Hep B Blog

Monthly Archives: June 2021

About Hepatitis B, HBV, Hepatitis B Awareness, Hepatitis B Prevention, Liver, Liver Cancer, Liver Health

Liver Cancer Among Men

June is Men’s Health Month. This month we bring awareness to preventable health problems and encourage early detection and treatment of disease among men and boys. In 2020, The World Health Organization found that liver cancer is the third leading cause of cancer deaths with 830,000 deaths.1 Liver cancer occurs more often in men than in women with it being the 5th most commonly occurring cancer in men and the 9th most commonly occurring cancer in women.2

There are two main types of liver cancers, hepatocellular carcinoma (HCC) which accounts for about 75% of liver cancer cases, and intrahepatic cholangiocarcinoma which accounts for 12-15% of cases. Liver cancer especially impacts Asian countries like Mongolia, Vietnam, Laos, Cambodia, Thailand, and China. Hepatitis B is the leading cause of HCC globally. Of the 300 million individuals living with a chronic hepatitis B diagnosis, about 25% will develop HCC.3

Risk Factors

HCC affects men with an incidence 2x-4x higher than women due to differences in behavioral risk factors and biological factors.3 Research has found men were less likely to undergo HCC screening and more likely to smoke.  Additionally, studies have shown alcohol is a major risk factor for HCC. In the United States, HCC associated with alcohol is higher among men than in women at 27.8% and 15.4% respectively.3

Biologically, there is evidence estrogen (a female hormone) decreases IL-6 mediated hepatic inflammation and viral production.3 Studies have demonstrated IL-6 may promote virus survival and/or exacerbation of the disease.4 In the context of hepatitis B, men are at an increased risk for HCC as they do not produce estrogen which would help decrease the risk of IL-6, in turn, promoting viral survival.

Prevention

The great news is that HCC can be prevented by preventing hepatitis B. There is a safe and effective vaccine that can be completed in either 2 or 3 doses over a span of 3 months. Ask your healthcare provider for the hepatitis B vaccine series.

If you are unsure of your hepatitis B status, you can get tested! Ask your healthcare provider for the “Hepatitis B Panel” – it should include 3 parts. The panel is super simple and only requires one sample of blood.  If you are of Asian descent and male, it is especially important for you to get tested as liver cancer disproportionately impacts individuals from Asian countries and men.

If you have chronic hepatitis B, make sure your doctor screens you regularly for liver cancer. Typically done with a combination of blood tests and imaging, liver cancer screening can help detect HCC early when it is still curable.

As we wrap up June and Men’s Health Month, you are encouraged to get vaccinated and tested for hepatitis B. Take control of your health, and don’t wait!

References

  1. https://www.who.int/news-room/fact-sheets/detail/cancer
  2. https://www.wcrf.org/dietandcancer/liver-cancer-statistics/
  3. Wu EM, Wong LL, Hernandez BY, et al. Gender differences in hepatocellular cancer: disparities in nonalcoholic fatty liver disease/steatohepatitis and liver transplantation. Hepatoma Res. 2018;4:66. doi:10.20517/2394-5079.2018.87
  4. Velazquez-Salinas L, Verdugo-Rodriguez A, Rodriguez LL, Borca MV. The Role of Interleukin 6 During Viral Infections. Front Microbiol. 2019;10:1057. Published 2019 May 10. doi:10.3389/fmicb.2019.01057

 

Author: Evangeline Wang

Contact Information: info@hepb.org

 

About Hepatitis B, Hepatitis B Awareness

World Refugee Day!

June 20th is World Refugee Day! This day “celebrates the strength and courage of people who have been forced to flee their home country to escape conflict or persecution. World Refugee Day is an occasion to build empathy and understanding for their plight and to recognize their resilience in rebuilding their lives.”1

In 2020, the United Nations Refugee Agency estimates that 80 million people were forcibly displaced. A majority of refugees originate from Syria, Venezuela, Afghanistan, South Sudan, and Myanmar and are mostly resettling in countries like Turkey, Colombia, Pakistan, Uganda, and Germany.1

As individuals who are experiencing forcible displacement begin to resettle, it is important to encourage hepatitis B testing and vaccination, even though hepatitis B might be the last thing on their minds. It is important to keep health, and especially hepatitis B in mind because hepatitis B disproportionately affects people from the World Health Organization’s (WHO) African, Western Pacific, and Asian regions.

In South Sudan, hepatitis B accounts for 80% of the viral hepatitis cases. Moreover, Myanmar has a moderate to high burden, with 6.5% of the general population being infected with hepatitis B. It is imperative that testing and vaccination is encouraged in countries like South Sudan and Myanmar and in countries where people are resettling to not only prevent the spread of hepatitis B but also allow people living with hepatitis B who might not know it to live a long and healthy life. Additionally, it is important to note that the continuation of care for people experiencing forcible displacement is halted when resettling in different countries. This interruption can be damaging to individuals’ health, especially those living with hepatitis B as medication must be taken daily, and seeing a liver specialist should happen every 6 months.

However, some people who are in the process of resettling might be hesitant to get tested for hepatitis B. This can be due to a myriad of reasons like the cost of healthcare if they do test positive, access to quality healthcare, fear of stigma, and other cultural/language barriers.

So how can organizations encourage people experiencing displacement to get tested for hepatitis B? This answer is frankly too complicated and complex for a simple blog post, but here are a few suggestions for organizations.

  1. Utilize community health workers. Community health workers who are fluent in refugee languages and cultures can educate community members about preventative health measures. People might be more receptive to the information if someone familiar with the community is the educator.
  2. Reduce barriers to healthcare. Transportation sometimes is a barrier for individuals experiencing resettlement. Offering transportation to and from healthcare clinics can greatly increase access to quality healthcare. Furthermore, when the individual arrives at their healthcare facility, they must have an interpreter if they do not speak the local language or go to a provider who speaks their native language.
  3. Use culturally sensitive educational materials. Using materials in languages other than English is so important to effectively communicate health information about hepatitis B! The Centers for Disease Control and Prevention (CDC), has their Know Hepatitis B Campaign where you can access FREE multi-lingual hepatitis B educational materials.

Reference:

  1. https://www.unhcr.org/en-us/world-refugee-day.html

About Hepatitis B, HBV, Hepatitis B Prevention

Happy Pride Month – HIV/HBV Co-Infection

 

June is Pride Month in the United States! This month we celebrate the LGBTQ+ community in honor of the 1969 Stonewall Uprising in Manhattan. This blog post will discuss HIV/HBV coinfection in LGBTQ+ individuals and how to prevent both viruses.

HIV/HBV Co-Infection

Human Immunodeficiency Virus or HIV disproportionately affects LGBTQ+ individuals, mostly gay and bisexual men. In the United States, approximately 69% of the 37,968 new HIV cases were among gay and bisexual men in 2018. HIV can also impact lesbian women, although the infection rate among this community is lower. There is also very limited current data out about lesbian and bisexual women and the burden of HIV. However, HIV can be transmitted between women who have sex with women through sex toys and injection drug use. The CDC reports 1 million people have identified as transgender in the United States, and 2% of those individuals are affected by HIV.

Approximately 5-20% of the HIV-infected population worldwide is also living with hepatitis B. These rates vary among different regions and at-risk populations based on modes of transmission. This figure may approach 20% in Southeast Asia, and 5% in North America and Western Europe. In the U.S., Western Europe, and Australia, the prevalence of chronic hepatitis B was reported to be 5%-14% among HIV-positive individuals.

Since both HIV and the hepatitis B virus share similar transmission routes, it is not surprising that there is a high frequency of coinfection. Sexual activity and/or injection drug use are the most common routes of transmission of the hepatitis B virus among those also infected with HIV.

Prevention

You can easily prevent hepatitis B with a safe and effective vaccine. The vaccine comes in either 2 or 3 doses, given over a span of 6 months. Learn more about the vaccine dose schedule here!

If you are not vaccinated for hepatitis B, ask your doctor or primary care provider for the vaccination! Check out this list of LGBTQ+ friendly providers.

If you are unsure of your hepatitis B status, ask your doctor or primary care provider to become tested! The hepatitis B test is super simple – it only requires one blood sample. Your doctor should order the “hepatitis B panel” which includes different tests. Read more hepatitis B testing here!

You can lower your risk of acquiring HIV by using PrEP (pre-exposure prophylaxis). PrEP is a daily medication you can take to prevent HIV. Just make sure you are tested for hepatitis B before starting PrEP. Read more about PrEP here!

 

Author: Evangeline Wang

Contact Information: info@hepb.org

Baruch S. Blumberg Institute