Join Kristine Alarcon, MPH for A Day in the Life of a Public Health Coordinator to learn about some of the activities we at the Hepatitis B Foundation take part in!
This episode highlights our events for our local program, Hep B United Philadelphia, during January 2018. We show you the “behind-the-scenes” of a hepatitis B screening event.
Hepatitis B Foundation Health Outreach Coordinator and Guest Blogger Sierra Pellechio, B.S., CHES discusses her work with the African Immigrant community.
Hepatitis B affects over 2 million people in the United States, disproportionately affecting Asian, Pacific Islander and African Immigrant (AI) communities in the U.S. Although partners around the U.S. have been trying to increase awareness and improve screening and linkage to care rates among high risk communities, there have been few programs designed to address the urgent need for intervention among U.S. AI communities. An estimated 5% to 18% of African immigrants in the U.S. are affected by hepatitis B, with less than 20% aware of their infection. However, since research and prevalence data specific to AIs are lacking, it has been difficult to understand the true burden of this disease. One thing we do know is that there are significant knowledge gaps and low screening and linkage to care rates in AI communities. If left undiagnosed, people with hepatitis B are at risk of developing liver complications, including cirrhosis and liver cancer, which can lead to premature death, making it vital to identify those affected. This is complicated by the fact that hepatitis B is a silent disease with few or no symptoms for decades.
Working with a diverse sixteen-member expert advisory committee comprised of African community leaders, providers, and public health experts from across the U.S., the first phase of this project assessed the individual, community, and society-level barriers that affect hepatitis B screening, vaccination, and linkage to care. Findings revealed that a potentially effective strategy for improving awareness and testing could involve first educating community health workers, who would then serve as trusted educators and advocates to promote education and testing in their communities. In collaboration with the advisory committee, the Hepatitis B Foundation is developing two training modules tailored to community health workers. The modules focus on providing basic hepatitis B information, addressing myths and stigma, and suggesting strategies for incorporating health messages into their work that are culturally and religiously relevant. These educational modules will have an accompanying audio recording, a comprehensive resource guide, and a flipchart for direct community education on hepatitis B. To ensure relevance and effectiveness, these materials will be pilot tested and revised prior to nationwide dissemination. Once the project concludes, resources and materials will be available on the Hepatitis B Foundation and CDC resource pages in early 2019.
If you are a community health worker working in the African Immigrant community and would like to connect, share resources, or learn more, please contact the manager of this project, Sierra Pellechio at sierra.pellechio@hepb.org.
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!
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.
Did you know that the hepatitis B virus doesn’t just infect humans? It also infects chimpanzees1, tree shrews1, Peking ducks1, horses2, and woodchucks2. The hepatitis B virus that infects woodchucks is closely related to the human hepatitis B virus.2 Because of this, woodchucks have been a prominent animal model in studying the hepatitis B virus and testing drugs for the disease.2,3
Behind every legacy, there is a man who started it all. In the case of the woodchucks and hepatitis B, there was Bud Tennant, DVM. Dr. Tennant was a California native, born in the San Joaquin Valley.2 He studied veterinary medicine, earning his Doctor of Veterinary Medicine from the University of California at Davis in 1959. 2 As a veterinarian, Dr. Tennant conducted research in comparative medicine focusing on hepatocarcinogenesis (development of liver cancer), hepatic injury mechanisms, viral hepatitis, and gastrointestinal and liver diseases of domestic animals.2
His work in hepatitis started during his tenure as the James Law Professor of Comparative Medicine at Cornell University, where he studied the pathogenesis of serum hepatitis in horses.2 He would not work with woodchucks until Dr. Norman Javitt, Chief of Gastroenterology at Weill-Cornell Medical College at the time, approached him, urging the need for an animal model for studying hepatitis B virus to understand pathogenesis, treatment, and prevention of hepatitis B. Dr. Javitt introduced him to Drs. Jesse Summer and William Mason’s research on a new virus infecting woodchucks, its close relation to human hepatitis B virus, and its association with chronic hepatitis B and liver cancer.
Dr. Tennant spent over thirty years on the study of Woodchuck Hepatitis Virus infection, working with a colony of woodchucks in Ithaca, New York. 2 He developed the woodchuck as a successful animal model to learn how hepatitis B effects the liver, including the development of liver cancer. His work with the woodchuck model ultimately enabled scientists to run clinical therapeutic trials for treating hepatitis B in humans. 2 In fact, preclinical studies for almost every hepatitis B therapeutic drug licensed by the FDA have been conducted using the woodchuck model! Today, the Woodchuck Hepatitis Virus infection study continues at the Roswell Park Cancer Institute in Buffalo, New York. 2
Dr. Baruch S. Blumberg would also contact him to work together on fighting the hepatitis B virus in humans.
Dr. Bud Tennant is famous in the scientific world for his game-changing work in hepatitis B, and won many awards. At the 2016 Hepatitis B Foundation Crystal Ball, Dr. Tennant was presented with the 2016 Baruch S. Blumberg Prize, the Foundation’s highest honor. 2 He was also beloved by those who worked with him. He was known as “a towering physical presence, yet soft spoken and humble, and he was greatly admired for his good nature and his ability to share a story on just about any topic.” 2 Though Dr. Tennant passed away in 2016, he will always be remembered for his unwavering commitment, and thought of as a valued friend and mentor to many scientists. 2
References:
Schinazi, R.F., Ilan, E., Black, P.L., Yao, X., & Dagan, S. (1999). Cell-based and animal models for hepatitis B and C viruses. Antiviral Chemistry & Chemotherapy, 10, 99-114.
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.
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.
Have you received a vaccine for hepatitis A? The HAV vaccine is recommended for children and adults living with HBV. The vaccine will protect you from another liver virus and additional stress to your liver. There is no vaccine available for HCV, HDV, or for HIV, so please take precautions to avoid coinfection with any of these infectious diseases. No one wants a coinfection. It’s complicated.
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.
Do you ever feel like life is kicking you in the butt? Or do you ever feel like life is dragging you down? Though it may be hard preventing negativity from pulling you into a rut when you have a chronic condition, like hepatitis B, being more positive can help lift your spirits. When you do this, you can improve your health-related quality of life!
Though there is no set definition for health-related quality of life, the CDC defines it as an individual’s or a group’s perceived physical and mental health over time. Health related quality of life explains how a person’s physical, emotional, mental and social aspects impact their overall life. Health-related quality of life can impact your overall well-being, which the CDC defines as “a positive outcome that is meaningful for people.” Basically, improving health-related quality of life and overall well-being can help people feel that things are going well in their lives. Ultimately, this can help decrease stress and improve how well someone manages a chronic illness. This can be very useful for those of us living with the physical, emotional and social aspects of chronic hepatitis B..
Here are some tips and suggestions on how you can improve your health-related quality of life:
Make healthy lifestyle changes. You can develop a healthy lifestyle by starting a healthy diet, an exercise routine, or incorporating daily meditation. If you are don’t know where to start, try to find a workout buddy, join an online support group, or look through the many free apps that are available. There are also YouTube videos that can help you find workout routines and diet plans. And you don’t have to do it all at once – even small changes can make a big difference!
Keep a journal. This is a great opportunity to chronicle your progress towards a healthy lifestyle, and keep track of other milestones in your life. “Gratitude journals” are also very popular – you can spend time writing about one thing a day that you are thankful for – many people enjoy looking back over time to see how all of those “gratitudes” add up. People often say that this helps them to feel better and even appreciate life more. You can search online for “journal topics” or “journal exercises” to help you start a journal.
Find inspiration. Get some inspiration and tips from others who are going through the same thing! You can check out our #justB storytelling campaign about stories of how people cope with hepatitis B and liver cancer. We also have an empowering story from a liver cancer survivor.
Connect with a good support system. Spend time with people who make you feel better emotionally and physically! When you are in good company, you will feel more positive and happy too. You should also find out who is on your HBV Team!
These are just a few tips and suggestions on how you can improve your health-related quality of life. There are many articles and resources online with more tips and suggestions on how to improve your quality of and feel more positive! Some websites include CDC’s Health-Related Quality of Life program, advice on how to cope with your chronic illness from HealthCentral, and Huffington Post’s Habits to Improve your Life.
Remember that everyone goes through ups and downs in life, especially those of us living with a chronic illness. But working to make small, positive changes in your life gives you the power to live your best life!
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!
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.
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.