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HBV Journal Review – November 2014
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: Experts Say Breastfeeding While Taking Antivirals Is Safe Doctors Fail to Adequately Treat HBV-Infected Women After Childbirth Doctors Continue to Fail to Screen Asian-Americans for Hepatitis B Statins Protect Hepatitis B Patients Against Heart Disease and Liver Cancer New Study Finds Antivirals Lower Liver Cancer Risk Studies Find Tenofovir Lowers Viral Load Faster Than Entecavir Liver Transplants Safe in Older Hepatitis B Patients Scientists Develop Micro Weapon to Disable HBV's Cancer-Causing X Protein Foreign-Born U.S. Residents Less Likely to Be Immunized Antivirals Can Safely Replace HBIG Following Liver Transplantation All Hepatitis B Patients Appear at Risk from Chemotherapy November 1, 2014 Volume 11, Issue 11 by Christine M. Kukka Experts Say Breastfeeding While Taking Antivirals Is Safe Women infected with the hepatitis B virus (HBV) face a medical conundrum. If they have high viral loads they are encouraged to take antivirals during pregnancy to reduce their HBV DNA levels to avoid infecting their newborns–but then they're told not to take antivirals if they want to breastfeed. A fetus is exposed to far higher levels of an antiviral in utero if the mother takes a daily antiviral pill than through breast milk. And to date, no medical studies have found any harm to babies from exposure to the miniscule amounts of antivirals found in breast milk, according to a provocative study published in the October issue of the journal of Clinical Infectious Diseases. In fact, the World Health Organization recommends that HIV-infected women continue antiviral treatment (which includes some of the same drugs used to suppress viral load in HBV-infected women)
http://www.hepb.org/blog/hbv-journal-review-november-2014/ -
Antiviral Therapy May Prevent Liver Cancer in Hepatitis B patients
Useful confirmation of what we already thought was true. Good news... (HealthNewsDigest.com) - DETROIT, June 9, 2014 -- Researchers have found that antiviral therapy may be successful in preventing hepatitis B virus from developing into the most common form of liver cancer, hepatocellular carcinoma (HCC). That was the finding of a study published in the May issue of Clinical Gastroenterology and Hepatology. Investigators from Henry Ford Health System in Detroit, Geisinger Health System in Danville, Pa., and Kaiser Permanente in Honolulu, Hawaii and Portland, Ore. participated in the study, along with investigators from the Centers for Disease Control and Prevention in Atlanta. According to the first-of-its-kind analysis of more than 2,600 adult participants with hepatitis B, those treated with antiviral therapy had a significantly lower occurrence of HCC during a five-year follow up period. Overall, 3 percent of patients developed HCC during the study's timeframe. But patients who received antiviral therapy were 60 percent less likely to develop HCC than untreated patients. "The results of this study allow us to reassure our patients that we are not just treating their viral levels, but that antiviral therapy may actually lessen their chance of developing liver cancer," said the study's lead investigator, Henry Ford Health System's Stuart C. Gordon, M.D., who worked closely with Henry Ford Senior Scientist Mei Lu in Detroit. Continue reading here.
http://www.hepb.org/blog/antiviral-therapy-may-prevent-liver-cancer-in-hepatitis-b-patients/ -
Operation Storm Philadelphia City Council : The Aftermath
Hepatitis B Foundation Intern and Guest Blogger Limi Lo shares her personal reflection of last week's advocacy event when hepatitis B partners and advocates stormed Philadelphia City Council A few months ago, I was sitting in my public policy class learning about advocacy. In simple English, it means, "to fight for a cause that you believe in." As much as I understood what it meant, I never thought I would take part in a real advocacy event until I attended the City Council resolution presentation on May 8th, 2014. The event was held at the Philadelphia City Council during a city council session, and included supporters from Hep B United Philadelphia (lead by the Hepatitis B Foundation), HepCAP, and Philadelphia County Medical Society. Together, supporters came out and advocated for better viral hepatitis care in the greater Philadelphia area. City Councilman David Oh had introduced a resolution declaring May as Hepatitis Awareness Month and calls for all high-risk Philadelphians to receive appropriate testing and proper care for viral hepatitis. The event not only provided me with a valuable learning experience, but more importantly, it was a life changing experience. I was able to witness community partners, students, professors, and other advocates coming together to help raise awareness and fight for a substantial cause (to improve hepatitis care). There were dozens of posters held high and being displayed: “Be proactive, get tested today”, “know more hepatitis”, and “Give hope to your family”. These messages were inspirational in addressing the need for city leaders to pay greater attention for the silent epidemic of viral hepatitis. Throughout the event, the atmosphere was filled with positive energy and a sense of hope was tangibly present—a hope that, in Philadelphia, all high-risk individuals can access screening tests, vaccines, and care for viral hepatitis. Since beginning my practicum with the Hepatitis B Foundation, I've gained a variety
http://www.hepb.org/blog/operation-storm-philadelphia-city-council-the-aftermath/ -
HBV Journal Review – December 2013
… Journal of Virology finds that the number of vaccinated Chinese children with mutated HBV has increased from 6.5% in 1992 to 15% in 2005.(1) And, as these vaccinated children age and become adults, the rate of mutations increases. Researchers also fear these mutated virus may cause more severe liver disease in patients than regular HBV. "The vaccine has been successful in protecting millions of children from HBV, but there is concern that use of the vaccine puts selective pressure on the virus to develop 'breakout' mutations that could render the vaccine less effective," wrote M. J. Friedrich in an editorial citing the study, entitled, "Hepatitis B vaccination spurs virus mutation rise," in the November issue of the Journal of the American Medical Association.(2) In the investigation, researchers from the U.S. and China compared blood samples taken from vaccinated children and unvaccinated adults before and after universal HBV immunization began in China in 1992. "They found that the prevalence of HBV mutants in children increased from 6.5% in 1992 to almost 15% in 2005, whereas in the adults, little difference was seen in HBV mutation prevalence from 1992 to 2005—as would be expected because the adults did not receive vaccines. "Although the vaccine remains effective, this study indicates that HBV mutations should be monitored so that additional vaccination strategies can be implemented when necessary," Friedrich cautioned. In another study, published in the November issue of the Journal of Viral Hepatitis, researchers compared outcomes in babies born to HBV-infected mothers who were given only the vaccine or a combination of the vaccine and HBIG, which is composed of hepatitis B surface antibodies derived from humans. They found occult hepatitis B, with HBsAg mutations, in 42% of 222 babies two years after their births.(3) The occult infection rate was higher in infants treated with both the vaccine and HBIG, and whose mothers had high rates of HBV DNA when they
http://www.hepb.org/blog/hbv-journal-review-december-2013/ -
Study Suggests Vaccine and HBIG Ineffective at Preventing "Occult" Hepatitis B in Babies Born to Infected Mothers
— Christine M. Kukka, Project Manager, HBV Advocate A new study suggests for the first time that the combination of the hepatitis B vaccine and HBIG (hepatitis B immune globulin) may be ineffective in preventing "occult" hepatitis B in babies born to mothers infected with the hepatitis B virus (HBV). An occult infection occurs when a person tests negative for the hepatitis B surface antigen (HBsAg)—considered an essential antigen building block for HBV—while testing positive for HBV DNA. When this occult infection occurs, researchers suspect the HBsAg has somehow mutated so conventional lab tests can't identify it. In the recent study, published in the November issue of the Journal of Viral Hepatitis, researchers compared outcomes in babies born to infected mothers who were given only the vaccine or a combination of the vaccine and HBIG, which is composed of hepatitis B surface antibodies derived from humans. They found that occult HBV infection occurred in 42% of 222 babies two years after their births. Most of the children with occult infections had received both the vaccine and HBIG, leading researchers to suggest that HBIG may play a role in promoting the development of an occult infection, or else the mothers may have received antiviral treatment that led to the HBsAg mutation. Hepatitis B vaccination with or without hepatitis B immunoglobulin at birth to babies born of HBsAg-positive mothers prevents overt HBV transmission but may not prevent occult HBV infection in babies: a randomized controlled trial. Pande C, et al.. Department of Gastroenterology, GB Pant Hospital, New Delhi, India; Special Centre for Molecular Medicine (SCMM), Jawaharlal Nehru University (JNU), New Delhi, India. J Viral Hepat. 2013 Nov;20(11):801-10. doi: 10.1111/jvh.12102. Epub 2013 Apr 23. Source: http://www.ncbi.nlm.nih.gov/pubmed/24168259 Abstract Vertical transmission of Hepatitis B virus HBV can result in a state of chronic HBV infection and its complications. HBV
http://www.hepb.org/blog/study-suggests-vaccine-and-hbig-ineffective-at-preventing-occult-hepatitis-b-in-babies-born-to-infected-mothers/