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Category Archives: Hepatitis B Diagnosis & Monitoring

Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Living with Hepatitis B

Hepp-B Valentine’s Day: What to do on Valentine’s Day when you have hepatitis B.

Happy Valentine’s Day!! Today is dedicated to celebrating love. Though it can be exciting, anxiety can creep up on this day too. Maybe you’re thinking about confessing your feelings to your crush? Or nervous about planning the best date ever? Maybe you’re timid about the holiday in general because of your hepatitis B status?

If you have chronic hep B, you may think that starting a relationship and initiating sex can be stressful and feel overwhelming. Questions like “What if we break up because I disclosed my status?” or “Can I even start a relationship with someone if I have a chronic disease like hepatitis B?” may be swimming in your mind. Doubt and anxiety may overwhelm your thoughts, but don’t forget that you’re more than your illness. You should not focus on things you cannot change. You are worthy of love and can live out that romantic story you always wanted because you have wonderful things to offer to a future love interest.

If you’re spending time with someone on Valentine’s this year or any day, it’s important that you remember to take precautions if your date leads to an intimate night. If you are living with hep B, properly wearing a latex condom keeps you safe from becoming co-infected with another infectious disease. No one wants a co-infection. It is complicated and potentially dangerous for you and your partner’s health. If your partner does not have hep B, then avoid infection by wearing a condom. Hep B is vaccine preventable, but hepatitis C, HIV and other sexually transmitted infections (STIs) are not. Considering the health and safety of yourself and your sexual partners is paramount. You may not know what they have, and they may not know what you have.

Also, it is important to disclose your status before sex (even if it’s safe sex with a condom). You may jeopardize your partner’s trust (and their health) before the relationship deepens. Disclosing your chronic hep B status can be scary, but talking about it reduces the stigma surrounding the infection and may even prompt your partner to get tested or vaccinated if needed. If your partner is not understanding after you have explained your HBV infection, then you know that person was not meant for you, and not deserving of your love. There are other potential partners out there that will be understanding and loving. Do not let rejection discourage you!

Disclosure should be done calmly and carefully. It is important to do some research before you do disclose your hepatitis B status. Having a thorough understanding of hepatitis B can make it easier for you to explain it to a future partner. The more you know, the less scary and more comfortable it is to dispel fear, so that you can share your status with confidence and integrity.

Whether you think of today as Valentine’s or Single Awareness Day, remember that hep B is only a small part of who you are and should not be a reason for you to give up on loving someone. Remember that you are more than your chronic hep B! It’s only a part of you and does not define your entire life. You have so much to offer to your current or future partner!

Read our previous posts about dating and hepatitis B, advice for navigating the dating world for those with hepatitis B, disclosing your status on Valentine’s, loving safely on this holiday, and tips for disclosure (or a #justB video).

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Living with Hepatitis B

Adoption and Hepatitis B

Have you been thinking about adoption for a long time or have been inspired by NBC’s show, This is Us, to adopt? Adoption is exciting! However, it can be nerve wracking and feel overwhelming. We at the Hepatitis B Foundation can help with one aspect of the adoption process – making sure you have accurate information about hepatitis B.

It is important to be armed with accurate information about hepatitis B when preparing for adoption for both international and domestic adoptions. This can help protect your future child, family members and yourself when you welcome your future child with open arms.

Many people wish to adopt children from countries where hepatitis B infections are common: Asia, South America, Eastern Europe, and some parts of Africa. Children from these regions could be infected with the virus since it can be unknowingly passed from birth mothers who have hepatitis B and transmit the disease to their children during delivery. In addition, many of these countries struggle with proper infection control practices that place babies and young children at risk with unsafe medical procedures. Unfortunately, many infants still do not have access to the birth dose of the hepatitis B vaccine to help prevent transmission.

Domestic adoptions also present some risk. Children born to women in high-risk groups (e.g. illicit drug users, multiple sexual partners, etc.) could be exposed to hepatitis B at birth. In addition, children from group homes are at increased risk for hepatitis B infection. The good news is that there are procedures in place that can prevent a baby from getting infected if born to an infected mother – and the success rate is up to 95%! This includes providing the first dose of the hepatitis B vaccine along with a dose of hepatitis B immune globulin (HBIG) within 12 hours of birth. If you are planning a U.S. adoption, and know that the birth mother is infected, you can ensure that the birth hospital knows about these procedures and can administer the shots on time.

During the adoption process, the adoption agency should tell you if your child has been tested for hepatitis B, but there can be errors if the child was tested only as an infant. With an international adoption, it is advised that you do not request that your child be tested since the blood test itself could be a source of infection. If you are concerned about the results of these tests, please contact us to speak with our knowledgeable staff. We can also refer you to a parent who has adopted a child with hepatitis B. Whether your child has been diagnosed with hepatitis B or not, testing for HBV should be repeated once you’re home. If needed, you can refer to our physician directory to find a pediatric specialist who knows about hepatitis B.

If you do find out that your child does have hepatitis B, you can handle it!Hepatitis B is a manageable disease. Many families seeking a “special needs adoption” choose to adopt a child with chronic hepatitis B because it is manageable and treatable. Hepatitis B is a vaccine preventable disease, so newly adopted children can be safely integrated into vaccinated families. Children with chronic HBV can expect to live a long and healthy life if they are monitored by a pediatric liver specialist. Some may need treatment during childhood, most probably won’t. Hepatitis B does not affect a child’s growth and development, and there are generally no restrictions associated with chronic hepatitis B. It is recommended that those with chronic hepatitis B see a pediatric liver specialist every six months for hepatitis B management. Often this entails only blood work to monitor the child’s HBV and liver health. Also make sure household members are vaccinated and that you talk to talk to all of your children about the importance of handwashing and “never touching anyone’s blood”. When your children get older, help them acclimate to dating and disclosure. The hepatitis B vaccine is required for school in all but four states.

For some tips, you can visit our website on adoption, children with hepatitis B, and one of our previous blogs. You can also watch some adoption stories from our #justB storytelling campaign. Be sure to watch Maureen’s, Maureen K’s, and Jin’s stories about the international adoption process with hepatitis B. You can also watch Janet and Kurt’s domestic adoption process. Please consider opening your home to an adopted child. It will change your life.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

Journey to the Cure: What is Hepatitis B? ft. Timothy Block, PhD

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 first episode (part 1), Kristine Alarcon, MPH sits down with Timothy Block, PhD, President and Co-Founder of the Hepatitis B Foundation, to talk about the basics of 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 twitter@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 by:
Samantha Young

Music:
Modern – iMovie Library Collection

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

Checking In on Your New Years’ Resolutions for Hepatitis B

How are your New Years’ Resolutions going?  When you were making your resolutions, did you consider hepatitis B specific New Year’s resolutions?  Here are a few ideas…

  • Make an appointment to see your liver specialist.  If you have hepatitis B, and you are not being seen regularly by a liver specialist, or a doctor knowledgeable about hepatitis B every six months, then make the commitment to do so this year. It is important to know and keep track of your HBV status and your liver health. Check out HBF’s Directory of Liver Specialists. We do not have names and contact information for all countries, so please feel free to share your favorite liver specialist with the HBV community. Make an appointment today!

 

  • Organize your hepatitis B lab dataand make a table with the date of the blood draw and the associated blood test results. You’ll want to start by requesting copies of all of your labs from your doctor. Then you can generate data tables using Excel, Word or a pencil and paper table for your charted data.  It will help you visualize your HBV over time, and you may find your doctor likes to see both the lab results and your table of results.

 

  • Generate a list of questionsfor your next appointment with your liver specialist.  People get nervous anticipating what their doctor might say about their health. It is very easy to forget those important questions, so be sure to write them down, or add them to a note app on your phone or tablet. If the option is available, have a family member or friend attend the appointment with you. That will allow you to pay closer attention while your friend or family member takes notes for you.

 

 

  • Avoid the use of alcohol. Hepatitis B and alcohol is a dangerous combination. An annual toast to the New Year? Sure. Drinking daily, weekly or even monthly? Not a good idea.  Binge drinking? Dangerous. A studyshows an increased risk for liver cancer among cirrhotic patients with HBV. Don’t let it get that far. If you have HBV and you are still drinking alcohol, seek the help you need to stop.

 

 

  • Exercise. Many people think that having a chronic illness precludes them from exercise. This is rarely the case, but if you have concerns, talk to your doctor. If you consistently exercise, keep up the good work. If you don’t, please start slowly and work your way up to a more strenuous routine, and follow general physical activity guidelines for adults. Join a gym or find an exercise buddy. Don’t compare yourself to others and work at your own pace. Set realistic workout goals. You don’t need to run a marathon. Brisk, daily walking is great, too. You may find that you experience both physical and emotional benefits, and if you exercise with friends, you’ll also benefit socially. Clinical and experimental studiesshow that physical exercise helps prevent the progression of liver cancer and improves quality of life. It also helps prevent the development of non-alcoholic fatty liver disease (NAFLD or “fatty liver”. Get moving. It’s good for your overall health and specifically your liver!

 

  • Maintain a healthy weight by eating a well-balanced diet.This is a favorite on the New Year’s Resolution list for just about everyone with or without HBV. You can’t prevent or cure HBV with a healthy diet, but it does help by preventing additional problems like the onset of fatty liver disease or diabetes. If you’ve been following trending health problems, then you are well aware that fatty liver disease and type 2 diabetes are huge problems both in the U.S. and around the globe. Fatty liver disease and type 2 diabetes can often be prevented with a healthy diet and regular exercise. Start by avoiding fast foods, and processed foods. Cut down on fatty foods and sweets. Sugar (fructose) is not your friend. Avoid sugary treats and drinks with sugar, including sodas and fruit juices. Reduce the amount of saturated fats, trans fats and hydrogenated fats in your diet. Saturated fats are found in deep-fried foods, red and fatty cuts of meats and dairy products. Trans and hydrogenated fats are found in processed foods. With fatty liver disease, fat accumulates in the liver and increases inflammation. If you have hepatitis B, you want to avoid any additional complications that may arise with fatty liver disease. Diabetes and HBV together can also be very complicated.  So what should you eat? Eat plenty of fresh vegetables, fresh fruits, whole grains, fish and lean meats, and whole grains. Eat brown rice, whole wheat breads and pastas, instead of white rice, bread and pasta.  Go back to the basics! If you have specific questions about your diet, be sure to talk to your doctor.

 

  • Don’t worry, be happy… Easy to say, but not so easy to accomplish. Anxietyand depression associated with a chronic illness are challenging problems that may be short term, or can worm their way into nearly every aspect of your life. They can even create physical symptoms that may be confusing and may result in even more worry. Please talk to your doctor if you believe your anxiety or depression is something you are unable to manage on your own. Consider joining a support group where you can talk to others facing the same challenges. Personally, I found the Hepatitis B Information and Support List a wonderful source of information and support. Chronic illness can feel very lonely – especially with a disease like HBV that has a stigma associated with it. Find a trusted confident with whom you can share your story.

Check out our previous post about New Year’s resolutions to get more ideas and tips!

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

New Year’s Resolutions

Image courtesy of Wikimedia Commons

The holidays are over and it’s time for a fresh new year- a fresh new start! Have you made your New Year’s resolutions yet? Do you need some suggestions or help creating your list? Here are some ideas!

  • Be healthier.
    • One of the most popular New Year’s resolutions in the US is to be healthier, whether it is to eat healthier, get more exercise, and/or to head over to the gym more often. There are studies that continue to show the importance of exercise, which favorably impacts the health of your liver as well. Although there is no specific diet for chronic hepatitis B, studies show that eating cruciferous vegetables such as cabbage, broccoli, and cauliflower is good for the liver.  Green, leafy vegetables are also good for the liver. All of these veggies tend to naturally protect the liver against chemicals from the environment.  The American Cancer Society’s diet, which includes low fat, low cholesterol, and high fiber foods is a good, general diet to follow.  It is also good to avoid processed foods and foods from “fast food restaurants”. These foods along with too many foods high in saturated fats, and foods or sugary drinks with refined sugars and flours may result in fatty liver disease, which can also harm the liver. When possible, eat whole grains and brown rice. For more suggestions, check out the World Health Organization’s healthy diet and CDC’s tips for staying healthy.
  • See your doctor more often.
    • We encourage those chronically infected to be regularly monitored by a liver specialist, treated when necessary, and to make lifestyle changes that help keep the liver healthy. The most important thing is to find a doctor who is knowledgeable about hepatitis B, who can help manage your infection and check the health of your liver on a regular basis. The doctor will take blood tests, along with a physical examination of the abdominal area and perhaps an ultrasound, to determine the health of the liver. Talk to the doctor and see what he or she recommends. Don’t forget to get copies of test results for personal files to see how test results change over time
  • Stop drinking/limit alcohol.
    • Chronic hepatitis B and alcohol is a dangerous mixture.  Studies have shown that even small amounts of alcohol can cause damage to an already weakened liver.  Avoiding alcohol is one decision someone can make that will greatly reduce the risk of further liver disease. It is also important to avoid smoking and other environmental toxins.  For example, avoid inhaling fumes from paint, paint thinners, glue and household cleaning products, which may contain chemicals that could damage the liver.  Keep in mind that everything that you eat, drink, breathe in or absorb through the skin is eventually filtered by your liver and toxins are removed. If you can limit the toxins in your body, your liver will benefit.
  • Pursue your dreams.
    • Don’t let your hepatitis B status stop you!! Find friends, family members, colleagues, and/or doctors who can support and encourage you to learn about your hep B status. Become an advocate for yourself, just like our #justB storytellers!

Start off your resolutions with attainable goals! You don’t have to quit cold turkey and completely eliminate certain foods. Take it step by step! Keeping a journal and tracking your progress will help you keep an eye on those resolutions this year. Even if you break your New Year’s resolutions, don’t be discouraged! Everyone goes through pitfalls and experiences lows. The important thing is to start over again when you break your resolutions!

Check out our previous post on New Year’s resolutions for more ideas for your resolution this year!

Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B

Celebrating the Holidays with Hepatitis B

Image courtesy of Pixabay

The holidays are a joyous time as family and friends gather for parties, dinners and get-togethers. However, they can also be a difficult, stressful time on so many levels, and especially for those who might not yet have disclosed their hepatitis B to loved ones.  You may have been recently diagnosed, or decided this is the year you’re going to let them know about your status. If you’re not there yet, that’s okay, but consider making this the year you choose to disclose.

Enjoy and celebrate the holiday cheer, but …alcoholic beverages may be an issue during this time, and it may be tempting to indulge. The most important thing to do is not pick up that drink no matter what! Hepatitis B and alcohol is a dangerous combination. Here are some tips that may help you politely refuse a drink:

  • Practice saying no
  • Prepare a reason for not drinking (i.e., “Sorry, I’m taking mediation and I can’t drink.” or “My stomach is upset and I want to enjoy all this food.”)
  • Leave the event early if you feel uncomfortable.
  • Find others who are not drinking.
  • Choose a non-alcoholic drink – sparkling water with fruit is a healthy option!
  • Volunteer to be the designated driver. You may suddenly find you have many friends!

You might want to think long and hard about disclosing your status to coworkers and acquaintances.  Only you know for sure, but family and close friends can become a new source of support for you moving forward. If the holidays inspire you to share your status, you may start with talking about your family’s health history. Even though hepatitis B is not genetic and does not run in families like some other chronic diseases, it is possible that you may have hepatitis B because you were exposed to it from an infected family member, possibly at birth or by accidental household exposure; 90% of babies and 50% of young children who were infected with hepatitis B become chronically infected. It is also important to talk about hepatitis B if there is a history of liver disease and cancer in your family. Having hepatitis B can put you at an increased risk of developing liver disease and liver cancer during your lifetime.

Here are some other considerations:

  • Choose a time when there will not be too many distractions.
  • Think about whether your loved ones will be open and accepting.
  • Bring up an interesting fact to open up the conversation.
  • Ask a relative about their health history.
  • Try to break stereotypes surrounding hepatitis B.
  • Encourage your family members to get tested, vaccinated, or treated.
  • Family members may mention that “an uncle had liver problems”, or “died of cancer”, but not know if it was related to hepatitis B.
  • Be prepared with a printed fact sheet or video from the Hepatitis B Foundation or material from the Know Hepatitis B campaign!

Disclosure can be scary and make you anxious! When you are disclosing to a loved one, their response is out of your control, but their response might surprise you. Be prepared with simple explanations about hepatitis B. A Google search may highlight frightening statistics, so be sure to reassure loved ones that HBV is controllable and manageable.

Take a look at the videos from our #justB storytellers about how HBV has impacted their lives, and share them with family members. We must all do what we can to break the silence about hepatitis B so we can get more people tested and into care, and reduce stigma and discrimination!

For more tips on how to navigate the holidays with hepatitis B, check out our previous post here.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

It’s Flu Season! Did you get your shot?

Flu season is upon us! It usually ranges from the winter into early spring. It’s important that you get your flu shot, especially if you or a family member has a chronic disease such as hepatitis B.

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get the flu vaccine every year. Flu viruses change constantly from season to season and can even mutate during a single flu season. It takes 2 weeks for antibodies to develop, so get your flu shot today!

There are some people who cannot get the flu shot, including certain age groups, those with health complications, and those with allergies. However, there are still ways people can protect against getting sick. Be sure to wash your hands to prevent the spread of germs. If you feel you are sick, stay home from work or school.

While we all know antiviral drugs are effective against the hepatitis B virus, researchers have also developed antivirals that can help us fight the flu once it is confirmed someone are infected. People at high risk of serious flu complications (such as children younger than 2 years, adults 65 and older, pregnant women, and people with chronic hepatitis B) and people who simply get very sick with the flu should talk to their doctor about getting one of three available flu antiviral drugs–oseltamivir, zanamivir, or peramivir.

According to CDC, prompt treatment with a flu antiviral can mean the difference between having a mild case versus a very serious one that can potentially land you in the hospital.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still help if administered later during your illness. Antivirals are effective in all age and risk groups. Studies show some doctors do not prescribe antiviral drugs to people at high risk of complications from the flu, so be assertive and ask your doctor for them if you have the flu!

It’s time to get your flu shot! It will help you, your family, and friends get protected against the flu. To find out where you can get a flu shot, click here.

For more information about hepatitis B and the flu vaccine, check out our previous posts on the flu here, here, and here.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

HIV/HBV Co-Infection

World AIDS Day was last Friday, December 1st. It is a day dedicated to raising awareness about HIV and AIDS. However, it is also a great opportunity to discuss the possibility of coinfection with hepatitis B virus, HBV.

 Dr. John Ward, MD, Director, Division of Viral Hepatitis, CDC talks about hepatitis B, hepatitis C, and HIV epidemics in the United States.

Hepatitis B (HBV) and HIV/AIDs have similar modes of transmission. They can be transmitted through direct contact with blood, or sexual transmission (both heterosexual and MSM). Unfortunately, people who are high risk for HIV are also at risk for HBV, though hepatitis B is 50-100 times more infectious than HIV. Fortunately hepatitis B is a vaccine preventable disease and the vaccine is recommended for individuals living with chronic HIV.

Nearly one third of people who are infected with HIV are also infected with hepatitis B or hepatitis C (HCV).2 To break down the numbers further, about 10% of people with HIV also have hepatitis B, and about  25% of people with HIV also have hepatitis C.2 Liver complications due to HBV and HCV infections have become the most common non-AIDS-related cause of death for people who are HIV-positive.3

Who is at risk of HIV and HBV co-infection? Because both infections have similar transmission routes, injection drug use and unprotected sex (sex without condoms) are risk factors for both infections.4 However, there are additional risk factors for HIV and  for HBV that put people at risk4

It is important that people who are at risk of both diseases are tested! HIV-positive people who are exposed to HBV are more likely to develop a chronic HBV infection and other liver associated complications, such as liver-related morbidity and mortality if they are infected with HBV.1

If a person is co-infected with both HBV and HIV, management of both diseases can be complicated, so a visit to the appropriate specialists is vital.3 Some anti-retrovirals, which are usually prescribed to treat HIV, can eventually lead to antiviral resistance or liver-associated problems.3 One or both infections will require treatment and must be carefully managed.  Treatment differs from person to person .4

It is also important to hear about the perspectives of those who are living with co-infections. As a part of our #justB: Real People Sharing their Stories of Hepatitis B storytelling campaign, Jason shares his experience of living with both hepatitis B and HIV/AIDs.

To learn more about HIV and viral hepatitis coinfection, go here. For more #justB videos, go here.

References:

  1. Centers for Disease Control and Prevention (CDC). (2017, Sept). HIV/AIDS and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hepatitis/populations/hiv.htm
  2. Centers for Disease Control and Prevention (CDC). (2017, June). HIV and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hiv/pdf/library/factsheets/hiv-viral-hepatitis.pdf
  3. Weibaum, C.M., Williams, I., Mast, E.E., Wang, S.A., Finelli, L., Wasley, A., Neitzel, S.M, & Ward, J.W. (2008). Recommendations forMorbidity and Mortality Weekly Report (MMWR), 57(RR08), 1-20. Retrieved from: Identification and Public Health Management of Persons with Chronic Hepatitis B Infection. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B, Uncategorized

Sharing Your Story – Your Family’s Story

Sharing Your Story – Your Family’s Story

Image courtesy of Good Free Photos

Thanksgiving is not only a day to eat turkey or remind us to remember what we are thankful for; it is also National Family History Day!!1 This holiday can be used an opportunity for families to discuss and record health problems that run through the family, as this helps us live longer and healthier. 1

There are many chronic diseases that may run through multiple generations of a family. 1 Doctors can predict whether or not you could have a chronic disease just by knowing if your parents, grandparents, and other relatives have had it. 1 That is why knowing your family health history is an important and powerful screening tool.1 You can change unhealthy behaviors, reduce your risk of diseases, and know when you should be screened when you learn about what diseases run through your family. 2

Image courtesy of Wikimedia Commons

Hepatitis B is not like other chronic diseases, where if your parents have it, your genes make you more prone to it. Hepatitis B is not genetic. The hepatitis B virus is transmitted through blood and infected body fluids. This can happen through direct blood-to-blood contact, unprotected sex, body piercings or tattooing, intravenous drug use, and as a result of unsafe medical or dental procedures. It can also be transmitted from an hepatitis B positive mother to her baby at birth.

Even though hepatitis B is not genetic, you should still include it in your family health history discussion! The most common method of hepatitis B transmission worldwide is from mother-to-child due to the blood exchange that happens during child birth. Pregnant women who are infected with hepatitis B can transmit the virus to their newborns during delivery. 90% of babies exposed to hepatitis B at birth will become chronically infected with hepatitis B, which increases their risk of serious liver disease later in life. Knowing your family’s hepatitis B history can help you figure out if you and other loved ones should get screened for or vaccinated to protect against hepatitis B.

Image courtesy of Wikimedia Commons

Knowing if you have a family history of liver cancer can also be important, since hepatitis B is one of the leading causes of liver cancer. If your family has a history of hepatitis B related liver cancer, then you may have a greater risk of developing liver damage or liver cancer if you have hepatitis B. Be sure to discuss a family history of liver cancer with your liver specialist.

If you need some advice on how to start the conversation about your family health history, read more here. You can also use the US Department of Health & Human Services’s My Family Health Portrait Web tool to help start this dialogue and learn how to share family history information at a future doctor visit.

You don’t need to wait until this Thanksgiving to talk about your family health history. You can talk to your family about your family health history and hepatitis B status RIGHT NOW!

References:

  1. https://www.hhs.gov/programs/prevention-and-wellness/family-health-history/about-family-health-history/index.html
  2. https://www.cdc.gov/genomics/famhistory/famhist_basics.htm

 

 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Living with Hepatitis B

Diagnosing Hepatitis D in the U.S.

Robert Gish, MD

David Hillyard, MD

By Sierra Pellechio, Hepatitis Delta Connect Coordinator

Hepatitis D, or hepatitis delta, is the most severe form of viral hepatitis known to humans. The hepatitis D virus infects the liver and is dependent on the hepatitis B virus to reproduce. This means that people who are already infected with hepatitis B are at risk of contracting hepatitis D as well.

Worldwide, more than 257 million people live with hepatitis B and of this number, an estimated 15-20 million are also infected with the hepatitis delta virus (HDV). While uncommon in the United States, HDV co-infection is more common in parts of the world such as China, Russia, Middle East, Mongolia, Romania, Georgia, Turkey, Pakistan, Africa, and the Amazonian river basin. For this reason, it is important to test hepatitis B patients who originate from these higher endemic areas for hepatitis D. Anyone with chronic hepatitis B who is not responding to antiviral treatment, or who has signs of liver damage even though they have a low viral load (HBV DNA below 2,000 IU/mL) should also be tested. Fatty liver disease (caused by obesity) and liver damage from alcohol or environmental toxins should be ruled out as causes of liver damage before testing for HDV.  Hepatitis D infections lead to more serious liver disease than hepatitis B infection alone. It is associated with faster progression to liver fibrosis, increased risk of liver cancer, and early decompensated cirrhosis and liver failure. This is why it is so important that people with hepatitis B and D coinfection are diagnosed before it can lead to severe complications.

Robert Gish, MD, Hepatitis B Foundation Medical Director, and David Hillyard, MD, Medical Director, Molecular Infectious Diseases, ARUP Laboratories, tackled the topic of diagnosing hepatitis D in a webinar in October. Dr. Gish also answered additional questions, which are featured below:

  • What is the first step in diagnosing an HDV patient?

The HDV antibody test (anti-HDV) is the first test that is run to see if a patient has been infected with hepatitis delta. Because this test will be positive even if a patient has cleared a hepatitis delta infection, it is followed up with an HDV RNA test, which determines an active infection. There is also an antibody test (anti-HDV igM) that can test for an acute active infection.

  • Are there tests available in the US that can detect the HDV genotypes or just genotype I?

Although there have been 8 genotypes of HDV identified, each with their own distinct progression outcomes, genotype testing in the US remains rare and often difficult to acquire.

  • What is the role of measuring HDV RNA in monitoring chronic HDV progression or response to treatment?

The most effective way to understand the progression of a hepatitis D infection is to use liver ultrasounds, elastrography and fibroscans. These tests can evaluate the health of the liver. Declining HDV RNA level usually indicates a positive response to treatment.

  • Is there value to testing patients for a disease for which there are not many treatments?

Because patients who are coinfected with B and D have twice the risk of cirrhosis and liver cancer compared to monoinfected patients, it is an important diagnosis to make. Although there is currently only 1 treatment, lives are still being saved.

  • Should primary care providers be testing high-risk patients for HBV and HDV at the same time?

No, providers should only test patients who already have hepatitis B. One in twenty people with hepatitis B are thought to also be infected with hepatitis D. Bottom line: testing for hepatitis D is a simple blood test that could change the course of treatment and save your patient’s life!

If you do find out that you have hepatitis D, it can be overwhelming and scary. However, knowing the basics can help you manage your diagnosis. Through the Hepatitis B Foundation’s Hep Delta Connect program, you can get information on how to protect your loved ones, find a physician, and seek out support.

For more information, please click here or visit our Hepatitis Delta Connect program website. Please also contact Sierra Pellechio, the Program Manager for Hepatitis Delta Connect program at sierra.pellechio@hepb.org for any questions.

Baruch S. Blumberg Institute