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Monthly Archives: March 2022

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What Can We Do During National Minority Health Month?

As March wraps up and we look to April, let’s celebrate National Minority Health Month!

This month is all about building awareness around the disproportionate burden of premature death and illness in minority populations and encouraging action through health education, early detection, and control of disease complications. 

Why is There a Disproportionate Burden of Hepatitis B in African and Asian and Pacific Islander Populations?

To address this, we first must know some background information. The hepatitis B virus was discovered in 1965 by Dr. Baruch Blumberg, and the recombinant vaccine was approved in 1986. Almost 300 million individuals across the globe are living with chronic hepatitis B. Hepatitis B is a virus that affects your liver. Left untreated, it does damage to your liver and could lead to fibrosis, cirrhosis, or liver cancer.

Multiple factors influence why hepatitis B is so common in African and Asian Pacific populations. Hepatitis B is an ancient virus, and because it is transmitted through blood contact, it has been spread from generation to generation throughout Asia and Africa. Many countries have effective vaccination programs that have drastically slowed transmission over the past 15 years – but some countries, where up to 10% of the population has hepatitis B, still don’t provide universal vaccination to newborns, children or adults – so hepatitis B transmission remains high. Additionally, lack of awareness regarding hepatitis B transmission, lack of hepatitis B testing and data, stigma and hepatitis B related discrimination also play roles in the continued spread of hepatitis B in endemic regions.

In WHO Africa Region, 81 million people are living with hepatitis B, 116 million in the Western Pacific Region, and 18 million in the South East Asian Region.1 In the US, hepatitis B primarily impacts communities of color, especially 1st and 2nd generation Americans.

So, what does this mean for you in the context of hepatitis B during National Minority Health Month?

What Can You Do National Minority Health Month? 

Those from communities that are highly impacted by hepatitis B, including Asian Americans, Pacific Islanders, and people of African origin, are at higher risk for having hepatitis B. If you do not know your hepatitis B status, go get tested and encourage your family members and close contacts to get tested as well. Testing for hepatitis B is very simple and if your test results show that you need vaccination, there is a safe and effective vaccine.

Did you know that most transmission occurs from mother to child, due to the exchange of blood during the childbirth process? If you are expecting a baby, be sure your doctor tests you for hepatitis B – this way, the doctor can be sure that your baby gets the appropriate shots at delivery to prevent them from getting infected. If you live in the United States, health insurance, including Medicare and Medicaid, should cover the cost of hepatitis B testing for pregnant women. Find out more about the birth dose here.

We know getting tested for hepatitis B can be challenging. Schedules can conflict, the associated cost can be a barrier, and sometimes we do not want to find out our status due to possible stigma and discrimination. The good news is that you can reach out to your local clinic or community center to link to testing and vaccination for a low or at no cost with a culturally sensitive provider that might be able to speak your native language. Finding out our hepatitis B status can be scary. However, it is important to know because there are effective treatments for hepatitis B.

Find a testing and vaccine provider here!

Next, you can help create and build awareness of hepatitis B in your community. Do you and your community use social media like WhatsApp, Facebook, Twitter, and Instagram? You can share hepatitis B information with them here from the Know Hepatitis B Campaign from the Centers for Disease Control and Prevention (CDC) or follow the Hepatitis B Foundation on social media to share our posts with your friends and followers.

What Can Providers Do During National Minority Health Month? 

Providers also have a responsibility during National Minority Health Month. Providers can help educate their patients about hepatitis B, especially those at higher risk, and talk about testing and vaccination. Recently, the CDC’s Advisory Committee on Immunization Practices recommended universal hepatitis B vaccination for all adults ages 19-59. Healthcare practitioners should incorporate this recommendation into their practice to help reduce the number of new cases of hepatitis B in the United States.

Working together, we can commemorate National Minority Health Month and eliminate hepatitis B-related health disparities for the future!

References

  1. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
  2. https://www.pewresearch.org/fact-tank/2020/08/20/key-findings-about-u-s-immigrants/

About Hepatitis B, HBV, Living with Hepatitis B

Feelings of Sadness and Hepatitis B? – You Are Not Alone!

 

Why Did This Happen to Me? 

Being diagnosed with hepatitis B can be scary and maybe you feel like you can’t tell anyone, but you are not alone. Living with hepatitis B is more common than you think, about 300 million people are living with hepatitis B worldwide! You might be wondering how could this happened to me?

Did you know that hepatitis B is an ancient virus? It has been around for thousands of years, is most common in Africa, Asia, and the Western Pacific. And transmission of the virus is almost always from mother-to-child, due to the blood exchange during labor and delivery. Most people with chronic hepatitis B infection were infected at birth or during early childhood. There are other, less common ways hepatitis B can be transmitted through unsterile medical or dental equipment, unprotected sex, or unsterile needles.

Feeling Sad After Your Hepatitis B Diagnosis?

 Sometimes after our diagnosis, we might feel overwhelmed with emotions. These emotions could be anger, sadness, anxiousness, numbness, or maybe a combination of everything. It never hurts to ask someone for some help. Consider going to a therapist. Talking to a therapist, especially if you’ve always kept your hepatitis B a secret, can help you get a better handle on your hepatitis B diagnosis. It can be freeing to talk to another person and have them support you on your emotional and physical health journey. If you don’t have access to a therapist or prefer to be more anonymous, you can join online support groups. Hep B Community is a great resource if you are in need of online global support – they are dedicated to connecting people affected by hepatitis B with each other and with verified experts in the field, who provide trustworthy and accurate advice.

You can also incorporate healthy habits into your lifestyle like taking daily walks, mediation, or incorporating any exercise you enjoy. Eating healthy, with lots of fruits and vegetables can make you feel better inside as well!

Can I Take Anti-Depressants with Medication for Hepatitis B?

 Sometimes, if we have persistent sadness for a long time it can be diagnosed as depression. Luckily, depression can be treated with medication called antidepressants. Antidepressants generally do not harm the liver, unless you have severe, pre-existing liver damage (such as cirrhosis), are older, or are taking several medications at once.

According to research, about 0.5 percent to 3 percent of those taking antidepressants may develop very mild elevation in their liver enzymes (called ALT or SGPT), which indicate mild liver damage. It is a good idea to talk to your doctor about this. If you already have liver damage, or you/your doctor are concerned, your doctor can monitor your ALT/SGPT levels more frequently than usual during your first weeks of antidepressant treatment, especially if your ALT/SGPT level is already elevated.

The antidepressants that may cause the highest risk of moderate liver damage,  include monoamine oxidase (MAO) inhibitors, tricyclic/tetracyclic antidepressants, nefazodone, bupropion (Wellbutrin, also used for ADD and smoking cessation), duloxetine and agomelatine.Drugs with lower risk of causing liver damage include citalopram, escitalopram, paroxetine (Paxil) and fluvoxamine.

Among the most common antidepressants used today is fluoxetine (Prozac).  According to the National Institutes of Health LiverTox report,  in people with no pre-existing liver infections or damage, “Liver test abnormalities have been reported to occur rarely in patients on fluoxetine (less than 1 percent), and elevations (in ALT/SGPT) are usually modest and usually do not require dose modification or discontinuation.”

Feeling sad and depressed is normal reaction to receiving news that you have hepatitis B. However,  hepatitis B does NOT define you and a gentle reminder is that you can live a long and healthy life with hepatitis B.

About Hepatitis B, HBV, Living with Hepatitis B

Zero Discrimination Day

Every year, UNAIDS marks March 1st as Zero Discrimination Day. This year, Zero Discrimination Day highlights “the urgent need to take action to end the inequalities surrounding income, sex, age, health status, occupation, disability, sexual orientation, drug use, gender identity, race, class, ethnicity and religion that continue to persist around the world”.

Although hepatitis B affects about 300 million people worldwide, hepatitis B related discrimination still is pervasive. In fact, the Hepatitis B Foundation has been documenting these inequalities through our Discrimination Registry. Since May of 2021, we have documented over 250 cases of hepatitis B related discrimination from all over the globe. Of these cases, 213 individuals experienced discrimination personally and 151 knew of people who were discriminated against. Within these reports, people have described instances where they have been denied employment or lost employment due to their hepatitis B status or had been denied educational opportunities or immigration to another country. The top 10 countries where people have reported hepatitis B related discrimination are the Philippines, Nigeria, India, Pakistan, United States, Ghana, Uganda, Ethiopia, Bangladesh, and Sierra Leone. The Hepatitis B Foundation is aware that discrimination is happening around the world and encourages people to report any discrimination on the registry here.

Notably, the United States is in the top 10 countries where people have reported hepatitis B discrimination. Most of the reporting within the United States comes from individuals in the military living with hepatitis B. Currently, the military in the United States and many countries unethically prohibits individuals with hepatitis B to serve due to outdated guidelines. Now, since most individuals within the military setting should be vaccinated against hepatitis B and with the accessibility of hepatitis B antiviral therapy which can control the virus, the risk of transmission is extremely low. These guidelines should be updated to reflect national policies in the United States that prohibit discrimination. In the broader setting of the U.S. outside of the military, it is illegal to discriminate against people living with hepatitis B. The Americans with Disabilities Act (ADA) prevents employers, institutions, and other organizations from discriminating against an individual based on their hepatitis B status. The Hepatitis B Foundation hopes to one day end hepatitis B related discrimination not only in the United States, but also globally.

Ending hepatitis B related discrimination globally will require incredible effort from multiple partners like governments, organizations, community advocates, and people living with hepatitis B. The first step is demonstrating that discrimination is a serious issue around the world that impacts one’s life in a variety of ways, both economically and psychologically. The discrimination registry that we launched in 2021 will help us document discrimination around the world and help us determine areas of focus. We want to publish and share what we find from this registry so academic partners, policy leaders, advocates and health professionals can be made aware of the current situation and challenges people living with hepatitis B face. We hope to maintain this registry so we can assist people experiencing hepatitis B related discrimination. And we want to create a global movement to enact change, advocating for ending policy and practice that allows for discrimination, and instituting policies that protect people with hepatitis B worldwide. But we need your help – people living with hepatitis B, and people who have faced discrimination, are the most important partners in this effort! We need you as partners, to maintain the registry and fight hepatitis B related discrimination, and ensure the fight for equality continues. We are currently fundraising to keep the Discrimination Registry going and expand on these plans to help fight discrimination globally.

This fight against discrimination will take some time! Change does not happen overnight. Improving awareness, growing an advocacy movement, engaging leaders and decision makers, and especially changing policy, can take years – but we must continue our work together. The Hepatitis B Foundation has long been dedicated to assisting in discrimination related causes. In fact, the Hepatitis B Foundation played a key role in a landmark settlement by the U.S. Department of Justice that established protection for people with hepatitis B under the Americans with Disabilities Act (ADA). That effort took three years to see policy change once we took up the fight, but it was worth it to have protections in place for people with hepatitis B. Learn more in our Know Your Rights section.

On Zero Discrimination Day, March 1st, and moving forward, please continue to use your voice to speak out against discrimination. If you need assistance please fill out the Discrimination Registry to document your experience and the Hepatitis B Foundation will try its best to assist you and navigate you through it.

Baruch S. Blumberg Institute