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• Fighting the Doom and Gloom: It Takes a Team

  By Anu Hosangadi People generally think liver cancer is non-treatable and non-curable. But that perception needs to change. Diagnosis and treatment of liver cancer have improved so much in the past 20 years that it can be cured if caught early and managed by an experienced health care team. Liver Cancer Connect’s "Fighting the Doom and Gloom" series explains how the right treatment plan  and teamwork offer the best chances for a cure.  More Treatment Options with Early Detection Previously, we talked about how liver cancer can be prevented, and how screening and surveillance save lives by detecting the cancer early. Early detection means more treatment options and a greater chance of treatment success. What Are the Options? Surgery (also called resection) is the treatment of choice if the cancer is detected early, has not spread, and the liver is working well. Liver transplantation— where the diseased liver is replaced with a healthy liver—has advanced remarkably in the past decade, thanks to earlier detection of liver cancer, improved surgical techniques and antiviral treatment, and post-transplant care. But there is a waiting list for people needing liver transplants. For people on a transplant waiting list, or those who cannot undergo surgery, other so-called localized therapies are available. These include ablation using radiofrequency, microwave, or laser procedures, and transarterial chemoembolization or radioembolization.Some of these therapies can also be combined. Chemotherapy has not been very successful against liver cancer and has been largely replaced by targeted therapies. These therapies block specific chemical pathways that the tumor needs for growth. One such targeted drug, sorafenib, is the first FDA-approved oral drug to treat liver tumors that cannot be surgically removed. What’s in the Pipeline? Many other treatments are being developed for liver cancer. Liver Cancer Connect’s Drug Watch regularly updates its list of therapies

  http://www.hepb.org/blog/fighting-the-doom-and-gloom-it-takes-a-team/
• Vlog: Advocacy Day on Capitol Hill

  Join Michaela Jackson for A Day in the Life of a Public Health Coordinator as she takes you behind the scenes of Advocacy Day - a day of speaking to Congress members and their staffers about hepatitis B. In this episode, participants visit Capitol Hill to ask Congress to support funding for Hepatitis B research and to raise awareness on the topic. Advocacy Day takes place the day before the Hep B United Summit.

  http://www.hepb.org/blog/vlog-advocacy-day-capitol-hill/
• A Day in the Life of Program Managers: #justB Workshop

  Welcome to a Day in the Life of Program Managers! Join Catherine Freeland, MPH, and Rhea Racho, MPAff for a day in their work life and the justB workshop. "#justB: Real People Sharing Real Stories of Hepatitis B" is collaboration between the Hepatitis B Foundation, Story Center, and Association of Asian Pacific Health Organizations (AAPCHO) to share the stories of people affected by hepatitis B. The episode highlights the workshop and process our storytellers go through to develop their impactful stories. Music Clouds - Joakim Karud WEBSITE: http://www.hepb.org FACEBOOK: https://www.facebook.com/hepbfoundation TWITTER: https://www.twitter.com/hepbfoundation INSTAGRAM: @hepbfoundation SNAPCHAT: @hepbfoundation

  http://www.hepb.org/blog/day-life-program-managers-justb-workshop/
• Reflection on Liver Capitol Hill Day Visits

      Wednesday I participated in the Liver Capitol Hill Day Visits sponsored by the American Association for the Study of Liver Diseases (AASLD). I wanted to write this reflection to demystify Hill visits for those that are reluctant to participate or feel that they are not particularly political or up on on the legislative issues. I would certainly put myself in that category, but I am an HBV advocate, and I recognize that there are simple ways I can participate that might make a difference for those living with HBV in my state and in our country. Liver Capitol Hill Day was a well organized event with specific "talking points" and "asks", and the logistics were very well coordinated, but in general the individual visits themselves were the same as others where I have participated. If you are in D.C. and wish to visit with your Representative or Senator's office, I would highly encourage it. They want and need to hear from their constituents, and if you have a personal story to tell, that's even better. Call your Representative's or Senator's office and ask to make an appointment with the staff member that handles health issues. If you are not sure who your Representative is, merely type in your zip code at www.house.gov. To determine who your Senators are go to www.senate.gov and select your state from the drop down member. Call them and set up an appointment. If you are looking for specific talking points, you could consider contacting an organization like the Hepatitis B Foundation, AASLD or other viral hepatitis organizations that might be able to provide you with some ideas for your visit. It is very unlikely you will even catch a glimpse of your Representative or Senator, so don't worry about feeling nervous. The Staffers are accustomed to constituents coming in with their requests. There is nothing formal about the meeting and often you are crammed in a closet-sized room with a desk and a chair, or meeting wherever there is space.  This is

  http://www.hepb.org/blog/reflection-on-liver-capitol-hill-day-visits/

• 一般的情報 B型肝炎とは？ B型肝炎は、世界で最も多く見られる肝臓の感染症で、肝臓を攻撃して傷つけるB型肝炎ウイルス（HBV）が原因でかかります。B型肝炎ウイルスは、血液、無防備な性交渉、使いまわした注射針を通じて、また妊娠中や出産中に感染した母親から新生児に感染します。感染した成人のほとんどは、問題なくB型肝炎ウイルスを取り除くことができますが、一部の成人、赤ちゃんや子どもの大半ではウイルスを血液中から取り除くことができず、慢性（一生の間感染したままの状態が続く）感染症を引き起こします。 B型肝炎の感染を予防する安全なワクチンや、既にB型肝炎に感染している患者に対して新しい治療法が開発されています。  感染者はどのくらいいますか？ 全世界では、20億人（3人に1人）がB型肝炎に既に感染したことがあり、そのうち2億5,700万人は慢性感染者です（この人たちはウイルスを取り除くことができません）。毎年、推定で約70万人がB型肝炎やその合併症で死亡しています。 世界の一部の地域でB型肝炎が多いのはなぜですか？ B型肝炎は年齢や民族に関係なく感染することでかかる病気ですが、特にアジア、アフリカや南アフリカの一部、東ヨーロッパ、中東に住む人々は感染するリスクが高くなっています。また、B型肝炎はこれらの地域で生まれた（または両親がこれらの地域で生まれた）アメリカ人にもよく見られます。 B型肝炎は、世界の一部の地域では他の地域に比べて多く見られます。それは、これらの地域で極めて大勢の人々が既にB型肝炎に感染していることによります。B型肝炎は、「アジア特有の病気」でも「アフリカ特有の病気」でもありませんが、これらの地域の何億人もの人々に影響を与えていることから、他の地域にくらべより大勢の人々がB型肝炎のウイルスを他の人々に感染させる恐れがあり、あなたが感染するリスクも高まります。西側諸国での感染者は少ないため、感染するリスクは低くなっています。 B型肝炎がよく見られる地域では、感染は通常、母親がB型肝炎感染者であることを知らずに、出産時に新生児をウイルス感染させてしまうことから発生します。また感染している家族と毎日接触している幼い子どもも、感染する危険があります。赤ちゃんや子どもは、自身が持つ免疫システムでウイルスを取り除くことが難しいため、慢性のB型肝炎に感染する可能性がより高くなります。 あなた、またはご家族の方が、地図の濃い青で示されている地域の出身である場合は、あなたもB型肝炎に感染する危険性が高くなります。その場合は肝炎の検査について医師と話し合ってください。 なぜB型肝炎について注意すべきなのですか？ 慢性のB型肝炎は、肝硬変や肝臓がんなど重い肝臓の病気につながる可能性があります。早期に診断すれば、早めに治療を開始して命を救うことができるため、検査を受けることが大切です。また、ほとんどの感染者は感染していることを知らないため、意図せずに他の大勢の人にウイルスを広めてしまう可能性があります。検査を受けないことで、一つの家族で何代にもわたってB型肝炎が伝染したり、地域全体が感染したりする恐れもあります。 B型肝炎は一家族で何代にもわたって伝染する可能性があるため、「遺伝」であると誤って信じられていますが、B型肝炎は遺伝病ではなく、ウイルスにより引き起こされる病気です。ウイルスは、母親から子どもに伝染する、あるいは家庭内で誤って血液に触れてしまうなど、家族の間で伝染することが多くあります。検査して、予防接種や治療を受ければ、家族内でのB型肝炎のサイクルを断ち切ることが可能です。 B型肝炎はなぜとても危険なのですか？ B型肝炎が危険な理由は、知らず知らずに感染するおそれがある「自覚症状のない感染」のためです。B型肝炎に感染しているほとんどの人は、自分が感染していることを知らずに、血液や感染した体液を通じて他の人にウイルスを感染させてしまいます。慢性的に感染している人は、中年期以降に肝障害、肝硬変、肝がんにかかるリスクが高まります。ウイルスは長年にわたって潜伏し、自覚症状がないまま肝臓を継続的に攻撃します。 急性B型肝炎とは？ 急性B型肝炎の場合、（症状のある、なしに関係なく）最大で6ヶ月ほど続くため、この時期に感染者はウイルスを他の人に伝染させてしまうおそれがあります。 急性B型肝炎の症状は、食欲不振、関節や筋肉の痛み、軽い発熱、腹痛などです。大半の人には症状が出ませんが、発症すると感染してから60～150日後に症状が現れ、症状は平均で3ヶ月ほど続きます。人によっては、吐き気、嘔吐、黄疸（両目や皮膚が黄色くなる）、または腹部膨張など重い症状が現れ、医師の診察を受けなければならなくなります。 B型肝炎のウイルスが血液中に存在する場合は、血液検査をするだけで感染していることがわかります。急性B型肝炎と診断された場合は、医師は6ヶ月以内にもう一度血液検査をして、患者が回復したのか、それとも慢性B型肝炎にかかったのかを確認する必要があります。血液検査によって血液中にB型肝炎のウイルスが残っていないと確認されるまでは、他の人に感染させないようにすることが重要です。性交渉のあるパートナーや家族（または、家族がひんぱんに接触する人たち）にB型肝炎の検査を受けてもらうことも重要です。彼らが感染していなくても、B型肝炎のワクチンを接種していないなら、B型肝炎のワクチンを連続して接種してもらうようにします。 急性B型肝炎にかかっている患者に対して、特別なB型肝炎の治療は行われません。急性B型肝炎を克服する治療法はなく、大半の大人の感染者は自力で回復しますが、重い症状のある患者は入院して総合的な看護を受けることもあります。急性の場合の主な治療は、休息と症状の管理です。まれにですが、急性患者に「劇症肝炎」と呼ばれる、命にかかわる症状が発生することがあり、これは突然肝不全を引き起こすおそれがあるため、緊急治療が必要です。 急性B型肝炎に感染したら、アルコールを避け、タバコを止めるか本数を減らし、健康に良い食べ物を食べ、脂肪分の多い食べ物を避けて、肝臓になるべく負担をかけないようにします。また、現在服用している薬（処方薬、市販薬、ビタミン剤、ハーブサプリメントなど）について医師に助言を求め、肝臓にとって安全かどうか確認します。その際には、疑問に思っていることを医師に質問してください。ビタミン剤や肝臓用のサプリメントは、回復の助けとならないばかりか、肝臓の症状をさらに悪化させる可能性あります。 急性感染から回復したことを確認するために必要な追加の血液検査については、医師に確認してください。 慢性B型肝炎とは？ B型肝炎のウイルス血液検査で6ヶ月以上陽性の結果が続く人は、慢性肝炎に感染していると診断されます。これは、免疫システムがB型肝炎のウイルスを除去できず、ウイルスが血液中や肝臓に留まっていることを意味します。慢性肝炎では、効果的な治療や管理の方法があるものの、完治はしません。B型肝炎が慢性化すれば、ウイルスが一生血液中に留まる可能性があります。 慢性B型肝炎にかかっている人は、ウイルスを知らず知らずに他の人に感染させてしまうおそれがあります。また、慢性のB型肝炎では、肝硬変や肝臓がんなど重い肝臓の病気につながるおそれがもあります。慢性B型肝炎にかかっている人全員が、重い肝臓の病気を発症するわけではありませんが、感染していない人に比べて可能性は非常に高くなります。 慢性B型肝炎にかかるリスクは最初にB型肝炎に感染した年齢と関連しており、 新生児や乳児のときに感染した人のうち90%が、 小児（1～5歳）のときに感染した人のうち最大50%が、 成人してから感染した人のうち5～10%がかかります（つまり、90%は回復します）。 慢性B型肝炎にかかっているとわかったら、とても動揺してしまうかもしれません。大半の人には自覚症状がなく、感染してから何十年も経ってから診断が下される場合もあり、慢性B型肝炎に感染していると診断されたらショックを受け、驚くのも無理はありません。ですが、慢性B型肝炎にかかっていても大半の人は長く健康的な人生を送ることができますので、安心してください。 肝炎に感染している妊婦の場合は、出産時に新生児にウイルスを感染させてしまうおそれがあります。出生時に新生児が慢性肝炎に感染するリスクが高いことから、世界保健機関（WHO）と米国疾病管理予防センター（CDC）はすべての新生児に対して、出生後12～24時間以内にB型肝炎の最初の予防接種を行うように勧めています。もしあなたが妊婦であり肝炎に感染している場合は、出産後12～24時間以内に赤ちゃんがB型肝炎の最初の予防接種を受けられるように手配してください！ 慢性B型肝炎は完治しませんが、効果的な薬物療法でB型肝炎のウイルスを管理し、肝臓のダメージを阻止することができます。また、研究段階ではあるものの、有望な新薬が開発されていますので、ごく近い将来にB型肝炎は完治する病になるかもしれません。慢性B型肝炎にかかっている人は、感染していない人と比べて重い肝疾患や肝がんにかかるリスクが高いものの、以下に挙げたようにリスクを下げるためにできることはたくさんあります。 6ヶ月ごとに（または少なくとも年に1回）肝臓の専門医、またはB型肝炎に詳しい医師の定期診断を受け、肝臓の健康状態を監視してください。 慢性B型肝炎の治療が重い肝疾患や肝がんの予防に役立つかどうか、担当の医師と話し合ってください。 定期検診の際に、担当の医師に肝がんのスクリーニングも欠かさず実施してもらってください。がんを初期の段階で発見できれば、治療の選択肢が増え、治療効果も高まります。 アルコールと喫煙はどちらも肝臓に多くの負担をかけるため、避けるか量を制限してください。 揚げものや油っこい食品は肝臓に負担がかかりますので、野菜を多く含む健康に良い食事を摂ってください。 「慢性キャリア」とはどういう意味ですか？ 医師は、慢性B型肝炎の患者を「慢性キャリア」と呼ぶことがあります。「慢性キャリア」とは、慢性B型肝炎にかかり、ウイルスを他人に感染させる可能性があるため、医師が管理する必要がある患者のことをいいます。 B型肝炎の治療法はありますか？ 大半の成人は、薬物療法に頼らずに自力で急性B型肝炎から回復します。慢性B型肝炎にかかった成人、子ども、幼児を完治させる治療方法は、現在のところ存在しません。ただし、ウイルスの活動を遅くすることで、慢性B型肝炎にかかっている人の肝臓病の進行を遅らせる治療法がありますので、安心してください。生成されるB型肝炎のウイルスが少なければ、肝臓へのダメージも抑えられます。 また、新しい画期的な研究が進んでいますので、近い将来慢性B型肝を完治させられる治療法が確立されることも大いに期待されています。現在開発中の将来有望な薬のリストについては、Drug Watch（新薬安全性情報）を参照してください。 B型肝炎の治療オプションには何がありますか？ 急性B型肝炎については、休息あるいは症状を管理する対症療法以外に治療法はありません。 慢性B型肝炎については、いくつかの治療方法があります。ここで大切なのは、B型肝炎にかかっている人全員が治療を必要とするわけではないということです。担当医師は、薬物治療が必要か、あるいは病状を監視しながら静観するべきかの決定を支援してくれます。 B型肝炎ウイルスの動きを遅くしたり阻止したりして、肝臓の炎症やダメージを抑えてくれる抗ウイルス薬がいくつか存在しています。抗ウイルス薬は、少なくとも1年以上、毎日1錠服用します。米国食品医薬局（FDA）の承認を受けている抗ウイルス薬は6種類ありますが、お勧めできるのはそのうちのテノホビル・ジソプロキシル（Viread/TDF）、テノホビル・アラフェナミド（Vemlidy/TAF）、エンテカビル（Baraclude）の3種類の「第一選択」抗ウイルス薬のみです。第一選択抗ウイルス薬をお勧めするのは、これらが安全でより効果が高いためです。第一選択抗ウイルス薬を使って治療しても効果がない、またはこれらの薬を利用できない方は、別のオプションとして、テルビブジン（Tyzeka、Sebivo）、アデホビル・ピボキシル（Hepsera）、ラミブジン（Epivir-HBV、Zeffix、Heptodin）の服用も可能です。 これらの慢性B型肝炎用抗ウイルス薬はFDAに承認されているものの、服用して全快するわけではありません。ただし、肝臓へのダメージや肝がんに対するリスクを大幅に抑制してくれます。抗ウイルス薬の服用開始時期や停止時期は明示されておらず、慢性B型肝炎の治療を始める前に豊富な知識を持つ医師に入念に評価してもらうことが非常に重要です。 また他の薬として、免疫システムによるB型肝炎ウイルスに対する制御能力を高める免疫調節剤もあります。この調節剤は、6ヶ月から1年の間注射で投与します。最もよく処方される抗ウイルス薬には、インターフェロン アルファ-2b（イントロンA）やペグインターフェロン（Pegasys）などがあります。 この治療を受ける場合は、担当医師と治療オプションについて話し合い、どの抗ウイルス薬が最も適しているかを決めることが必要です。一般的にこれらの医薬品はB型肝炎ウイルスの減少または阻止に効果を発揮します。結果として、ウイルスによる肝臓へのダメージの進行が遅くなるため（長期投与の場合には、進行が逆転することもある）、患者の症状が数ヶ月以内に改善されます。 B型肝炎のFDA承認薬や開発中のほかの将来有望な医薬品の全リストについては、Drug Watch（新薬安全性情報）を参照してください。 General Information What is hepatitis B? Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B.  How many people are affected by hepatitis B? Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world? Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B? Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous? Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected.  What is acute hepatitis B? An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver. Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. What is chronic hepatitis B? People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected. The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with the hepatitis B virus: 90% of infected newborns and babies will develop a chronic hepatitis B infection Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risk. Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver. Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer. Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life. Avoid or limit alcohol and smoking since both cause a lot of stress to your liver. Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver. What does it mean to be a “chronic carrier”? When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B? Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. 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. 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. What options are there to treat my hepatitis B? For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals 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: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. 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 hepatitis B. There are also immunomodulator 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). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. 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. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.

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• Happy 20th Anniversary to the Hepatitis B Foundation!

  Hepatitis B Foundation 20th Anniversary Gala   Join the Hepatitis B Foundation with this short, fun, YouTube video with great snapshots and music as the Hepatitis B Foundation  celebrates its 20th Anniversary.  The Hepatitis B Foundation is the only national non-profit organization solely dedicated to the global problem of Hepatitis B.  If you want to know more about HBF, check out our mission and story.  We've had some great accomplishments over the last year, so take a moment and review our  2010 annual report, and see what contributions HBF has made to hepatitis B research, outreach, and advocacy.

  http://www.hepb.org/blog/happy-20th-anniversary-to-the-hepatitis-b-foundation/

• 预防和疫苗接种  我如何患上乙型肝炎？乙型肝炎是由一种通过血液传播的病毒引起的传染病。下面列出的是乙型肝炎传给他人最常见的方式： 直接接触受感染血液或受感染体液  在怀孕或分娩期间由受感染的母亲传染给新生婴儿  与受感染的伴侣发生无保护性行为  共用或重复使用的针头（例如，服用非法药物时共用针头，或者在医药、针灸、纹身或穿耳孔/人体穿孔方面重复使用未经适当消毒的针头）  街头医生、牙医或理发师可能使用的未经消毒的医疗设备或针头 乙型肝炎是随意传播的吗？不是，乙型肝炎不通过随意接触传播。您不能通过空气、拥抱、触摸、打喷嚏、咳嗽、马桶座圈或门把手感染乙型肝炎。您不能通过与某个感染者同食同饮、或者食用由某个乙型肝炎患者准备的食物而感染乙型肝炎。 谁最有可能感染乙型肝炎？虽然每个人都有一定的乙型肝炎感染风险，但有些人更容易受感染。您的工作、生活方式、或者仅仅是出生在有乙型肝炎的家庭，都可以增加您受感染的可能性。以下是一些最常见的“高危”群体——但请记住，这并非完整清单： 与乙型肝炎患者结婚或与其在家庭中密切接触之人。这包括成年人和儿童。 在乙型肝炎较为常见的国家出生，或者其父母在乙型肝炎较为常见的国家（亚洲、非洲和南美洲部分地区、东欧以及中东）出生之人。  在乙型肝炎较为常见的国家（亚洲、非洲和南美洲部分地区、东欧以及中东）居住或旅行之人。 性活跃的成年人和青少年  男男性行为者  受感染母亲所生的婴儿  卫生保健工作者和其他在工作中接触到血液之人。 紧急救援人员  进行肾透析的患者 团体家庭、机构或惩教设施的居民和工作人员。 1992 年以前的输血接受者，或未经适当筛查血液的近期接受者 曾经和现在的注射吸毒者  刺纹身或人体穿孔者  找街头医生、牙医或理发师看病或服务的人 针对乙型肝炎疫苗的建议是什么？ 世界卫生组织 (WHO) 和美国疾病控制和预防中心 (CDC) 建议所有婴儿和 18 岁以下的儿童接种乙型肝炎疫苗。CDC 还建议高危群体中的成年人接种疫苗。 乙型肝炎疫苗是一种安全有效的疫苗，建议所有刚出生的婴儿和 18 岁以下的儿童接种该疫苗。也建议患有糖尿病的成年人，以及因其工作、生活方式、生活环境或出生国而有高感染风险的人群接种乙型肝炎疫苗。因为每个人都有一定的风险，所以所有成年人都应该认真考虑注射乙型肝炎疫苗，以终生防护患上可预防的慢性肝病。 乙型肝炎疫苗安全吗？ 安全，乙型肝炎疫苗十分安全有效。事实上，它是第一种“抗癌疫苗”，因为它能保护您远离乙型肝炎，而乙型肝炎是全世界八成肝癌的病因。 随着全世界已注射超过 10 亿剂疫苗，医学和科学研究已表明，乙型肝炎疫苗是迄今制成的最安全的疫苗之一。 我会从疫苗中感染乙型肝炎吗？不会，您不会从疫苗中感染乙型肝炎。这种疫苗是在实验室中以合成酵母产品制成的。最常见的副作用是手臂上注射部位红肿和疼痛。 乙型肝炎疫苗计划表是什么？乙型肝炎疫苗可在您的医生的办公室和当地卫生部门或诊所提供。尽管针对年龄 11 岁到 15 岁的青少年有一种加速型双剂量系列，但通常需要三剂来完成乙型肝炎疫苗系列，而且有一种新型 2 剂疫苗于 2017 年获得美国食品和药物管理局 (FDA) 批准用于成年人。重要的是要记住，受感染的母亲所生的婴儿必须在产房或生命最初 12 小时内接受首剂乙型肝炎疫苗接种。 第 1 次注射——在任何特定时间，但新生儿应在产房接受这一剂 第 2 次注射——在首次注射后至少 1 个月（或 28 天） 第 3 次注射——在首次注射后 6 个月（或者在第 2 次注射后至少 2 个月） 第 1 次和第 3 次注射必须相隔至少 16 周。如果您的疫苗计划表已延迟，您无需重新开始此系列，您可以从您已中断之处继续——即使剂量已经相隔数年。 为了确定您能抵抗乙型肝炎，要求进行简单验血来检查您的“乙型肝炎抗体滴度” (HBsAb)，这会确定疫苗接种是否成功。 我还能做些什么来保护自己免受乙型肝炎感染？因为乙型肝炎通过受感染的血液和受感染的体液传播，所以您可以做几件简单事情，保护自己远离感染可能性，直到您完成疫苗接种： 避免直接接触血液或任何体液  与性伴侣使用避孕套  避免非法药物和处方药物滥用，包括注射此类药物  避免共用诸如剃须刀、牙刷、耳环和指甲钳等尖锐物品  确保在医药、牙医、针灸、纹身、穿耳孔和人体穿孔方面使用无菌针头和设备  戴手套并使用新鲜的漂白剂和水溶液来清理血液溢出物  在接触或清洁血液后，用肥皂和水彻底洗手  最重要的是，确保您接种乙型肝炎疫苗！ Prevention and Vaccination How can I get hepatitis B?Hepatitis B is an infectious disease caused by a virus that is spread through blood. Listed below are the most common ways hepatitis B is passed to others: Direct contact with infected blood or infected bodily fluids  From an infected mother to her newborn baby during pregnancy or delivery  Unprotected sex with an infected partner  Shared or re-used needles (for example, sharing needles for illegal drugs or re-using needles that are not properly sterilized for medicine, acupuncture, tattoos, or ear/body piercing)  Unsterilized medical equipment or needles that may be used by roadside doctors, dentists or barbers   Is hepatitis B transmitted casually?No, hepatitis B is not spread through casual contact. You cannot get hepatitis B from the air, hugging, touching, sneezing, coughing, toilet seats or doorknobs. You cannot get hepatitis B from eating or drinking with someone who is infected or from eating food prepared by someone who has hepatitis B. Who is most likely to become infected with hepatitis B? Although everyone is at some risk for getting hepatitis B, there are some people who are more likely to get infected. Your job, lifestyle, or just being born into a family with hepatitis B can increase your chances of being infected. Here are some of the most common "high risk" groups -- but please remember that this is not a complete list: People who are married to or live in close household contact with someone who has hepatitis B. This includes adults and children. People who were born countries where hepatitis B is common, or whose parents were born in countries where hepatitis B is common (Asia, parts of Africa and South America, Eastern Europe, and the Middle East).  People who live in or travel to countries where hepatitis B is very common (Asia, parts of Africa and South America, Eastern Europe, and the Middle East). Sexually active adults and teenagers  Men who have sex with men  Infants born to infected mothers  Healthcare workers and others who are exposed to blood in their jobs. Emergency personnel Patients who are on kidney dialysis Residents and staff of group homes, institutions, or correctional facilities. Recipients of blood transfusions before 1992, or more recent recipients of improperly screened blood Injection drug users, past and present  People who get tattoos or body piercing  People who use roadside doctors, dentists or barbers   What are the recommendations for the hepatitis B vaccine? The hepatitis B vaccine is recommended for all infants and children up to age 18 years by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). The CDC also recommends that adults in high-risk groups be vaccinated. The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease. Is the hepatitis B vaccine safe? Yes, the hepatitis B vaccine is very safe and effective. In fact, it is the first “anti-cancer vaccine” because it can protect you from hepatitis B, which is the cause of 80% of all liver cancer in the world. With more than one billion doses given throughout the world, medical and scientific studies have shown the hepatitis B vaccine to be one of the safest vaccines ever made. Can I get hepatitis B from the vaccine?No, you cannot get hepatitis B from the vaccine. The vaccine is made from a synthetic yeast product in a laboratory. The most common side effects are redness and soreness in the arm where the shot is given. What is the hepatitis B vaccine schedule?The hepatitis B vaccine is available at your doctor's office and local health department or clinic. Three doses are generally required to complete the hepatitis B vaccine series, although there is an accelerated two-dose series for adolescents age 11 through 15 years, and there is a new 2-dose vaccine that was approved by the U.S. Food and Drug Administration (FDA) for use in adults in 2017. It is important to remember that babies born to infected mothers must receive the first dose of hepatitis B vaccine in the delivery room or within the first 12 hours of life. 1st Shot - At any given time, but newborns should receive this dose in the delivery room 2nd Shot - At least one month (or 28 days) after the 1st shot 3rd Shot - Six months after the 1st shot (or at least 2 months after the 2nd shot) There must be at least 16 weeks between the 1st and 3rd shot. If your vaccine schedule has been delayed, you do not need to start the series over, you can continue from where you have left off – even if there have been years between doses. To be certain that you are protected against hepatitis B, ask for a simple blood test to check your “hepatitis B antibody titers” (HBsAb) which will confirm whether the vaccination was successful. What else can I do to protect myself from hepatitis B?Since hepatitis B is spread through infected blood and infected body fluids, there are several simple things that you can do to protect yourself from possible infection until your vaccination is complete: Avoid touching blood or any bodily fluids directly  Use condoms with sexual partners  Avoid illegal drugs and prescription drug misuse, including injection of such drugs  Avoid sharing sharp objects such as razors, toothbrushes, earrings, and nail clippers  Make sure that sterile needles and equipment are used for medicine, the dentist, acupuncture, tattoos, ear and body piercing  Wear gloves and use a fresh solution of bleach and water to clean up blood spills  Wash your hands thoroughly with soap and water after touching or cleaning up blood  Most importantly, make sure you receive the hepatitis B vaccine!  

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