Hep B Blog
Uncategorized

The Global Need for Hepatitis B Immunization

In the United States, August is National Immunization Awareness Month (NIAM)! During this time, health care providers, educators, and advocates use their resources to inform the public about the safety and importance of vaccines. NIAM was established by the Centers for Disease Control and Prevention (CDC) to encourage individuals of all ages to stay up-to-date with their vaccines and make sure that they are protected. The modern hepatitis B vaccine has been widely used – with over 1 billion doses given – since it was created in 1985, and has been proven to be one of the safest and most effective vaccines in the world. So why do we need to promote the hepatitis B vaccine during NIAM? 

United States: 

On a national level, vaccination rates for hepatitis B are far below where they should be despite being the most effective way to prevent transmission. In the United States, while 91% of children complete the hepatitis B vaccine series, only 64% of children who are born in hospitals are given the hepatitis B birth dose (first dose of the vaccine) as recommended by the CDC – which means that there is much room for improvement. And without the follow-up doses, children are still vulnerable to potential exposures; one dose of the vaccine is not enough. 

Adults in the United States have extremely low rates of vaccination, primarily because many were born before the vaccine became a healthcare standard and mandated for school. According to the CDC, just 25% of adults have received all three doses. Coupled with the recent increase in injection drug use, low vaccination rates among adults have been driving a rise in acute hepatitis B cases across the nation. The good news is that adults can be fully vaccinated with just 2 doses of the Heplisav-B vaccine! This new vaccine has proven to be highly effective and can be completed in just one month.  

Globally: 

Internationally, vaccine rates differ from country to country due to issues with storage, access, affordability, general awareness and priorities. In July 2019, the World Health Organization (WHO) announced that 189 countries now provide the vaccine for infants on a national level, but the global coverage of the birth dose is just 42%. The birth dose is significant for a number of reasons. Ninety percent of babies and up to 50% of young children will progress to chronic hepatitis B if they are infected. Since only 10% of the 292 million chronically infected individuals know about their infection, there is the potential for friends or family members to unknowingly transmit the virus to an infant or young child. In addition, a mother who is unaware of her status has the potential to pass the virus to her newborn via the delivery process. The birth dose significantly lowers the risk of transmission in both of the previous scenarios. That is why it is critical pregnant women are tested early in their pregnancy so they are aware of their infection and can ensure the birth dose is available.

In some countries, the pentavalent vaccine is offered. This vaccine protects against five diseases, including hepatitis B. However, it cannot be administered until the baby is at least 6 weeks old, which leaves a gap in the baby’s protection. The monovalent hepatitis B vaccine should be given to all infants in order to make sure they are covered during this vulnerable time period. It is especially important for infants born to hepatitis B surface antigen positive  (HBsAg +) mothers to receive the monovalent vaccine within 12-24 hours of birth to prevent transmission. 

Vaccines are also essential for healthcare workers. WHO estimates that out of the 3 million healthcare workers who are exposed to bloodborne diseases a year, approximately 2 million of those exposures are to hepatitis B. These exposures, which largely occur in countries where hepatitis B is common, put unvaccinated healthcare workers at risk. International recommendations list hepatitis B as one of the essential vaccines  for health occupations. WHO also reports that unsanitary healthcare practices, such as reusing sharp objects that have not been sterilized following proper infection control practices, were responsible for nearly 2 million hepatitis B infections globally in 2010. Infections from an accidental exposure can easily be avoided with the vaccine!

NIAM is a reminder that a vaccine is only effective at preventing disease when it is used widely. Governments, healthcare providers, and individuals all play an important role in ensuring that people of all ages – especially high-risk individuals – are protected. You can do your part today by asking your doctor for the 3-panel hepatitis B blood test. If your results come back negative (HBsAg -, HBsAb -, and HBcAb -), ask them to begin the vaccination series! In two or three simple doses, you can be protected from the largest risk factor for liver disease and liver cancer!

About Hepatitis B, Hepatitis B Prevention

Hepatitis B is NOT A Genetic Disease – And Here’s Why

There are many misconceptions about the hepatitis B virus. One recurring one is the myth that hepatitis B is a genetic or hereditary disease. The belief is that because multiple family members can be infected by hepatitis B, it must be a virus that runs in families. This is not true. Hepatitis B is NOT genetic. Hepatitis B is spread through direct contact with infected blood. Although transmission can occur a number of different ways, it does not happen at conception or while the child is developing in the uterus. 

Let’s start by breaking down what it means for something to be genetic or hereditary: 

A genetic disease is caused by an error in a person’s genes and is   carried by an individual in their genes. This type of disease may be passed on to a person’s child (which means it is hereditary) or it can occur spontaneously as a result of a gene mutation while a child is growing in the womb. Genes – which make up each of our unique DNA strands – are passed on to a child from both the mother and the father. Therefore, if a mother or father carries a certain hereditary disease or genetic trait, such as brown hair or green eyes, the child has the ability to have that as well. 

Hepatitis B is not a genetic disease because it does not exist in a person’s genes. It is not carried in the egg of a woman or the sperm of a man. The hepatitis B virus exists in the liver cells and circulates in the bloodstream. Unlike a genetic disease, a person is not born with the hepatitis B virus already in their bodies. Instead, the virus is passed from mother to baby during childbirth through infected blood passing from the mother to the child during the physical delivery process. If a pregnant woman tests positive for hepatitis B, she can pass the virus to her newborn through infected blood and tiny tears in the skin that occur during childbirth. Oftentimes, these tears are unable to be seen by the human eye but can still allow for the virus to pass through and make direct contact with mucous membranes (“wet skin”) of the eyes, ears, nose, and mouth of the infant

A number of different factors play a role in determining if a newborn will contract hepatitis B from their mother: the mother’s viral load levels, the mother’s knowledge of her infection, and if the newborn receives post-exposure prophylaxis. Post-exposure prophylaxis is the key to preventing mother-to-child transmission and consists of two parts: the first dose of the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG). Both shots need to be administered 1) in two different limbs and 2) within 12 hours of birth in order to be as effective as possible. Once the shots have been given, the infant should complete the standard hepatitis B vaccine schedule in order to ensure that they are protected for life! *Please note that HBIG is not recommended by WHO, so it may not be recommended or available in all countries.

Commonly Asked Questions: 

It can be difficult to understand facts when they do not align with what you have been told for many years, so we’ve answered some of the most common responses to our information below: 

  1.  If it is not genetic, how is it sexually transmitted? 

 This question goes back to the topic of genes. A genetic disease differs from a sexually transmitted disease because of where the virus is hosted during transmission from one individual to another. A genetic disease is given to a person via cellular DNA while a baby is developing in the mother’s womb. Sexual transmission occurs because the virus is present in blood and sexual fluids and can be transmitted through very tiny, microscopic tears as a result of sexual intercourse.

2.  If it’s not genetic, why do multiple members of my family have it? 

Families tend to share objects – and that’s okay! However, sharp objects like earrings and body jewelry or personal care items like razors, nail clippers, or toothbrushes, can make tiny, microscopic cuts and abrasions in our skin that bleed. Sometimes, we don’t even notice! When a family member uses an object with trace amounts of infected blood and they also have a wound, such as a mouth sore,  cut, or freshly shaved skin, the virus can spread to the uninfected individual. Because hepatitis B is so infectious (at least 50 times more infectious than HIV!), even small amounts of infected blood can cause a person to become infected. Therefore, it is recommended that personal items and sharp objects are not shared – even between family members, or ensure all family members are properly vaccinated for hepatitis B and confirm they are protected

Accidents also occur frequently in households, and sometimes blood is spilled. The virus can live on surfaces outside of the body, so it is essential to properly clean up any blood spills. The key to safely cleaning up blood and killing the virus is to wear gloves and use a fresh diluted bleach solution of 1 part bleach mixed with 9 parts water. 

It’s extremely important to note that infected blood must come into contact with uninfected blood or a mucous membrane for transmission to occur. A person cannot become infected from skin-to-skin contact such as shaking hands or hugging, sharing utensils or food prepared by an infected individual, or even kissing.

Prevention: 

The best thing to remember is that hepatitis B is preventable, even if a child is born to a mother living with chronic hepatitis B! Always remember to wash your hands thoroughly with soap and hot water after any possible exposure to blood. In addition, any family members and loved ones who test negative for the hepatitis B surface antigen (HBsAg) and did not recover from a past infection (HBcAb total negative) should get vaccinated to prevent any possible transmission. The vaccine is one of the most effective vaccines in the world! 

Hepatitis B Advocacy

Eliminating Hepatitis B: Highlights of the Hep B United Summit 2019

Last week, the Hepatitis B Foundation, Hep B United, and the Association of Asian Pacific Community Health Organizations (AAPCHO) hosted over 100 hepatitis B experts, advocates, and public health professionals in Washington D.C. to collaborate and share best practices on how to advance the elimination of hepatitis B. This year’s theme was Eliminating Hepatitis B: Local Change, Global Impact. The 7th annual Summit began with a day of advocacy on Capitol Hill, where attendees met with their states’ congressional members to make a case for legislative prioritization of the epidemic and increased funding for hepatitis B and liver cancer research. Following Advocacy Day were two days of educational sessions, networking, and coalition building activities that aimed to strengthen and expand our ability to address hepatitis B on a national level. 

The Summit was live-streamed on Hep B United’s Facebook; all of the sessions can be viewed here! Below are a few highlights of the Summit. Be sure to look out for the annual Summit Report in the upcoming weeks for a more comprehensive overview of the events! 

Highlights: 

  • We spoke to nearly  60 congressional offices. Some of our advocates got to personally speak with Representative Grace Meng, Representative Judy Chu, Senator Tammy Duckworth, Representative Alexandria Ocasio-Cortez, and Representative Ilhan Omar!
  • Dr. Tim Block, co-founder, and President of the Hepatitis B Foundation, provided an update on the path to a hepatitis B cure and the stages of therapeutic drug development research. 
  • Right before the Summit, it was announced that 6 of our partners received grants from the HHS Office of Minority Health to conduct hepatitis B screening, education, linkage to care! 
  • Representatives Judy Chu and Grace Meng stopped by our Congressional Reception to share some inspiring words!
  • The new director of the Centers for Disease Control and Prevention’s Division of Viral Hepatitis, Dr. Caroyln Wester, MD, MPH, stopped by to share current hepatitis B strategies at the CDC, and to emphasize the importance of funding. 
  • Five of our #justB storytellers shared their diverse personal stories about their hepatitis B journeys. Each story will be featured in the upcoming months, so be sure to stay tuned!
  • The New York City Health Department shared their research and work on the “Hep B  Moms Project”, which provides in-language services to hepatitis B positive mothers and helps link them to care. 
  • We displayed 14 hepatitis B-related research posters from partners across the nation! 
  • Our partners helped us to create an interactive World Hepatitis Day exhibit that was displayed on Capitol Hill on Friday, July 26th! The exhibit featured a map of all of the places where Hep B United’s partners work endlessly to eliminate hepatitis, and pledges from our partners & passersby to help #FindTheMissingMillions! 

 

 

 

Check out some more photos on Facebook! 

The Summit was a success, with partners feeling inspired and invigorated to continue the fight against hepatitis B. In addition to partnership building and creating political awareness, the annual gathering is a reminder of the power of collaboration, dedication, and persistence. 

HBV, Hepatitis B Advocacy

Join the Conversation at the 2019 Hep B United Summit; Watch Summit Sessions On Facebook Live!

 

 

The annual Hep B United Summit, organized by the Hepatitis B Foundation, convenes in Washington D.C. from Wednesday, July 24 through Thursday, July 25. The theme of the 2019 summit is Eliminating Hepatitis B: Local Change, Global Impact. National and local coalition partners, experts, stakeholders, and federal partners will meet to discuss how to increase hepatitis B testing and vaccination and improve access to care and treatment for individuals living with hepatitis B.

You can watch many of these sessions on Facebook Live. You can also follow the conversation at the Summit on Twitter with #Hepbunite19!

Facebook Live video streaming is available to all Pages and profiles on Facebook. Check out the agenda below and go to the Hep B United Facebook Page to view the live broadcast. Some breakout sessions may be broadcast from the Hepatitis B Foundation Facebook Page. Sessions will also be available following the broadcast for those who are not able to join us live.

Here are the details on the sessions that will be broadcast on Hep B United’s Facebook Live unless noted otherwise:

Day 1 – Wednesday July 24:

8:00 – 9:00 AM:  Welcome and Introductions
Tim Block, PhD, President & Co-Founder, Hepatitis B Foundation
Chari Cohen, DrPH, MPH, Co-Chair, Hep B United and Senior Vice President, Hepatitis B Foundation
Jeff Caballero, MPH, Co-Chair, Hep B United and Executive Director, Association of Asian Pacific Community Health Organizations (AAPCHO)

9:00 AM: CDC Division of Viral Hepatitis 
Carolyn Wester, MD, MPH, Director, Division of Viral Hepatitis, Centers for Disease Control and Prevention

9:30 AM: The Path to a Hepatitis B Cure
Tim Block, PhD, President and Co-Founder, Hepatitis B Foundation

10:15 AM: Local Initiatives: Eliminating Hepatitis B Across the Lifespan
Moderator: Catherine Freeland, MPH, Public Health Program Manager, Hepatitis B Foundation
Panelists:
Moon S. Chen, MPH, PhD, Professor, University of California – Davis
Liz Tang, Health Care Access Specialist, and Farma Pene, Health Care Coordinator, New York City Department of Health & Mental Hygiene
Chelsie Porter, MPH, Prevention & Outreach Program Manager, Hepatitis Education Project

11:15 AM: Integrating Systems Level Changes to Eliminate Hepatitis B
Moderator: Chari Cohen, DrPH, MPH, Senior Vice President, Hepatitis B Foundation
Panelists:        
Jeff Caballero, MPH, Executive Director, AAPCHO
Su Wang, MD, MPH, Medical Director, Center for Asian Health, Saint Barnabas Medical Center, Livingston, NJ
Richard Andrews, MD, Research Director, HOPE Clinic, Houston, TX

12:30 PM: Lunch Keynote Presentation
Center for Disease Analysis Foundation
Devin Razavi-Shearer, Hepatitis B/D Project Lead

 1:45-3:00 PM  BREAKOUT SESSIONS I

Innovative Strategies to Conduct HBV Education, Testing, and Linkage to Care
Discuss effective outreach strategies to conduct HBV education, testing, and patient navigation among high-risk communities.
Moderator: Sherry Chen, MPH, CHES, CDC Division of Viral Hepatitis

Panelists:
Paul Lee and Ohkyun Ko, Korean Community Services, New York, NY
Chooson Byambaa & Tuya Lkhaijav, Hepatitis B Initiative of Washington, DC
Alia Southworth, Asian Health Coalition, Chicago, IL

Increasing HBV Provider Education (HepBFoundation Facebook)
Join the National Task Force on Hepatitis B to discuss the development of provider education tools to manage chronic hepatitis B in the primary care setting.
Facilitators: Amy Trang, PhD, MEd, Administrator and Richard Andrews, MD, Co-Chair, National Task Force on Hepatitis B

 

3:15 PM – 4:45 PM     BREAKOUT SESSIONS II

Local, National, and Global Efforts to Increase HBV Testing and Education Among African Communities (HepBFounation Facebook)
Discuss pioneering efforts and strategies to raise awareness and promote testing in African communities, whose hepatitis B burden rivals that of Asian Americans. Learn tips for education and how your organization can begin or expand current work.
Moderator: Cynthia Jorgensen, DrPH, CDC Division of Viral Hepatitis

Panelists:
Oni Richards, African Family Health Organization, Philadelphia, PA
Chioma Nnaji, Multicultural AIDS Coalition, Boston, MA
Sierra Pellechio, CHES, Hepatitis B Foundation
Catherine Freeland, MPH, Hepatitis B Foundation

Combating HBV-Related Stigma and Discrimination
Discuss the impact of HBV-related stigma and development of policies to combat institutional discrimination.
Moderator: Maureen Kamischke, Hepatitis B Foundation

Panelists:
Vrushabh Shah, MPH, NASTAD
Nadine Shiroma, Alexa Canizzo,, Hepatitis B Foundation

 

 Day 2 – Thursday July 25

8:30 AM: National Action Plan to Eliminate Hepatitis B
Carol Jimenez, Deputy Director for Strategic Initiatives,  Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services

9:00 AM: Global Efforts to Eliminate Hepatitis B
Su Wang, MD, MPH, President-Elect, World Hepatitis Alliance

  9:30 AM: Patients Driving Change: #justB Storytelling Campaign
Moderator: Rhea Racho, MPAff, Public Policy & Program Manager, Hepatitis B Foundation
#justB Storytellers Panel: Cuc Kim Vu, Peter Vo, Bright A., Xuan Phan, and Jacki Chen

11:00 AM: Improving Access to Hepatitis B Treatment
Panelists:
Michaela Jackson, MS, Public Health & Outreach Program Coordinator, Hepatitis B Foundation              
Alyssa Gallipani, PharmD, BCACP, Ambulatory Care Specialist and Clinical Assistant Professor of Pharmacy Practice, RWJ Barnabas Health & Fairleigh Dickinson University
Carl Schmid, MBA, Deputy Executive, Director, The AIDS Institute

 12:15 PM:

EliminatingTuberculosis in Asian American Communities
Nickolas Deluca, PhD, Branch Chief, Communications, Education, and Behavioral Studies, Division of TB Elimination, Centers for Disease Control and Prevention

 1:00 PM:  HBU Coalition Strategies
Facilitator: Amy Trang, PhD, Administrator, National Task Force on Hepatitis B

Not able to join the sessions with Facebook Live? Follow the conversation on Twitter using the #Hepbunite19 hashtag. Follow the events, retweet and engage with event attendees and help us raise hepatitis B awareness in the U.S. and around the globe. We’ll also be posting on twitter during our Advocacy Day, Tuesday, July 23rd.

World Hepatitis Day is July 28th, and this Summit is an opportunity to share with the world what we’re doing to help those living with hepatitis B in our communities. Other popular hashtags for World Hepatitis Day, and to raise hepatitis B awareness, include: #NOhep, #KnowHepB, #WorldHepatitisDay, #WorldHepDay, #WHD2019, #FindTheMissingMillions #hepatitis, #hepatitisB, #HBV, #hepB, #justB. Connect with, follow and engage with fellow partners and advocates on twitter to keep the hep B conversation going during the Hep B United Summit, World Hepatitis Day events, and beyond.

Check out: @AAPCHOpolicy, @aidsadvocacy, @alex_daleks, @aphfsd, @APPEALhealth, @AVACNow, @bentheactivator, @CAHE_AHC, @catherineafree, @CDAFound, @cdchep, @CDC_TB, @ChoosonB, @hepBaware, @HBIDC, @HepBFoundation, @HepBpolicy, @HepBUnited, @HepBUnitedPhila, @hepdconnect, @HepEduProject, @HepFreeHawaii, @hepfreeNYC, @HHS_ViralHep, @HOPECHC, @iwgroup, @jacki0362, @jeffaapcho, @KCSNY, @kmoraras, @Liz98223514, @nirahjohnson, @NYU_CSAAH, @ponnivp, @randrews98, @RheaRacho, @swang8 @tuugiil73

Missing from the list? Contact the Foundation at info@hepb.org to be added.

We’re having a World Hepatitis Day exhibit on Capitol Hill in the Rayburn Building Foyer,  Friday, July 26th from 10 am to 3 pm. We’ll be asking legislators and partners how they plan to “Find the Missing Millions” living with hepatitis B.

Visit the Hep B United and Hepatitis B Foundation websites for more information about hepatitis B and related programs.

HDV, Hepatitis Delta (HDV), Living with Hepatitis B

My Hepatitis B Viral Load is Low (Or Undetectable), Am I Still Infected with Hepatitis Delta?

For people who have been diagnosed with chronic hepatitis B and delta coinfection, a low or undetectable hepatitis B viral load does not usually indicate that they’ve cleared both infections. This is because, in cases of coinfection, hepatitis delta usually becomes the dominant virus, and suppresses hepatitis B, slowing or even stopping its replication entirely. If someone is still positive for the hepatitis B surface antigen (HBsAg), the hepatitis delta virus can still replicate (often with copies in the millions) and cause potential liver damage  1. For this reason, the test to measure hepatitis delta activity, the HDV RNA test, is important in disease monitoring and management  2,3. Available since 2013, the HDV RNA test can be acquired internationally through the Centers for Disease Control and Prevention (CDC), and from several labs in the US. 

For those suspected of having acute hepatitis B and delta coinfection, HBsAg testing should follow 6 months after initial diagnosis. If HBsAg is negative (non-reactive), both infections are likely to have cleared. It’s important to remember that people who contract hepatitis B and delta during one exposure are likely to clear both viruses.  If HBsAg is positive (reactive) after 6 months, both infections are likely chronic (life-long). Those who are known to have a chronic hepatitis B infection and then become infected with hepatitis delta later on, they are likely to develop chronic coinfections.  

Following diagnosis with hepatitis B, with or without delta coinfection, it is important to have close, household contacts and sexual partners screened, and to follow simple prevention measures and practice safe sex using condoms.  

Both hepatitis B and delta are prevented with the safe and effective hepatitis B vaccine series.  

For more information on hepatitis B and delta coinfection, visit www.hepdconnect.org or contact us at connect@hepdconnect.org.  

References: 

  1. Huang, C. R., & Lo, S. J. (2014). Hepatitis D virus infection, replication and cross-talk with the hepatitisB virus. World journal of gastroenterology, 20(40), 14589–14597. 
  2. YurdaydınC, Tabak F, Idilman R; Viral Hepatitis Guidelines Study Group. Diagnosis, management and treatment of hepatitis delta virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2017; 28(Suppl 2); S84-S89. Available at: https://www.turkjgastroenterol.org/sayilar/304/buyuk/S84-S89.pdf 
  3. Tseng, C. H., & Lai, M. M. Hepatitis delta virus RNA replication.Viruses, 1(3), 818–831.  

Uncategorized

Developing a Strategic Plan to Cure Hepatitis B with the NIH

As you may know, two years ago the Hepatitis B Foundation started our Hepatitis B Cure Campaign, to promote increased public-sector investment in hepatitis B and liver cancer research. We have made great progress and wanted to provide an update. Earlier this year, the HBF submitted House Labor-HHS report language, and HBF President Dr. Timothy Block met with the National Institutes of Health’s (NIH) Deputy Director Dr. Lawrence Tabak, to urge the NIH to establish an inter-institute working group to coordinate NIH research focused on finding a cure for hepatitis B and liver cancer. 

We are pleased to let you know that due to this outreach, the NIH is establishing a Trans-Institute Hepatitis B Working Group. This Working Group has been tasked with developing a Strategic Plan to Cure Hepatitis B, which Dr. Tabak stated should be a “huge boost” to the shared goal of finding a cure for hepatitis B. The formation of the group follows the NIH’s release in February 2019 of a Request for Information (RFI) that asked members of the research community to provide input on a strategic framework for the Working Group. The RFI suggested the Strategic Plan focus on three areas of research that are essential to developing a cure for hepatitis B:

  • Understanding Hepatitis B Biology
  • Developing Tools and Resources
  • Developing Strategies to Cure Hepatitis B

NIH has reported that there was a very enthusiastic response to the RFI, and they are currently working to finalize an RFI Analysis Report and will include all the responses as an appendix. The report will help to guide the Working Group as they create their strategic elimination plan. Both the Trans-Institute Hepatitis B Cure Strategic Plan and the RFI Analysis Report will be made available to you in the coming months.

The Trans-Institute Hepatitis B Working Group is comprised of representatives from various Institutes within the NIH: the National Institute of Allergy and Infectious Diseases (NIAID), the National Cancer Institute (NCI), the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), and the National Institute on Minority Health and Health Disparities (NIMHD). NIAID has been asked to lead and coordinate the Working Group.

This is good news as we work towards finding a cure for hepatitis B. All increased investments help support and implement the goal to eliminate hepatitis B globally. Having new treatments, and especially a cure, will be critical to reach this goal. Seeing the increased interest among the NIH, as well as the nation’s hepatitis B experts and researchers, is an exciting step in the journey to find a cure. 

Hepatitis B Advocacy, Hepatitis B Treatment, Living with Hepatitis B, Uncategorized

We’re Here to Help: New Resource to Improve Medication Access in the U.S.

Are you a hepatitis B patient living in the United States? Are you taking entecavir or tenofovir disoproxil fumarate (TDF) to help manage your hepatitis B infection? Thanks to the Hepatitis B Foundation’s new strategic partnership with Rx Outreach – America’s largest fully licensed, non-profit, mail order pharmacy and Patient Assistance Program – you may be able to receive your medication for less than 5% of the average retail price!

Each year, we answer thousands of national and international phone calls, emails, and social media messages from people who have been impacted by hepatitis B. Over the past year, we have seen a significant increase in calls regarding access to medication. The majority of those calls have been from people living in the United States. The ability to access medications is more than just having them available at a local pharmacy – it is about the price as well.

In the United States, life-saving generic treatments can cost more than $830 a month on average. As treatments are typically taken for several years after a person begins, paying such high monthly out-of-pocket costs simply isn’t an option for most people. That’s why we partnered with Rx Outreach to increase patient accessibility to life-saving hepatitis B medications.

We believe that affordable treatments should be low-cost and widely available to everyone who needs them. Hepatitis B antiviral treatments need to be taken daily in order to be effective, and a lack of affordable options force some individuals who are living with chronic hepatitis B to avoid diagnosis and treatment, to stop taking medication or to only take it sporadically, which increases their risk of developing cirrhosis or liver cancer. Our new partnership can help eliminate the need for such potentially harmful actions by providing the same medication at a much lower cost than retail pharmacies, pharmaceutical companies, and insurance plans can offer.

Rx Outreach provides a 30-day supply of entecavir and TDF – two of the most effective, common, and preferred treatments – through the mail. Interested individuals can enroll in the program with 3 simple steps. If you need to transfer your prescription from another pharmacy, you can do that too!

Eligibility Requirements:

Eligibility is based upon household income, not on insurance status or prescription drug coverage. To be eligible for Rx Outreach’s pricing, please review the chart below or you can check your eligibility here. If it appears that you do not qualify but you believe that you should, you can also call Rx Outreach and a representative will assist you.

Our partnership with Rx Outreach will help to fill a gap in access to affordable medication and help to lessen the burden of one of the many forms of discrimination that those living with hepatitis B must face. It offers more than 1,000 medication strengths at affordable prices. Since 2010, Rx Outreach has saved people in need more than $662 million on their prescription medication.

Hepatitis B Advocacy, Living with Hepatitis B

#Tri4ACure: Racing For Hepatitis B Awareness, Cure Research, and Health

Edwin Tan learned about his hepatitis B diagnosis in high school after he was banned from donating blood to the Red Cross. Unsure as to why he was not allowed to donate, Edwin asked his doctor about it a few years later. When the routine blood tests came back with irregular results, the doctor ordered an additional test for hepatitis B; the hepatitis B test came back positive.

Despite the shock of the diagnosis, Edwin did not let it hold him back! He researched the infection and discovered the importance of keeping his liver healthy. He took steps to change his diet and incorporate more exercise into his daily routine. Studies show that regular exercise can greatly reduce the risk of liver disease and liver cancer. After a friend invited him to participate in a small triathlon, Edwin decided that triathlons and racing were the perfect ways to have fun while staying healthy!  

Now, Edwin is competing in a series of six races in midwestern America to help raise  money and awareness for hepatitis B research, patient outreach, and education through the Hepatitis B Foundation! You can make a gift to support Edwin’s fundraising efforts here.

“Hepatitis B is something that doesn’t seem to have a whole lot of awareness around it, has stigma associated with it, and doesn’t seem to attract the same attention as a lot of other major diseases out there,” said Edwin. “I believe that the Hepatitis B Foundation is working to tackle all of these issues and focus on finding a cure for it. Because hepatitis B was the reason I started racing and I am interested in increasing awareness, I found it fitting to race for the Hepatitis B Foundation.”

On Saturday, June 15th, Edwin competed in the Minnetonka Triathlon in Minnetonka, Minnesota – his first of six races this summer. In just under an hour and a half he accomplished: swimming more than 100 yards, biking 15 miles, and running 3 miles!

Edwin’s next race will be on Saturday, June 22nd at Grandma’s Marathon in Duluth, Minnesota and we are looking forward to cheering him as he works hard to raise awareness and prove that those living with hepatitis B can achieve their goals

To follow updates on Edwin’s journey, you can follow the Hepatitis B Foundation or Hep B United on Facebook, Twitter and Instagram. Be sure to use the hashtag #Tri4ACure!

Hepatitis B Advocacy, Living with Hepatitis B

Know Your Rights: Legal Protections for Those Living With Hepatitis B

Despite being the world’s most common liver infection, hepatitis B remains stigmatized and those living with it can still face discrimination from various sources. Each year, the Hepatitis B Foundation answers numerous calls from around the world from people who have faced school, workplace, and travel challenges due to their hepatitis B status. These challenges are typically rooted in misinformation, outdated laws or guidelines, stigma, and an overall lack of awareness. However, there are laws and organizations who will work to protect you from such discrimination!

The Hepatitis B Foundation has added a new section to our website that focuses on the rights of people living with hepatitis B. We’ve compiled information on common barriers that those living with hepatitis B may face while applying to schools, jobs, or accessing affordable medicine. Each of the below sections provides information on discriminatory practices, what you can do if you experience discrimination, and how the Hepatitis B Foundation is working to fight discrimination.

In the United States, all forms of hepatitis B related discrimination are illegal under the Americans with Disabilities Act (ADA) and the Affordable Care Act (ACA). Both laws include provisions that protect people living with chronic conditions. Unfortunately, some forms of discrimination are still legal in certain countries, but steps can sometimes be taken to appeal to immigration policies in these areas. Local organizations can also help those living in foreign countries to navigate complex laws or policies regarding those living with hepatitis B. Many of these organizations can be found through the World Hepatitis Alliance’s member list. Join them and add your voice to eliminate hepatitis B discrimination in your country.

Specific protections, resources, and ways to combat legal discrimination can be found in the Know Your Rights section of our website! If you are faced with discrimination due to hepatitis B, it is important to know your rights and to have information to support your case. Use the information on our site to help advocate for yourself, join with others, or contact the Hepatitis B Foundation at info@hepb.org if you need additional assistance.

Living with Hepatitis B, Relationships

If I Have Hepatitis B, Why Doesn’t My Partner?

Why do some people — who were not vaccinated — never get hepatitis B from their sexual partners who are living with chronic hepatitis B? The question is a common one. As a sexually transmitted infection, it may seem obvious that an individual may contract hepatitis B from their partner, especially if they have been together for some time.

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 hepatitis B vaccine is safe, effective, and provides lifelong protection.

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

Baruch S. Blumberg Institute