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Category Archives: Living with Hepatitis B

Living with Hepatitis B

Holidays with Hepatitis B: How to Tell Your Family

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As the holidays approach, families are planning parties and dinners and preparing to spend time with their loved ones. In such a merry atmosphere, the idea of discussing hepatitis B – whether its a recent diagnosis or the first time that you are ready to disclose your status – may be intimidating. However, it doesn’t have to be! In honor of  National Family Health History Day – which falls on Thanksgiving – we put together some tips to help you start the conversation.

 

  • Start Small – Facing your entire family at once can be frightening in any situation. Consider pulling one or two family members that you trust aside and speak with them first. They might offer advice on how to tell the rest of the family.
  • Come Prepared – Although chronic hepatitis B is the world’s most common risk factor for liver cancer, there is a universal lack of education and awareness about the infection. Use our fact sheets to help your loved ones understand what hepatitis B is, how it impacts your liver, and what it means to live with it.  For more fact sheets and to view them in different languages, click here. Be sure to let your family know that hepatitis B is spread by direct blood contact, not through casual interactions. They cannot be infected by sharing the same utensils as you, eating food prepared by you, or casual touches such as hugging.
  • Be Encouraging – Most people who are diagnosed with hepatitis B live long, healthy lives! Let your family know that you are monitoring the infection and taking the necessary precautions to prevent liver damage. Your family will be happy to know that you are in control of your health!
  • Let them know how to help – Although you may be able to
    Image courtesy of Canva

    manage hepatitis B by yourself, creating a support network is always a good idea! Do you have any active family members?  Exercise is great for the liver, so ask them to come along next time you go for a bike ride or hit the gym! Maybe you know someone who is great at cooking. Try cooking some healthy meals together!

  • Give them time – Hearing about a medical diagnosis can be difficult for everyone involved and may also be a sensitive topic for some. Don’t let this discourage you! Try showing them a few of our #justB campaign videos, which feature real people who have been impacted by hepatitis B. Some stories, like Alan’s, discuss how people often do not realize that hepatitis B and liver cancer are related. Other stories, like Alice’s, showcase the importance of being honest with your loved ones and explain how to turn a diagnosis into an educational opportunity. Viewing  #justB stories might help your family members feel more comfortable talking about the infection and encourage them to learn their own hepatitis B status.

National Family Health History Day

Image courtesy of Canva

In 2004, the Surgeon General declared Thanksgiving Day to be National Family Health History Day. It’s meant as a time for families to discuss health issues that appear to run in the family. While hepatitis B cannot be passed from generation to generation like genetic diseases, it is commonly spread within families due to how the virus is transmitted. The most common mode of transmission is from mother-to-child during childbirth, often because the mother was unaware that she was infected and that certain precautions needed to be taken to prevent transmission to the baby. As hepatitis B rarely has any symptoms, many people do not discover that they are infected until a family member is diagnosed or they develop liver damage.  Approaching the topic and starting the conversation can help to break this cycle of transmission within families.

The good news is that hepatitis B is preventable and, if detected early, liver damage can be prevented! Offer to help your loved ones make an appointment with their doctor or to accompany them when they go to get tested or vaccinated; they’ll appreciate the extra support!  

Also, consider making some time this Thanksgiving to fill out My Family Health Portrait – a free tool that maps out your family’s history of health conditions and identifies what you may be at risk for.

The topic of health is important all year round; you don’t have to wait for the holiday season to bring it up! Start the conversation today and help your family find the information they need to protect themselves and stay healthy!

 

Hepatitis Delta (HDV), Living with Hepatitis B

Karen and Dave’s Story

One Couple’s Journey through Hepatitis B, Hepatitis D and Liver Cancer

“Dave knew he had hepatitis B for decades, but honestly, no one ever seemed concerned. His liver
enzymes were slightly elevated, so the doctor told him to just watch what he ate and drank. He didn’t
even insist on bi-yearly blood tests!

In 2016, Dave was scheduled for a routine colonoscopy. Because he’d been looking pale and sickly
around that time, I suggested they do a blood test first at his family doctor. His numbers were off the
chart. They sent us back for the colonoscopy and added an endoscopy too. They found four varices
(enlarged veins in the esophagus that can indicate serious liver disease). How did this happen?

This was when I started to get angry. The gastroenterologist called us in to discuss the results. He asked
if Dave knew he had hepatitis B. Dave said yes, knowing his drug use in his teens and early twenties was
likely the source. Dave never felt shame about it at all, and just accepted it as a path he took, and
thankfully came out of. After that conversation, the doctor slammed his chart shut and pushed it across
the desk. He said that Dave’s liver was so badly damaged that there was nothing he could do and to
‘come back in a year’. When we asked about his options for treatment for the varices and his hepatitis B,
he actually told me that no one would treat the varices unless they were bleeding! He also told us that
hepatitis B antivirals would “make things worse”. That didn’t make sense. We asked about a transplant.
He said there was ‘no way’ anyone would give him a new liver. He didn’t even let us know that there
were actual liver clinics for this very purpose. He sent Dave away to die, really.

Many months later, with much perseverance, we made it to Stanford, where he was immediately put on
entecavir to treat his hepatitis B and to hopefully relieve some of his liver damage. That doctor alerted
us that he should also be tested for hepatitis D, a coinfection of hepatitis B. “It won’t be good if you have
it.” He did.

Due to changes in our health insurance, we were sent to continue at the University of California San
Francisco Liver Center…they were our saving grace. They treated the varices right away and put him on
other medications to help his failing systems. His hepatitis B viral load was now undetectable, with
hepatitis D being the biggest concern. Dave tried interferon to treat the hepatitis D, but with no luck. His
only chance was a transplant, but even though he was doing poorly, his test results didn’t qualify him to
get on the transplant list right away. He had lots of ER visits – 210 office visits in 2017 alone. It was a
whirlwind. Dave hadn’t even driven in 2 ½ years. It was an enormous stress on me, too.

Dave developed liver cancer but wasn’t in good enough shape to go through treatment. As he got sicker,
he eventually qualified for two different                  
liver transplant waiting lists. Finally, on
Thanksgiving night 2017, we got the call
that a healthy liver was available, and we
took it.
Caregiving is a very tough road. Especially
when your person also has encephalopathy,
caused by years of liver damage – and Dave
had it really bad. The encephalopathy
caused mood swings, short-term memory
loss, hand tremors, low appetite. He could
be down-right nasty. At that time, we were
doing the 4 ½ hour drive to San Francisco
once or twice a week. It was stressful for
both of us – and he was really unaware of
the stress that was put on me. Between
driving, taking out the garbage, bills, our
construction business…you name it, I did it
all.

The first 3-4 months out of the transplant, people were telling him all that had gone on. Much to my
frustration, he didn’t believe any of it! Now, over 6 months post-transplant, little things are coming back
to him. I showed him about 2 dozen pictures of him during his journey, and he was shocked! He said he
thought he was fooling everyone into thinking he was well.

The hardest part of this journey was seeing Dave so sick at times. I spent a lot of time in my closet
crying. It was hard on our adult girls too, to see their dad so weak and disoriented. I had a lot of support
through our girls though, and my family, which made a world of a difference. My sister is also a retired
nurse, and she accompanied us to most of our visits. She was a helpful adviser, since his medications
always needed tweaking, and we were often on long calls with our care team, health insurance
company, and pharmacies.

The good we took away is his health! He still doesn’t feel it’s real. We went through so much, and are so
grateful to be on the other side.

Things I’ve learned:
• Get on a Facebook forum for liver transplant patients…they are a great resource and a wealth of
information from other patients.
• Take a third person with you to doctor visits and procedures. At times, I was so consumed with
my concern for Dave, it was easy for me to forget some of the things we discussed. My sister
would take notes, and we would review them after.
• Always get a second opinion if you don’t have a good feeling about your doctor. You will all
become a team, and it’s important to have a team you can trust.
• Get on the transplant list at multiple hospitals, their criteria for transplant varies!
• Have willing family members and friends get tested to see if they are donor matches. Usually the
recipient’s insurance will pay for the testing and survey if they are a match. My sister-in-law and
I were both tested but were not a match.
• Ask about organ swap programs. Apparently, my kidneys were in perfect health. My
hepatologist had me apply to the kidney donor program, in hopes that I may be able to donate
my kidney in exchange for a piece of someone’s liver for Dave.
• Dave was put on depression and anxiety medication early in the process. He was initially very
resistant, mostly because of the stigma. His doctors finally convinced him it would be very
helpful for his general mood…it was!
• I had to make several phone calls to his team without his knowing. Encephalopathy really makes
you confused, and in Dave’s case, grumpy. I asked the doctor to push for the depression and
anxiety medications, which she did. Also, he wouldn’t exercise or take short walks before
surgery, which she had asked him to, to better prepare for surgery. I made the phone call, and
at the next visit, she set him up with a Fitbit! It helped that the ‘suggestions’ came from his
doctor and not me!
• After the transplant, I was so surprised he wasn’t more ‘thankful’ …that he wasn’t in awe of
what we had all gone through for HIM! I got angry with him. I made a private call to our new
post-transplant team. She said depression right after is very common. The patient feels
overwhelmed, and sometimes not very thankful. It’s kind of a way to deny they were in trouble,
to deny that they needed help. That fits my man to a tee!
• I would strongly suggest lots of patience after the transplant. I wish our team would have told
me the possible mental-state Dave might be in. Don’t force them to be thankful. Don’t play the
‘remember when’ game, “remember when I drove you to the ER in the middle of the night?
Remember when they told us you had cancer? Remember when I tried to be your donor?”
Because a lot of it he doesn’t remember.
• Take pictures along the way, but don’t show them until at least 6 months out. I showed Dave
pictures right away, and they didn’t resonate. I just showed him them the other night…and he
was floored! He really ‘got it’. He’s been looking at things differently lately: he’s calmer and
more loving.
• I wish I had kept a journal. The ups and downs of this journey were sometimes excruciating, and
Dave wasn’t ‘present’ to understand it. Hire cleaning help if needed. Get family and friends to
take the patient to lesser important appointments. Don’t let household things pile up on you. Fix
the gutter. Repair the screen. Hire a gardener for a few hours. Ask family to set things up for
you. It’s amazing how in two years without Dave to physically help around the house, things
started to go south pretty quickly! Luckily, I dug in and kept up.

Quite the journey for sure. I feel blessed to be on this side of health!”

– Karen

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Recently Diagnosed with Hepatitis B? Getting Through the Next Months Waiting to Confirm if Your Infection is Acute or Chronic

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Have you recently been told you have hepatitis B?  Dealing with the diagnosis and waiting out the next six months to determine if your infection will resolve itself or learning that it is a chronic infection can be nerve-wracking.

Fortunately, greater than 90 percent of healthy adults who are newly infected will clear or resolve an acute hepatitis B infection.  On the hand, greater than 90% of babies and up to 50% of children infected with hepatitis B will have lifelong, chronic infection. Sometimes people are surprised to learn they have a chronic infection. It can be confusing since there are typically few or no symptoms for decades. If a person continues to test hepatitis B positive for longer than 6 months, then it is considered a chronic infection. Repeat testing is the only way to know for sure.

Acute hepatitis B patients rarely require hospitalization, or even medication.  If you are symptomatic, (some symptoms include jaundice, dark urine, abdominal pain, fever, general malaise)  you may be anxiously conferring with your doctor, but if you are asymptomatic, you might not feel compelled to take the diagnosis seriously.  Ignoring your diagnosis can be very serious. If you have concerning symptoms like jaundice (yellow eyes and skin), a bloated abdomen or severe nausea and vomiting, please see your doctor immediately. Your doctor will be monitoring your blood work over the next few months to see if you clear the virus, or monitoring your liver if there are concerning symptoms.

Your job is to start loving your liver …today.  STOP drinking alcoholic beverages.  Refrain from smoking cigarettes.  Your liver is a non-complaining organ, but you cannot live without it.  Make your diet liver-friendly and healthy filled with a rainbow of vegetables and fruits, whole grains, fish and lean meats. Minimize processed foods, saturated fats and sugar.  Drink plenty of water.

Talk to your doctor before taking prescription medications, herbal remedies, supplements or over-the-counter drugs.  Some can be dangerous to a liver that is battling hepatitis B.  Get plenty of rest, and exercise if you are able.

Don’t forget that you are infectious during this time, and that loved ones, sexual partners and household contacts should be tested to see if they need to be vaccinated to protect against hepatitis B.  Sometimes family members or close household contacts may find that they have a current infection or have recovered from a past HBV infection.  If anyone fears exposure, ensure them that hepatitis B is not transmitted casually. They should get tested, and vaccinated if needed, and take simple precautions. Remind them that 1/3 of the world’s population will be infected with the hepatitis B virus during their lifetime.

On the flip-side… Do not let this new hepatitis B diagnosis consume you.  As the weeks and months pass, you might find that the infection is not resolving, and you might worry that you have a chronic infection.  The associated stress and anxiety can be challenging, even overwhelming.  It can contribute to physical symptoms you may be experiencing.  Find a family member, friend, or health care professional with whom you can share your concerns.

If you are told you have recovered from an acute HBV infection (you are now HBsAg negative, HBcAb positive and HBsAb positive) be sure to get copies of your lab reports to ensure there are no mistakes. Compare them with our easy to use blood tests chart.   If something looks wrong, or if you’re confused, speak up and ask your doctor. Once confirmed, be sure to include hepatitis B as part of your personal health history. This is important in case you have conditions requiring treatment later in life that might once again warrant monitoring of your hepatitis B. It is possible for a past HBV  infection to reactivate if a person requires longterm immune suppressing drugs .

No one wants to learn they have chronic hepatitis B but it is a manageable disease. You’ll want to see a doctor with experience treating chronic HBV so they can run additional tests. There are very effective treatments available, though not everyone with chronic HBV needs treatment. All people living with chronic HBV benefit from regular monitoring since things can change with time. Please do not panic or ignore a chronic hepatitis B diagnosis. Take a deep breath and get started today learning more about your HBV infection and the health of your liver.  Things are going to be okay!

If you are confused about your diagnosis, please feel free to contact the Hepatitis B Foundation at info@hepb.org.

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

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.

Hepatitis B Advocacy, Living with Hepatitis B, News

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.

Hepatitis B Advocacy, Living with Hepatitis B

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!

Hepatitis B Advocacy, Living with Hepatitis B

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

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

Hepatitis B Precautions for People Living with Diabetes

 

March 27th is Diabetes Alert Day!

Diabetes is a chronic condition that is characterized by high glucose (or sugar) levels in the blood. It usually occurs when a person cannot produce enough insulin, a hormone that controls blood sugar levels. According to the World Health Organization (WHO), global prevalence of diabetes is on the rise! In 1980, diabetes prevalence in adults over the age of 18 was 4.7%. The number rose to 8.5% in 2014 and continues to increase. In 2015, there was an estimated 1.6 million deaths that were attributed to diabetes.

Like hepatitis B, there have been several studies that show a strong link between type II diabetes and liver cancer. Diabetes and hepatitis B can be a dangerous combination and can work together to increase someone’s risk of developing liver cancer.

Since the hepatitis B virus can be transmitted via blood or other bodily fluids, people living with diabetes are at an increased risk of contracting hepatitis B. In fact, one study found that people living with diabetes between the ages of 23-59 have an approximately two-fold increased risk of hep B infection compared to those without diabetes. According to the Centers for Disease Control and Prevention (CDC), there have been hepatitis B outbreaks in nursing homes, assisted living, and long-term care facilities among people living with diabetes. Some risks for transmission include:

  • Sharing glucose meters between residents without cleaning and disinfecting between uses
  • Lack of proper hand hygiene and failure to wear gloves between fingerstick procedures
  • Using the same fingerstick devices for more than one resident
  • Cross-contamination of clean supplies with contaminated blood glucose monitoring equipment used by home health agencies
  • Sharing injection equipment such as an insulin pen or syringe for more than one person
  • Failure to perform proper sterilization and separating contaminated and clean podiatry equipment
  • Failure to perform proper disinfection between podiatry patients

So, what can you do if you are living with diabetes to prevent hepatitis B transmission?

  • Get tested! A simple three-part blood test will tell you if you have hepatitis B, were exposed, or are protected.
  • Get vaccinated – If you find that you are not protected or if you have not finished your hepatitis B vaccine series. The CDC and Advisory Committee on Immunization Practices (ACIP) recommend that adults between 19-59 years of age living with diabetes get vaccinated to protect against hepatitis B. Those 60-years-old or older should ask their doctor about the vaccine before getting it.
  • Do not share your diabetes care equipment to prevent exposure!

For more information about hepatitis B and diabetes, WHO, CDC, and/or American Diabetes Association. For a personal account of hepatitis B and diabetes, visit Martha Zimmer’s blog post. You can also visit our website for information about diabetes and liver cancer

Hepatitis B Prevention, Living with Hepatitis B, Uncategorized

What to do about hepatitis B when you’re pregnant?

Around the world, the most common mode of hepatitis B transmission is from mother to child. Unfortunately, pregnant mothers who have hepatitis B can transmit the virus to their newborn during the delivery process. 90% of these HBV infected babies will progress to chronic infection  putting them at increased risk of serious liver disease or liver cancer later in life.

It is important that ALL pregnant women get tested for hepatitis B to prevent the transmission of the virus to newborns at birth.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all newborns born to hepatitis B positive women be given two shots in the delivery room – the first dose of hepatitis B vaccine (5 mcg dose) and one dose of hepatitis B immune globulin (HBIG, 0.5 mL dose). If a woman knows that she is infected, it is important that she tell her doctor to have these two drugs available when she is ready to deliver. These two shots must be given at separate injection sites, i.e. different limbs. When administered correctly within the first 12 hours of life, a newborn has a 95% chance of being protected against a lifelong hepatitis B infection. The infant will need to complete the hepatitis B vaccine according to schedule as part of a 3 or 4 dose series. CDC recommends follow up testing to confirm immunity or protection against HBV at 9 months or at the baby’s 1 year checkup.

The World Health Organization (WHO) recommends the birth dose of the hepatitis B vaccine for ALL babies, though it is especially important for a baby born to a woman with hepatitis B to receive the first dose of the vaccine as soon as possible, within 24 hours. HBIG may not be available in all countries or may be cost prohibitive. The hepatitis B vaccine series may be completed with the remaining monovalent  (single) injections of the HBV vaccine, or may be completed as part of a combination vaccine series.

In developing countries combination vaccines such as the pentavalent vaccine are often given to babies. The first dose of the pentavalent vaccine (which includes hepatitis B vaccine) is given at 6 weeks of age, and the 2nd and 3rd doses are given at 10 and 14 weeks of age. Waiting for the first dose at 6 weeks is too late for babies born to mothers living with chronic hepatitis, though the pentavalent vaccine should never be used as the birth dose or before 6 weeks. Women who know they have hepatitis B should talk to their doctor about ensuring that a birth dose of the hepatitis B vaccine is available for their baby at birth.

There is no second chance!  It is vitally important that we protect all newborns from hepatitis B!

Also, all infected pregnant women need to learn more about their hepatitis B infection from a liver specialist or a doctor with experience treating patients with chronic hepatitis B. It is recommended that pregnant women have their hepatitis B monitored throughout their pregnancy, to check the health of their liver and to see if they need treatment. For HBeAg positive women with high hepatitis B viral loads, taking FDA-approved antivirals during the last trimester can reduce the amount of virus in the blood and help prevent the chance of transmission to the newborn. Once an infected woman gives birth, it is important that she routinely see her doctor to keep monitoring her hepatitis B infection. Keeping mothers healthy allows them to better take care of their families!

For more information, or if you live in the U.S. and need help with hepatitis B infection during pregnancy, please visit the Perinatal Hepatitis B Prevention Program to find a coordinator near you. If you are outside of the U.S., you may consider visiting the World Hepatitis Alliance to find if there are organizations in your country that can ensure your baby starts with a birth dose of the hepatitis B vaccine.

Visit our website for additional information!

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

#StigmaStops: Can We End Hepatitis B Discrimination

Around the world, millions of people with chronic hepatitis B face wrenching discrimination that limits their dreams, education, careers, income and personal relationships.

Discrimination is unethical, unnecessary and a violation of human rights. Hepatitis B is simply not transmitted through casual contact. The stigma that persists is based on ignorance and it impacts millions around the world daily. The United Nations created Zero Discrimination Day to highlight the negative impact of discrimination and promote tolerance, compassion and peace. Many hepatitis activist organizations, including the Hepatitis B Foundation, used this commemorative day to draw attention to global hepatitis B discrimination. Even though Zero Discrimination Day was on March 1, we still need to recognize the importance of stopping hepatitis B discrimination.

Every day is zero discrimination day, and ending discrimination starts with each of us working in any way we can in our communities to end this stigma.

No one is to blame for hepatitis B, and people who have hepatitis B deserve the same opportunities to live fulfilling lives – at work, at home and in the community.  . There is a safe and effective vaccine that prevents hepatitis B infection. When people are protected, there is no reason to fear that healthcare workers or hotel maids will spread this infection. Even without vaccination hepatitis B transmission can be avoided with simple prevention measures. Hepatitis B is not transmitted casually.

People who have hepatitis B are part of our global community. They are our mothers, brothers, doctors, teachers, spouses and friends. To learn about how the fear of discrimination affects people who have hepatitis B, check out some of our #justB patient stories. Jin’s story tells us how a vibrant young woman handles her fear, and Carolyn’s story shows us the devastating consequences of hiding a hepatitis B diagnosis.

It is morally reprehensible that given the tools and knowledge we have that discrimination against people who have hepatitis B should continue today. So we ask you to help us end this discrimination.

One way you can fight hepatitis B discrimination is by joining the World Health Alliance in their #StigmaStops awareness campaign. It is a year-long campaign that highlights the stigma and discrimination associated with hepatitis around the world. #StigmaStops provides people living with hepatitis a platform to strengthen their voice and speak about the stigma and its impact as well as dispel myths and misconceptions of hepatitis B. Another way to help is to talk about hepatitis B – with your colleagues, friends and family members. The more we talk openly about hepatitis B, the less it will be stigmatized. And feel free to share our #justB videos – they can be a great conversation starter!

Read our previous blogs about employment discrimination and more stories about hepatitis B discrimination.

Baruch S. Blumberg Institute