Hep B Blog

All posts by hepbtalk

If Hepatitis B Is Sexually Transmitted, How Come My Partner Isn’t Infected?

Image courtesy of Canva

I thought hepatitis B was sexually transmitted? I just tested positive, but my partner tested negative, we’ve been together for years, what gives?

This question is a common one. Hepatitis B can be transmitted sexually, so why do some people — who were not vaccinated — never get hepatitis B from their sexual partners?

It comes down to factors, such as the type of sexual activity partners engage in, the viral load (HBV DNA) of the infected partner, and who is on the receiving end of infectious body fluids, especially blood (which contains the most virus), and semen.

Having one partner infected, while the other is not, can add more stress to an already traumatic hepatitis B diagnosis. “It was very confusing and made me question how was it possible I was the only one infected,” said a woman who tested positive while her husband tested negative. “I thought it was possibly a mistake, maybe I was a biological anomaly, which of course I was not.”

Let’s look at the factors that may play a role in transmission of hepatitis B infection through sexual activity.

Viral load: Semen, vaginal fluids and blood all contain the hepatitis B virus (HBV), and the higher the viral load in the blood of an infected individual, the more infectious they are considered to be. Having an undetectable viral load might reduce or eliminate the chance of transmitting the virus to someone during unprotected sex; research is still trying to assess whether a person with an undetectable viral load in the blood is able to transmit the virus through sex. This is a good reason for individuals living with hepatitis B to talk to their doctor about the benefits of starting antivirals if they have detectable HBV viral load in their blood; treatment which lowers the viral load in the blood might also serve as a prevention measure for transmitting the virus.

Once an individual tests positive for hepatitis B surface antigen (HBsAg), they should encourage their partners to get screened for hepatitis B, and vaccinated if they are still susceptible to the virus.

The timing of sexual activity: An infected person who is menstruating is more likely to transmit hepatitis B infection to an unvaccinated partner, because menstrual blood can contain higher levels of HBV than vaginal secretions. That is why dental dams and condoms are recommended to provide a reasonable barrier against exposure, during that time of the month.

The type of sexual activity: Certain sexual activities are far more efficient at transmitting hepatitis B virus than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a higher risk of transmission because of tears in the skin that can occur during penetration, which increases the likelihood of transmission of HBV to an unvaccinated partner.

Fingering carries a lesser risk, unless the infected partner is menstruating while the other partner has bruises or cuts on their hands that could allow entry of hepatitis B virus from the body fluid into the bloodstream. In such cases, gloves are highly recommended.

The hepatitis B status of the other partner: The “uninfected” partner could have already been infected and cleared the virus, or vaccinated as an infant. When a person is first diagnosed with hepatitis B, doctors often test his or her partner for only the hepatitis B surface antigen (HBsAg), which indicates a current hepatitis B infection. If they are negative for HBsAg, they are advised to receive the hepatitis B vaccine as soon as possible. However, this does not mean that they were never infected.

Testing for the hepatitis B surface antibody (also known as anti-HBs or HBsAb), and hepatitis B core antibody (HBcAb) is the only way to identify a past recovered infection or prior vaccination.

Hepatitis B is often called the “silent” infection because many people who get hepatitis B may not experience any of the alarming symptoms (like fever or jaundice). As a result, many individuals may never realize they were infected. A partner who tested negative for HBsAg, may actually have been infected in the past and cleared the infection and now has protective hepatitis B surface antibodies to forever safeguard them from infection. If they’re vaccinated without proper screening, then tested for HBsAb after vaccination, they will test positive for surface antibodies, without ever knowing that their antibodies resulted from a past infection, not immunization.

Bottom line, if one partner is diagnosed with hepatitis B and the other is not, it might seem unusual, but it is not uncommon. Just like any other virus, there is not a 100% chance of transmission with exposure. The undiagnosed partner should get tested using the 3-panel blood test (HBsAg, HBsAb, and HBcAb) and immediately vaccinated if they are still vulnerable to a hepatitis B infection (HBsAb negative).

The is safe, effective, and provides lifelong protection.

Take a quiz to find out how much you know about hepatitis B transmission: click here.

World Hepatitis Day 2018: Why is Hepatitis B testing Important?

 You can help raise awareness and save lives…

Tell us why you think hepatitis B testing is important?

Globally, 292 million people are living with chronic hepatitis B. Only 10 percent are aware of their diagnosis. The theme for this year’s World Hepatitis Day is “Find the Missing Millions.” Help us raise awareness for World Hepatitis Day (July 28th, 2018) by telling the world why it is important to get tested for hepatitis B!

Create an awareness message about hepatitis B by answering the prompt below.The Hepatitis B Foundation will compile video entries for a larger video that will be released on World Hepatitis Day, July 28, 2018.

Who Can Enter? Anyone across the world!

Here’s how to Enter:

  1. Record a short video or an audio clip of yourself (15 seconds or less) answering the prompt, “People should be tested for hepatitis B because ….”

2. Note: You may choose the audio option if you wish to remain anonymous. Film yourself answering the above question. Your face and/or your picture does not have to be in the video; however, we must be able to hear you. If you choose to record an audio clip you are welcome to send a picture from your country or something that represents you. 

Keep your video no longer than 15 seconds!

  1. Send your video to us:
  1. When you send your video, please mention that you wish to participate in the World Hepatitis Day 2018 Campaign.

Video Tips/Guidelines

  1. Your video must be 15 seconds or less
  2. Your video should be in English

Note: If your video is recorded in a language other than English, please provide the English translation. If possible, provide a timed script with timings of phrases.

  1. Videos must be recorded in Landscape/horizontal mode. Videos recorded in a Vertical format cannot be used.
  2. Record your video in a quiet area or with a microphone.
  3. Record your video in good lighting.

Disclaimer

By submitting a video to this campaign, participants give the Hepatitis B Foundation permission to use their videos (audio and video), in the World Hepatitis Day campaign and promotion, as well as in future hepatitis B awareness efforts. The participant will waive any claims to royalty, right, or remuneration for such use. The Hepatitis B Foundation will not disclose any personal information obtained from participants (i.e., full names, email addresses, etc.) in the campaign to third parties or use the information for marketing or other purposes.

For inspiration, visit our website, World Hepatitis Alliance’sFind the Missing Millionscampaign, and CDC’s and Hep B United’s Know Hepatitis Bcampaign.

Submission Period: You must submit your video by July 20, 2018 (Submission closes at 11:59 PM EST on 7/20/18)

Have Questions? Please contact Kristine Alarcon at kristine.alarcon@hepb.org

Additional  information can be found at hepb.org/worldhepatitisday2018.

Journey to the Cure: What do I do if I’m pregnant and have hep B? ft. Maureen Kamischke

Welcome to “Journey to the Cure.” This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.

In the third episode (part 1), Kristine Alarcon, MPH sits down with Maureen Kamischke, Hepatitis B Foundation Social Media Manager, to discuss what expectant mothers can do when they have hepatitis B.

For any questions about hepatitis B, please email info@hepb.org.

The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure and improving the lives of those affected by hepatitis B worldwide through research, education and patient advocacy. Visit us at www.hepb.org, on Facebook at www.facebook.com/hepbfoundation, on Twitter at @hepbfoundation, and our Blog at www.hepb.org/blog

Disclaimer: The information provided in this video is not intended to serve as medical advice or endorsement of any product. The Hepatitis B Foundation strongly recommends each person discuss this information and their questions with a qualified health care provider.

Edited:
Kristine Alarcon, MPH

Special thanks:
Samantha Young

Music:
Modern – iMovie Library Collection

What New Treatments Are on the Horizon for Hepatitis B/D Coinfected Patients?

Although there are highly effective treatments available to manage hepatitis B, there are few available treatments for hepatitis D, and none are U.S. Food and Drug Administration (FDA) approved. Hepatitis D is the most severe form of viral hepatitis, and coinfection can accelerate liver damage and cause cirrhosis or liver cancer in as little as 5 years for some patients. Currently there is no approved drug for acute or chronic hepatitis B/D coinfection, but in trials pegylated interferon alpha has shown to be somewhat effective. By stimulating the body’s immune system, around 25-30% of patients are able to suppress their hepatitis D viral load with weekly injections over 48 weeks. Emerging research is showing higher rates of effectiveness with prolonged interferon treatment beyond one year, but it can be difficult for patients to continue due to the physical and mental toll of interferon on the body. Antiviral medications that are proven effective against hepatitis B are sometimes prescribed along with interferon therapy for patients with a high hepatitis B viral load, but these have no effect on hepatitis D. It is urgent that more treatment options be developed for the millions of hepatitis B/D patients that are eagerly awaiting them.

The good news is that with renewed scientific interest, research and funding, eight new drugs are currently in development that offer hope for more treatment options in the coming years. Two drugs have even been granted special designations by the FDA and one by European Medicines Agency (EMA), paving the way for increased resources and funding for development. Due to recent advancements, the future looks hopeful, and within a few years it is likely there will be more treatment options available. Below is a chart that provides more information on these new drugs and their current clinical trial status.

Pegylated Interferon Lambda

Pegylated-interferon-lambda (PEG-IFN-λ) is a well-characterized, late-stage, first in class, type III interferon that stimulates cell-mediated immune responses that are critical for the development of host protection during viral infections. This drug has now been granted “Orphan Drug Designation” by the FDA, fast-tracking the development process.

Myrcludex B

This drug is an “entry inhibitor” that prevents the virus from entering into hepatocytes (liver cells) and has shown activity against the hepatitis B virus. It may also stop the development of a hepatitis D infection. A recent study showed promise for Myrcludex B when combined with PEG-INF in reducing hepatitis D viral levels. It has been granted PRIME Eligibility by the European Medicines Agency, a status that promotes support in development of drugs that serve an unmet medical need.

Ezetimibe

Currently used to lower cholesterol in the blood, Ezetimibe is being studied for effectiveness against hepatitis D. Ezetimibe possesses pharmacophore features to stop NTCP, the receptor required for hepatitis B and hepatitis D hepatocyte entry.

Lonafarnib

This drug works by targeting the protein assembly process, preventing the production of new virus particles. In a current clinical trial, Lonafarnib combined with Ritonavir has shown promise in reducing hepatitis D viral levels, and the FDA has granted it fast-track status since this class of drugs have been developed for the treatment of cancers and have been shown to be safe.

Rep 2139

This compound is known as a “Nucleic acid-based Amphipathic Polymer” (NAP) which prevents the release of hepatitis B surface antigen (HBsAg) from infected liver cells and is being evaluated for hepatitis D virus in combination with pegylated interferon (PEG IFN).

GI-18000

GI-18000 Tarmogen is being studied for its effectiveness in causing a T cell immune response against cells infected with Hepatitis D and thereby improving outcomes. The strategy is to identify molecular targets that distinguish diseased cells from normal cells and activate the immune system to selectively target and eliminate only the diseased cells.

ALN-HDV

This approach is being used for both the hepatitis B and hepatitis D virus to “silence” the viral RNA with compounds that interfere with and cause the destruction of the viral genome (e.g. stop replication of the virus).

As clinical trials progress, sites may open across the world that are enrolling hepatitis D patients. Keep checking here for an up-to-date list of all current clinical trials.

Click here for more information about the phases of the clinical trial process.

For more information about hepatitis B/D coinfection, please visit www.hepdconnect.org or email us at connect@hepdconnect.org.

Join a Twitter Chat: Organizations Share Highlights From Hepatitis Awareness Month

Join Hepatitis B Foundation, NASTAD and CDC’s Division of Viral Hepatitis for a Twitter #HepChat at 2 p.m. (EST) Thursday, June 14. The chat will highlight Hepatitis Awareness Month outreach events and allow hepatitis B and C partner organizations to share their successes, challenges and lessons learned from their efforts. HBF’s Kristine Alarcon and Jason Crum, this month’s featured storyteller will also be LIVE on Facebook, so if you’re not on twitter join us at hepbfoundation.

Continue reading "Join a Twitter Chat: Organizations Share Highlights From Hepatitis Awareness Month"

May 19 is National Hepatitis Testing Day

May is Hepatitis Awareness Month and Saturday, May 19this National Hepatitis Testing Day in the United States. This day is an opportunity to increase awareness and testing for both hepatitis B and C. It is also a reminder for health care providers and the public of the importance of testing for viral hepatitis.

Why is hepatitis B testing necessary? Hepatitis B is largely asymptomatic, which means that symptoms don’t always occur or are not obvious. Some people will not know that they have hepatitis B until it is too late, or they may learn of their infection from a blood donation screening or lab work.  There are groups of people who have a greater risk of hepatitis B compared to others, so it doesn’t hurt to be sure. here are some places around the world that have an extremely high hepatitis B prevalence (where many people are infected). It is important that people who are at high risk for a hepatitis B infection see a doctor to get tested, to find out if they have a hepatitis B infection. People living with chronic hepatitis B should be monitored regularly and appropriately screened for liver cancer. So, if you find you do have hepatitis B, talk to your doctor about what to do next.

Remember, hepatitis B does not discriminate. Don’t wait for symptoms. B sure. B tested. If you do not have hepatitis B, then give yourself lifelong protection with the hepatitis B vaccine. The hepatitis B vaccine is safe and effective. Children or adults can get the 3-shot vaccine series, and there isa newly approved two-dose adult vaccine to protect us against hepatitis B! However, the vaccine doesn’t work if you are already infected.

Don’t forget to check out these free, confidential hepatitis screenings this weekend! Check out Hep B United’s resource to find local events in your area. You can also visit the CDC’s website for more ideas on how to increase awareness on National Hepatitis Testing Day, and every day!

Hepatitis Victoria’s “Little Hep B” Hero Book

Hepatitis Victoria in Melbourne, Australia recently released their “bright, colorful, positive and silly” children’s book, Little Hep B Hero! In addition to creating a book, Hepatitis Victoria also created an animation.

Little Hep B Hero, which is available in English, Simplified Chinese and Vietnamese, gives children and their families a delightful glimpse into a young girl’s visit to her neighbor and friend, Rosa. As Rosa and the young girl prepare food and lemonade together, Rosa tells her about living with chronic hepatitis B. Rosa explains what the liver does, what hepatitis B is, how the virus is transmitted, how she maintains a healthy lifestyle with chronic hepatitis B, and shares tips on preventing hepatitis B transmission. Little Hep B Hero also provides cute and easy to understand visuals of the little girl as a superhero while Rosa explains this information.

The book does an excellent job of explaining liver functions and what the hepatitis B virus does to the liver! The analogy of using a sieve to demonstrate how the liver filters toxins in the body was creative. The book also does a great job of indirectly tackling some myths associated with hepatitis B. For example, people are often hesitant to share meals with those living with chronic hepatitis B. Little Hep B Hero lets its audience know that you cannot get hepatitis B through food preparation or sharing a meal, so Rosa cooks a meal for her neighbors.

Little Hep B Hero is an important read for future generations and their families! Getting the conversation started early about hepatitis B will address the stigma and discrimination associated with it. When children are talking about hepatitis B and are knowledgeable about it, hepatitis B isn’t a scary topic anymore. The message of hepatitis B as a family matter highlights the importance of educating and testing family members.

For more information, check out their press release, and to purchase Little Hep B Hero, visit Hepatitis Victoria’s website here.

May is Hepatitis Awareness Month

Hepatitis Awareness Month is dedicated to increasing awareness of hepatitis in the United States and to encourage high risk populations to get tested. If you’re not sure how you can get involved in the hepatitis B community this month, here are some ways you can!

  • Share and spread hepatitis B knowledge. CDC’s Know Hepatitis B Campaign is a great resource to learn more about hepatitis B and to promote testing in your area! They also have great posters, handouts, and videos available in different languages including Spanish, Mandarin, Vietnamese, Korean, French, and more! You can also look for some of the Hepatitis B Foundation’s fact sheets and #justB storytelling campaign videos.
  • Join or organize a screening event. May 19th is National Hepatitis Testing Day! Organizations around the country will provide viral hepatitis screenings – both hep B and C! Be sure to look for some Hep B United partners’ websites for screenings in your local area, especially if you’re interested in volunteering.
  • Organize or join a flash mob to increase awareness! With our local hepatitis B campaign in Philadelphia, Hep B United Philadelphia, we held a “B A Hero Flash Mob” in the past. It is a great way to open the discussion about hepatitis B in an engaging and fun way!
  • Become an HBV advocate! You can join our Hep B United Action Center to get all the updates on our advocacy efforts. You can also share your hepatitis B knowledge on social media too!
  • Check out and share Hepatitis Victoria’s Little Hep B Hero book and animation. Hepatitis Victoria created an engaging book to explain hepatitis B to six to twelve-year-old children. Their book is available to order and in English, Simplified Chinese, and Vietnamese.
  • Join the #HepAware Thunderclap. You can easily share and show your support for CDC Hepatitis’s efforts by joining their Thunderclap by May 19th, Hepatitis Testing Day. You can use Facebook, a Facebook page you manage, Twitter, and Tumblr.
  • Join our international #HepBeLIeVER Social Media Contest. Not only will you be spreading hepatitis B awareness, but you can also get a chance to WIN a $50 AMAZON GIFTCARD and other Hepatitis B Foundation swag. All you have to do is take a picture loving your liver and upload it to Twitter, Instagram, or Facebook with #HepBeLIeVER. More information here.

There are endless possibilities to celebrate this month! If you need even more ideas, CDC has a plethora of resources available dedicated to Viral Hepatitis Awareness month. You can also check out our Hepatitis Awareness Month webinar from Hep B United, NASTAD, and CDC or Hep B United and NOHep’s webinar: The NOHep Fight for Elimination!

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

Journey to the Cure: What Programs are Available for People Living with Hepatitis B?

Welcome to “Journey to the Cure.” This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.

In the second episode (part 2), Kristine Alarcon, MPH sits down with Chari Cohen, DrPH, MPH, Vice President of Public Health Programs of the Hepatitis B Foundation, to talk about public health research at the Hepatitis B Foundation.

For any questions about hepatitis B, please email info@hepb.org.

Disclaimer: The information provided in this audio post is not intended to serve as medical advice of endorsement of any product. The Hepatitis B Foundation strongly recommends each person discuss this information and their questions with a qualified health care provider.

Edited by:
Kristine Alarcon, MPH and Samantha Young

Music:
Modern – iMovie Library Collection

Script:

Welcome to Journey to the Cure! Every month, we’ll sit down with scientists from the Hepatitis B Foundation and the Baruch S. Blumberg Institute to talk to you about hepatitis B and efforts to find a cure for hepatitis B. There’s still a long way to go, but we’re here to walk you through our journey.

Kristine Alarcon, MPH:
In our last episode, Dr. Block was talking about how the Hep B Foundation is dedicated to public health research. Can you tell us more about that?

Chari Cohen, DrPH, MPH:
One of our major goals is to get everyone in the United States – or in the world really – but primarily in the US, everyone who has hepatitis B should be aware of their diagnosis and should be able to access to care. In order to do that, we have to do research. We have to figure out what are the best ways to get people tested and into care. In order to do that, we have to first figure out why people aren’t getting tested now, what barriers are people facing, what challenges are people facing to get tested, and how can we help them overcome those challenges. Every time we do a public health program, we are also doing research, so we are collecting a lot of data. And then, we use the data to develop new programs, and we share it with others as well. We also collect information and data on prevalence, so looking at where some of the high risk and highly impacted communities are in the U.S. We will do testing ourselves. We’ll go into communities in Philadelphia, and we’ll do hepatitis B testing. Through that, we know which communities need more care.

Kristine Alarcon, MPH:
What types of public health programs are you carrying out right now?

Chari Cohen, DrPH, MPH:
We have a number of different programs right now. One is our Hep B United Philadelphia program, where we like to train the trainers. In Philadelphia, we’re training people who do health education; we’re training community leaders; and we’re helping them to learn about hep B, so that that they can go into high risk communities and teach other people about hep B. We’re also screening a lot of people. This year, we screened a little over 200 people for hepatitis B. When we find people to be infected, we link them into care. We’re also working on a new project, looking at the challenges that African immigrants face in the US in terms of hepatitis B testing. We’re trying to figure out what are the best ways to overcome those challenges and what are the best ways to get people tested and into care. And then, we have our #justB program, which is our national patient storytelling program, where people who have hep B or with family members who have hep B tell their stories and make videos, and they share how hep B has impacted their lives.

Kristine Alarcon, MPH:
Thank you so much for joining us in this episode!

Chari Cohen, DrPH, MPH:
Thank you!