor's hand, as HBV is not transmitted casually, but procedures where trace amounts of blood may not be properly disinfected or devices disposed is a different story.  HBV is transmitted by direct contact from an infected person's blood or body fluid to an open cut, mucous membrane or portal of entry of another person. A health care setting with blood, sharps, tubes and medical devices is an effective transmission route if there are infected body fluids.  Fortunately practices firmly put into place prevent nearly all such possible exposures. Regardless, these uncommon errors, could affect parents in nursing home environments, veterans in VA hospitals, patients getting colonoscopies, and all kinds of patients in various health care clinics and settings. Infection control practices are written, taught and implemented, but every once in a while, you’re going to get someone that neglects to follow the rules or makes a simple mistake.  This should not cause a panic among patients, but it is a reminder that mistakes happen, and sometimes it’s necessary for us to speak up and ask questions. Remember, infection prevention is everyone's business. Note: Please keep in mind that HBV is 100 times more infectious than HIV.  It is also more infectious than HCV.  There are no vaccines for HIV and HCV, but there is a safe, effective vaccine for HBV. Get vaccinated and be HBV free for life.

  http://www.hepb.org/blog/infection-prevention-is-everyones-business-that-means-you/

• Hepatit B ile yaşama  Hepatit B enfeksiyonundan iyileşir miyim?Yeni enfekte olmuş çoğu sağlıklı yetişkin herhangi bir problem olmadan iyileşir. Ancak bebekler ve küçük çocuklar virüsten başarıyla kurtulamayabilir. • Yetişkinler – sağlıklı yetişkinlerin %90'ı virüsten kurtulup problemsiz bir şekilde iyileşir; %10'unda kronik hepatit B gelişecektir. • Küçük Çocuklar – 1 ile 5 yaş arasındaki enfekte küçük çocukların %50'sine kadarında kronik hepatit B enfeksiyonu gelişir.• Bebekler – %90'ı kronik enfekte hale gelir; sadece %10'u virüsten kurtulabilir. "Akut" ve "kronik" hepatit B enfeksiyonu arasında ne fark vardır?Hepatit B enfeksiyonu virüse maruz kaldıktan sonraki ilk 6 ayda "akut" olarak düşünülür. Bu süre hepatit B enfeksiyonundan iyileşmek için geçen ortalama süredir. 6 aydan sonra halen hepatit B virüsü için testiniz pozitifse (HBsAg+) sizde ömür boyu sürebilecek "kronik" hepatit B enfeksiyonu olduğu düşünülür. Akut hepatit B durumum varsa hastalanır mıyım?Hepatit B genellikle belirtiye neden olmadığından "sessiz bir enfeksiyon" olarak düşünülür. Çoğu kişi kendini sağlıklı hisseder ve enfekte olduğunu bilmez, yani virüsü farkında olmadan başkalarına geçirebilirler. Başkalarında ise ateş, yorgunluk, eklem veya kas ağrısı veya iştah kaybı gibi hafif belirtiler olur ve bunlar nezleyle karıştırılabilir. Daha nadir ama daha ciddi belirtiler arasında şiddetli bulantı ve kusma, sarı gözler ve cilt ("sarılık" denir) ve karında şişlik vardır - bu belirtiler hemen tıbben ilgilenilmesini gerektirir ve kişinin hastaneye yatırılması gerekebilir. "Akut" hepatit B enfeksiyonundan iyileştiğimi nasıl bilirim?Doktorunuz vücudunuzdan virüsü attığınızı ve koruyucu antikorların (HBsAb+) geliştiğini bir kan testiyle doğruladıktan sonra gelecekteki bir hepatit B enfeksiyonundan korunmuş olursunuz ve artık başkaları için bulaşıcı değilsinizdir. Kronik hepatit B tanısı konduysa ne yapmalıyım?Hepatit B virüsü için testleriniz 6 aydan uzun bir süre pozitif çıkarsa bu durum sizde kronik hepatit B enfeksiyonu olduğu anlamına gelir. Bir hepatolog (karaciğer hastalıkları uzmanı), gastroenterolog veya hepatit B'ye aşina bir aile hekiminden randevu almanız gerekir. Doktor hepatit B virüsünün vücudunuzda ne kadar aktif olduğunu ve karaciğerinizin sağlığını izlemek için kan testleri ve belki de bir karaciğer ultrasonu isteyecektir. Doktorunuz muhtemelen hepatit B durumunuzu izlemek ve tedaviden fayda görüp görmeyeceğinizi belirlemek için sizi yılda bir veya iki kez görmek isteyecektir. Kronik enfeksiyonu olan herkes doktorları tarafından tedavi gereksin veya gerekmesin düzenli tıbbi bakım için en az yılda bir (veya daha sık) görülmelidir. Virüs daha az aktif bir fazda bulunup da hasar hiç olmasa veya çok az olsa bile bu durum zamanla değişebilir ve düzenli izleme bu nedenle önemlidir. Hepatit B ile kronik enfeksiyonu olan çoğu kişi uzun ve sağlıklı bir ömür sürmeyi bekleyebilir. Size kronik hepatit B tanısı konduğunda virüs kan ve karaciğerinizde ömür boyu kalabilir. Kendinizi hasta hissetmeseniz bile virüsü başkalarına geçirebileceğinizi bilmek önemlidir. Bu nedenle evdeki tüm yakın temas halindeki kişilerin ve cinsel partnerlerin hepatit B'ye karşı aşılandığından emin olmanız çok önemlidir. Hepatit B durumumu izlemek için hangi testler yapılacaktır?Doktorlar tarafından hepatit B durumunuzu izlemek için sık kullanılan testlere hepatit B kan paneli, karaciğer fonksiyon testleri (ALT, AST), hepatit B e-Antijeni (HBeAg), hepatit B e-Antikoru (HBeAb), hepatit B DNA miktar belirleme (viral yük) ve karaciğer görüntüleme çalışması (ultrason, FibroScan [Geçici Elastografi] veya BT tarama) vardır. Kronik hepatit B için tam bir tedavi var mıdır?Şu anda kronik hepatit B için tam bir tedavi yoktur, ama burada iyi olan kronik enfekte kişilerde virüsü yavaşlatarak karaciğer hastalığının ilerlemesini yavaşlatabilecek tedaviler bulunmasıdır. Daha az hepatit B virüsü üretiliyorsa karaciğerde daha az hasar oluşur. Bazen bu ilaçlar virüsü tamamen de atabilir ama bu sık rastlanan bir durum değildir. Heyecan verici tüm yeni araştırmalarla yakın gelecekte kronik hepatit B için tam bir tedavinin bulunacağı konusunda büyük ümit vardır. Geliştirilen diğer ümit veren ilaçların listesi için Drug Watch (İlaç Haberleri) kısmımızı ziyaret edin. Kronik hepatit B tedavisi için onaylanmış ilaç var mıdır?Hepatit B için mevcut tedaviler antiviraller ve bağışıklık düzenleyiciler şeklinde iki genel kategoriye girer: Antiviral İlaçlar - Bunlar hepatit B virüsünü yavaşlatan veya durduran ilaçlardır ve bu durum karaciğerde iltihap ve hasarı azaltır. Bunlar en az 1 yıl ve genellikle daha uzun bir süre boyunca günde bir kez bir hap olarak alınır. Şu anda ABD FDA onaylı 6 antiviral mevcuttur ama sadece üç birinci basamak antiviral ilaç önerilir: tenofovir disoproksil (Viread/TDF), tenofovir alafenamid (Vemlidy/TAF) ve Entekavir (Baraclude). Birinci basamak antiviraller önerilir çünkü daha güvenli ve en etkili olanlardır. Ayrıca direnç profilleri daha eski antivirallerden daha iyidir yani yazıldıkları şekilde alındıklarında mutasyon ve direnç olasılığı daha düşüktür. Direnç oluşması virüsü tedavi ve kontrol etmeyi zorlaştırır. Bağışıklık Düzenleyici İlaçlar - Bunlar hepatit B virüsünü kontrol etmeye yardımcı olmak üzere bağışıklık sistemini güçlendiren ilaçlardır. Bu ilaçlar 6 ay ila 1 yıl boyunca enjeksiyonlar şeklinde verilir. En sık yazılanlar arasında interferon alfa-2b (Intron A) ve pegile interferon (Pegasys) vardır. Bunlar hepatit delta enfeksiyonu da olan hastalar için tek önerilen tedavilerdir. Bu ilaçlar kronik hepatit B için "tam" bir tedavi sağlar mı?
Tam bir tedavi sağlamasalar da mevcut ilaçlar virüsü yavaşlatır ve yaşamın daha ileri dönemlerinde daha ciddi karaciğer hastalığı riskini azaltır. Bu durum birkaç ay sonra virüsün karaciğer hasarı yavaşladığı ve hatta ilaçlar uzun dönem alındıklarında geri döndürüldüğü için hastaların kendilerini daha iyi hissetmesiyle sonuçlanır. Antivirallerin durdurulup başlatılması planlanmamıştır ve bu nedenle kronik HBV tedavisine başlamadan önce bilgili bir doktor tarafından kapsamlı bir değerlendirme çok önemlidir. Kronik hepatit B enfeksiyonum varsa ilaç almalı mıyım?Kronik hepatit B durumu olan herkese ilaç vermeye gerek olmadığını anlamanız önemlidir. İlaç tedavisi için iyi bir aday olup olmadığınızı doktorunuzla konuşmanız gerekir. Doktorunuz ve siz tedaviye başlamaya karar verseniz de vermeseniz de bir karaciğer uzmanı veya hepatit B konusunda bilgili bir doktor tarafından düzenli olarak görülmeniz gerekir. Hepatit B enfeksiyonum için bitkisel ilaçlar veya takviyeler almak güvenli mi?Çoğu kişi bağışıklık sistemini güçlendirmek ve karaciğerlerine yardımcı olmak için bitkisel ilaçlar veya takviyeler almakla ilgilenir. Buradaki problem bu ürünleri üreten şirketlerin düzenlenmemesi yani güvenlik veya saflık açısından kapsamlı testler yapılmamasıdır. Bu nedenle bitkisel çözüm veya vitamin takviyesinin kalitesi şişeden şişeye değişebilir. Ayrıca bazı bitkisel çözümler hepatit B veya diğer hastalıklar için reçeteli ilaçlarınızı olumsuz etkileyebilir; bazıları hatta karaciğerinize zarar bile verebilir. Bu bitkisel çözümler kronik hepatit B enfeksiyonu için tam bir tedavi sağlamaz. İnternette ve sosyal medyada ürünleri hakkında olmayacak iddialarda bulunan birçok şirket vardır. Çevrim içi iddialar ve Facebook üzerindeki hasta ifadeleri doğru değildir ve insanları pahalı bitkisel çözümler ve takviyeler satın alma konusunda kandırmak için kullanılır. Unutmayın ki doğru olamayacak kadar iyi gibiyse muhtemelen doğru değildir. Aşağıda bitkiler ve alternatif tıp hakkında güvenilir bilgi kaynakları vardır. Bu bilgi desteksiz sözleri değil bilimsel kanıtları temel alır. Bitkisel çözümler veya takviyelerinizdeki aktif bileşenlerin gerçek olup olmadığını ve karaciğeriniz için güvenli olup olmadığını kontrol edin. En önemli şey karaciğerinizin daha da fazla zarar görmesini önlemektir. Kronik hepatit B ile yaşayanlar için ne gibi sağlıklı karaciğer önerileri vardır?Kronik hepatit B enfeksiyonu yaşayan kişiler için ilaç tedavisi gerekebilir veya gerekmeyebilir. Ancak kişilerin karaciğerlerini koruyup sağlıklarını düzeltmek için yapabileceği birçok başka şey vardır. Aşağıda bugün başlanabilecek en önemli 10 sağlık tercihi listemiz bulunmaktadır!• Sağlığınızı ve karaciğerinizin sağlığını korumak için karaciğer uzmanınız veya sağlık uzmanınızla düzenli ziyaretler planlayın.• Karaciğere saldıran başka bir virüsten kendinizi korumak için Hepatit A aşısı yaptırın.• Alkol ve sigara kullanmaktan kaçının çünkü her ikisi zaten hepatit B virüsünden zarar görmüş karaciğerinize zarar verecektir.• Herhangi bir bitkisel çözüm veya vitamin takviyesi başlamadan sağlık uzmanınızla görüşün çünkü bazıları reçeteli hepatit B ilaçlarınızı olumsuz etkileyebilir ve hatta karaciğerinize zarar verebilir.• Herhangi bir reçetesiz ilaç (örn. asetaminofen, parasetamol) veya hepatit B için olmayan reçeteli ilacı almadan önce karaciğer için güvenli olduklarından emin olmak için eczacınıza danışın çünkü bunların çoğu karaciğerinizde işlenir. • Boya, tiner, yapıştırıcı, ev temizlik ürünleri, oje ve karaciğerinize zarar verebilecek diğer toksik olabilecek kimyasalların dumanlarını solumaktan kaçının. • Meyve, tam tahıl, balık, yağsız et ve bol miktarda sebzeden oluşan sağlıklı bir diyet yiyin. Özellikle “turpgiller grubundan sebzelerin” - lahana, brokoli, karnabahar - karaciğeri çevresel kimyasallara karşı koruduğu gösterilmiştir. • Karaciğer için çok zehirli olan ve çok ciddi zarar verebilecek Vibrio vulnificus adlı bir bakteri bulunabileceğinden çiğ veya az pişmiş kabuklu deniz ürünleri (örn. deniz tarağı, midye, istiridye, fistolar) yemekten kaçının.• Fındık, darı, mısır, yerfıstığı, süpürge darısı ve akdarı gibi gıdaları kullanmadan önce üzerlerini küf belirtileri açısından kontrol edin. Gıda nemli koşullarda saklanırsa ve uygun şekilde kapatılmazsa küfün problem oluşturma olasılığı daha yüksektir. Küf mevcutsa gıdaya karaciğer kanseri için bilinen bir risk faktörü olan "alfatoksinler" bulaşmış olabilir.• Stres düzeylerinizi sağlıklı gıdalar yiyerek, düzenli egzersiz yaparak ve bol miktarda istirahat ederek azaltın. Yediğiniz, içtiğiniz, soluduğunuz veya ciltten emilen her şeyin zamanla karaciğerde filtrelendiğini unutmayın. Bu nedenle karaciğeriniz ve sağlığınızı koruyun! Hepatit B durumum varsa kan bağışı yapabilir miyim? Hayır. Akut bir enfeksiyondan iyileşmiş olsanız bile kan bankası hepatit B'ye maruz kalmış herhangi bir kanı kabul etmez. Living with Hepatitis B Will I recover from a hepatitis B infection?Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. • Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B. • Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection.• Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus. What is the difference between an "acute" and a "chronic" hepatitis B infection?A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime. Will I become sick if I have acute hepatitis B?Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection?Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B?If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment. All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B?Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B?Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B?Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B?
Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication?It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection?Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these products, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tips are there for those living with chronic hepatitis B?People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! • Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver.• Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver.• Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus.• Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver.• Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver. • Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver. • Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals. • Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage.• Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer.• Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest. Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.  

  https://www.hepb.org/languages/turkish/living-with-hepatitis-b/
• Call to Action! Urge Your Members of Congress to Attend Viral Hepatitis Congressional Briefing!

  On Thursday, May 12th, Congressman Mike Honda and Senator John Kerry will hold a Congressional briefing entitled “Combating the Hidden Epidemic: U.S. Department of Health and Human Services Action Plan for the Prevention and Treatment of Viral Hepatitis.” This briefing will inform Members of Congress and their staff about the long-awaited report from HHS that will detail the federal government’s strategy for combating hepatitis B and C in the United States. The release of this report and the briefing offer a tremendous opportunity to change the course of the viral hepatitis epidemic in the U.S. and demonstrate Congressional leadership in moving forward a comprehensive prevention and treatment strategy. We need as many Members of Congress and their staff to attend this briefing to show their commitment to implement and fund the HHS plan. You can help make this happen by making three important phone calls right now! How you can make a difference: Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your U.S. Representative. When you are connected, ask for the staff person who handles health care issues. Whether you speak directly to the staff person or leave a message, tell him/her: “My name is _____________ and I live in (city/state). I am calling to urge Representative _____________ to attend a Congressional briefing on fighting the viral hepatitis epidemic in the United States. This important briefing will outline the new HHS “Action Plan for the Prevention and Treatment of Viral Hepatitis.” The briefing will be held on Thursday, May 12th, from 9:30 – 11:00 am in 210 Cannon House Office Building. Please contact Meina Banh in Congressman Mike Honda’s office for more information and to register. In the next 10 years, about 150,000 people in the United States are projected to die from liver cancer and liver disease associated with chronic hepatitis B and C. I strongly urge your office to participate in this briefing and

  http://www.hepb.org/blog/call-to-action-urge-your-members-of-congress-to-attend-viral-hepatitis-congressional-briefing/
• About

  The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure for hepatitis B and helping to improve the lives of those affected worldwide through research, education and patient advocacy. Visit www.hepb.org Liver Cancer Connect, a dedicated program of the Hepatitis B Foundation, provides patient-focused information on primary liver cancer. Visit www.livercancerconnect.org.

  http://www.hepb.org/blog/about-2/