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Hepatitis B Awareness, World Hepatitis Day

292 Million People Worldwide Have Hepatitis B – So Why Do We Feel Alone?

 

Hepatitis B is the global pandemic no one talks about, yet 292 million people worldwide have been infected. In 2015, the World Health Organization estimated that hepatitis B caused 887,000 deaths annually.

Today, 292 million people have chronic hepatitis B1. Despite the availability of an effective vaccine, the number of people living with hepatitis B virus is projected to remain at the current, unacceptably high level for decades and cause 20 million deaths through 2030.

How can this happen? Viral hepatitis infection and death rates far outstrip that of ebola and zika. In fact, you have to combine the death toll from HIV and tuberculosis to find human suffering on par with what viral hepatitis causes around the world each year. How has this pandemic remained so hidden and ignored for so long? There are several factors that have kept hepatitis B off public health’s global radar. It’s a complicated, silent infection, often with few or no symptoms. Those who have it have been silenced by shame and ignorance, and more than two-thirds of those infected with hepatitis B have never been tested and are unaware of their positive status.

And then there’s avoidance by the global healthcare community. The development of a hepatitis B vaccine 40 years ago was thought to signal the death knell of this disease. While new infections have plummeted in North America and Europe, in impoverished countries, the vaccine is often not available or too expensive and infected mothers continue to unknowingly infect their children at birth.

There have been successful hepatitis B immunization campaigns around the world, even in poor, remote areas, but there’s a catch. The Global Vaccine Alliance (Gavi) provides a free hepatitis B pentavalent vaccine which is effective in children starting at 6 weeks of age. To break the mother-to-child infection cycle, a different and more costly hepatitis B vaccine must be administered as-soon-as-possible, within 12 hours of birth. However, this vaccine is often unavailable and out-of-reach financially in rural Africa and Asia, which is why chronic hepatitis B rates remain stubbornly high and are projected to remain unchanged.

To successfully combat hepatitis B, communities need to launch campaigns that combat stigma and teach how to prevent the spread of the disease through education and immunization. They need the resources to test people for hepatitis B and vaccinate those who need it. They also need to teach healthcare providers how to treat patients with liver damage.

Fortunately, we have started to see change. On May 28, 2016, at the United Nations World Health Assembly, 194 countries made a historic commitment to eliminate viral hepatitis by 2030. The Global Health Sector Strategy for Viral Hepatitis pledges to reduce deaths from hepatitis B and C by 65 percent and increase treatment by 80 percent. This action is the greatest global commitment to viral hepatitis ever taken.

On July 28, 2016, a campaign called NOhep, the first global movement to eliminate viral hepatitis, launched on World Hepatitis Day by the World Hepatitis Alliance. This day was chosen to mark the birthday of Baruch S. Blumberg, MD, D.Phil, who won the Nobel Prize in Medicine for the discovery of the hepatitis B virus.

Many of our partners and other organizations around the world are raising awareness to highlight World Hepatitis Day. Here are some of the activities you can support.

WHO – The World Health Organization is celebrating World Hepatitis Day through its theme: Hepatitis-free future with a strong focus on perinatal transmission. Read more about their efforts here. You can register to join their global virtual event, WHO Commemoration of World Hepatitis Day, on July 28th 1pm-3:15pm CEST here.

Hep B United – Yesterday, in anticipation of World Hepatitis Day, Hep B United kicked off a week of action with a call where we heard about the importance of hepatitis B elimination from hepatitis B advocates and representatives Judy Chu and Grace Meng. You can advocate for hepatitis B elimination here.

Hep B United and the Hepatitis B Foundation will have a #ThrowbackWHD twitter storm all day July 28th,  World Hepatitis Day! Partners and hepatitis B advocates are encouraged to share memories from past in-person Hep B United Summits and Advocacy Days.  Share your memories, pics, and videos with the hashtags: #ThrowbackWHD #WorldHepatitisDay and #Hepbunite.

Global Liver Institute – On July 28 at 12:30pm-1pm ET, the Global Liver Institute will host GLI LIVE on the Global Liver Institute’s Facebook page. Dr Chari Cohen will discuss the progress and challenges with eliminating hepatitis B globally, and strategies for commemorating World Hepatitis Day.

DiaSorin hosts Dr. Robert Gish, renowned hepatologist and HBF medical director – July 28th, 12 pm ET. Register now for Laboratory Testing for Viral Hepatitis: What’s new and what has changed?

Hep Free Hawaii – On World Hepatitis Day, July 28th at 12pm HST, Hep Free Hawaii will unveil Hawaii’s first Hepatitis B Elimination Strategy. More information and registration here!

CEVHAP and Burnet Institute – The Coalition to Eradicate Viral Hepatitis in Asian Pacific and the Burnet Institute is hosting a webinar on July 24th at 11am (GMT+5) to discuss access to hepatitis care, the world of hepatitis amidst the COVID-19 pandemic, and literacy on COVID-19 and hepatitis. You can stream it here.

You can be part of this global social justice movement. Take action, speak out, and join the effort to eliminate viral hepatitis by 2030. In anticipation of World Hepatitis Day 2020, NOhep is asking you to urge governments worldwide to uphold their commitment to eliminate hepatitis B. Add your voice to the open letter here.

For more information, visit the NOhep website, the Hepatitis B Foundation website or Hep B United’s website to learn how to lend your voice to this fight and to help address hepatitis and save lives in your community.

 

Reference

  1. Razavi H. (2020). Global Epidemiology of Viral Hepatitis. Gastroenterology clinics of North America, 49(2), 179–189. https://doi.org/10.1016/j.gtc.2020.01.001

About Hepatitis B, HBV, HDV, Hepatitis B Awareness, Hepatitis Delta (HDV)

Know Your ABCs

What is Hepatitis?

Hepatitis simply means inflammation of the liver which can be caused by infectious diseases, toxins (drugs and alcohol), and autoimmune diseases. The most common forms of viral hepatitis are A, B, C, D, and E. With 5 different types of hepatitis, it can be confusing to know the differences among them all.

The Differences

While all 5 hepatitis viruses can cause liver damage, they vary in modes of transmission, type of infection, prevention, and treatment.

Hepatitis A (HAV) is highly contagious and spread through fecal-oral transmission or consuming contaminated food or water1. This means that if someone is infected with hepatitis A they can transmit it through preparing and serving food and using the same utensils without first thoroughly washing their hands. Symptoms of HAV include jaundice (yellowing of skin and eyes), loss of appetite, nausea, fever, abnormally colored stool and urine, fever, joint pain, and fatigue1. Sometimes these symptoms do not present themselves in an infected person which can be harmful because they can unknowingly spread the virus to other people. Most people who get HAV will feel sick for a short period of time and will recover without any lasting liver damage2. A lot of hepatitis A cases are mild, but in some instances, hepatitis A can cause severe liver damage. Hepatitis A is vaccine preventable and the vaccine is recommended for people living with hepatitis B and C. Read this blog post for a detailed comparison of hepatitis B and hepatitis A!

Hepatitis B (HBV) is transmitted through bodily fluids like blood and semen, by unsterile needles and medical/dental equipment and procedures, or from mother-to-child during delivery1. HBV is considered a “silent epidemic” because most people do not present with symptoms when first infected. This can be harmful to individuals because HBV can cause severe liver damage, including cirrhosis and liver cancer if not properly managed over time3. Hepatitis B can either be an acute or chronic infection meaning some cases last about 6 months while other cases last for a lifetime. In some instances, mostly among people who are infected as babies and young children, acute HBV cases can progress to a chronic infection3. Greater than 90% of babies and up to 50% of young children will develop lifelong infection with hepatitis B if they are infected at a young age.

Hepatitis C (HCV) is similarly transmitted like HBV through bodily fluids, like blood and semen, and by unsterile needles and medical/dental equipment and procedures. Symptoms of HCV are generally similar to HAV’s symptoms of fever, fatigue, jaundice, and abnormal coloring of stool and urine1, though symptoms of HCV usually do not appear until an infected individual has advanced liver disease. Acute infections of hepatitis C can lead to chronic infections which can lead to health complications like cirrhosis and liver cancer1. Read this blog for a detailed comparison of hepatitis B and hepatitis C!

Hepatitis Delta (HDV) infections only occur in persons who are also infected with hepatitis B1,3. Hepatitis Delta is spread through the transfer of bodily fluids from an infected person to a non-infected person. Similar to some other hepatitis viruses, hepatitis Delta can start as an acute infection that can progress to a chronic one. HDV is dependent on the hepatitis B virus to reproduce3. This coinfection is more dangerous than a single infection because it causes rapid damage to the liver which can result in fatal liver failure. Find out more about hepatitis B and hepatitis Delta coinfection here!

Hepatitis E (HEV) is similar to hepatitis A as it is spread by fecal-oral transmission and consumption of contaminated food and water1. It can be transmitted in undercooked pork, game meat and shellfish. HEV is common in developing countries where people don’t always have access to clean water. Symptoms of hepatitis E include fatigue, loss of appetite, stomach pain, jaundice, and nausea. Talk to your doctor if you are a pregnant woman with symptoms as a more severe HEV infection can occur. Many individuals do not show symptoms of hepatitis E infection1. Additionally, most individuals recover from HEV, and it rarely progresses to chronic infection. Read this blog for a detailed comparison of hepatitis B and hepatitis E!

Here is a simple table to further help you understand the differences among hepatitis A, B, C, D, and E.

Prevention

Fortunately, hepatitis viruses are preventable.

Hepatitis A is preventable through a safe and effective vaccine. The Centers for Disease Control and Prevention (CDC) recommend that children be vaccinated for HAV at 12-23 months or at 2-18 years of age for those who have not previously been vaccinated. The vaccine is given as two doses over a 6-month span1. This vaccine is recommended for all people living with hepatitis B & C infections

Hepatitis B is also preventable through a safe and effective vaccine. The vaccine includes 3 doses over a period of 6 months, and in the U.S. there is a 2-dose vaccine that can be completed in 1-month1,3. Read more here, if you would like to know more about the vaccine series schedule.

Hepatitis C does not have a vaccine, however, the best way to prevent HCV is by avoiding risky behaviors like injecting drugs and promoting harm reduction practices. While there is no vaccine, curative treatments are available for HCV1.

Hepatitis Delta does not have a vaccine, but you can prevent it through vaccination for hepatitis B1,3.

Hepatitis E does not have a vaccine available in the United States. However, there has been a vaccine developed and licensed in China1,2.

 

References

  1. https://www.cdc.gov/hepatitis/index.htm
  2. https://www.who.int/news-room/q-a-detail/what-is-hepatitis
  3. https://www.hepb.org/what-is-hepatitis-b/the-abcs-of-viral-hepatitis/

 

Hepatitis B Awareness

Take Pride in Your Health: LGBTQ+ & Hep B

June is Pride Month! As we celebrate our differences and recognize the rights of the LQBTQ+ community, it is important to highlight the health disparities that they face, and ways to overcome such difficulties. To help spread awareness about the impacts of hepatitis B within this group, we‘ve interviewed Thaddeus Pham, Co-Director of Hep Free Hawaii!

 

 

 

 

 

 

Hi Thaddeus! So to start off with, can you tell us a little about who you are, and why this topic is important to you?

Thanks, Michaela! Well, I am currently the Co-Director for Hep Free Hawaii, our statewide coalition dedicated to eliminating hepatitis and related harms on our islands. I am also the Viral Hepatitis Prevention Coordinator for the Hawaii State Department of Health, although most folks in the community have also dubbed me the “Queen of Hepatitis” hahaha. 

This work is important to me personally because I am a cisgender, gay man whose parents were born in Vietnam. As such, my work in public health has always been informed by the intersection of multiple identities, in this case, people who are LGBTQ+ and also foreign-born Asians or Pacific Islanders. That’s why I was so excited you asked me to chat about the impact of hepatitis B on gay and bisexual men. 

As the Queen of Hepatitis, can you explain more about hepatitis B & how it impacts members of the LGBTQ+ community?

Sure thing! First of all, hepatitis B is a highly infectious blood-borne disease that can be transmitted through sex, injection drug use, and from mother-to-child during childbirth. The hepatitis B virus attacks the liver and causes an acute (short-term) or chronic (life-long) infection. If untreated, it can lead to liver disease, liver cancer, and even death. 

In the United States, gay and bisexual men are at high risk for hepatitis B infection, usually through sex. According to the CDC, about 20% of new hepatitis B infections occur among this community. Think about that: 1 out of 5 new cases of hep B is a gay or bisexual man. To my community, I say: get tested!

Good point! What are some additional reasons to get tested for hepatitis B? 

Well, getting tested for hepatitis B is essential for many reasons:

  1. Hepatitis B is called a “silent infection”; there are usually no symptoms until it gets pretty bad (e.g., serious liver damage or even liver cancer). Liver damage can be happening even if you don’t notice any symptoms. Also, the virus can be spread even if you are asymptomatic. Testing is the only way to know for sure that you are not living with hepatitis B. 
  2. Co-infections with hepatitis B can be dangerous. People living with hepatitis C and HIV/AIDS are at higher risk of contracting hepatitis B, and will also suffer more serious complications.  Even a co-infection with hepatitis A, which is short-term, can cause liver damage. Knowing your hepatitis B status can help your healthcare providers treat you properly and lower your risk of liver disease and liver cancer!
  3. Acute infections can have future consequences. About 90% of hepatitis B infections in adults are acute. This means that your body will recover from the virus in 6 months or less. The virus will no longer be in your bloodstream, but it will be “sleeping” in your liver. Even though the hepatitis B virus is not causing any damage and you are not infectious, the infection can be reactivated by certain medications and treatments. That’s why it is important to know that both you and your healthcare provider are 100% sure of your hepatitis B status. 

Wow, so is hepatitis B preventable? 

Hepatitis B can be prevented with a vaccine! If you get tested for hepatitis B and learn that you have no infection and no immunity, you can get the 2-dose hepatitis B vaccine, which protects you in a month, or the 3-dose vaccine, which can offer protection in six months. If possible, get tested first because the vaccine will only protect you if you don’t have the virus yet. Also, remember to get ALL the recommended doses of the vaccine series so you can be fully protected. Finally, if you are unsure of your status, it is important to use a condom. A condom is effective in preventing transmission of hepatitis B as well as other STIs, including HIV.

Great! So, where can someone get tested or vaccinated for hepatitis B? 

Your healthcare provider can provide hepatitis B testing and vaccination services. If you do not have a doctor, federally qualified health centers, community health clinics like Planned Parenthood, and your local health department can test and vaccinate you for hepatitis B. The CDC  lists LGBTQ+-friendly health centers here. The vaccine is covered by most insurance providers, as well as Medicare part B for high-risk groups.

Is there anything I can do to help raise awareness? 

Let’s talk about it! Even though it is just as harmful as HIV, hepatitis B is not as widely discussed among gay and bisexual men. This is scary because the U.S. is seeing an increase in adult acute hepatitis B cases, and studies show that hepatitis B vaccination rates are low amongst gay and bisexual men. 

Talk to your friends, your partners, and your community to know their status, and to take action to protect themselves! The CDC has free resources that can help promote vaccination, as well as information that can help you get the discussion started. 

Thanks Thaddeus! Any final thoughts you would like to share with our readers? 

Thank YOU, Michaela! I really appreciate this opportunity to chat about the impact of viral hepatitis on gay and bisexual men. I think it is important to point out the LGBTQ+ community also encompasses our lesbian and bisexual sisters as well as our transgender and gender nonconforming siblings, who could also benefit from hepatitis vaccinations and care.  

Finally, I can’t help but think about Pride month in the context of the COVID-19 pandemic and Black Lives Matter protests. I am super grateful to work with Hepatitis B Foundation, who has always aligned with one of the core concepts of our hepatitis efforts in Hawaii: public health work is social justice work! 

Hepatitis Awareness Month, Hepatitis B Awareness

Join Hepatitis Partners for a Twitter Chat on May 19th, #HepTestingDay!

Join HepBUnited, NASTAD, National Viral Hepatitis Roundtable (NVHR) and CDC’s Division of Viral Hepatitis for a Twitter Chat on Hepatitis Testing Day, May 19th at 2 P.M. EDT.  The chat will highlight hepatitis events and allow partner organizations to share their successes, challenges and lessons learned from their efforts, particularly during this unique time. Partners will also highlight innovative strategies for outreach during COVID-19. This twitter chat serves to keep us all informed, raise awareness and share messaging. All are encouraged to join the twitter chat conversation with the hashtag #HepChat20, and to keep partners posted throughout the month about events and messaging with the hashtag #HepAware2020.

Continue reading "Join Hepatitis Partners for a Twitter Chat on May 19th, #HepTestingDay!" →

Baruch S. Blumberg Institute