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Hepatitis B Prevention, Living with Hepatitis B

Celebrate World Hepatitis Day By Making Hepatitis B History

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Joan M. Block, Co-Founder and Executive Director
Joan M. Block, Co-Founder and Executive Director

By Joan M. Block, RN, BSN
Executive Director and Co-Founder, Hepatitis B Foundation

Tuesday, July 28, is World Hepatitis Day, which commemorates the birthday of Dr. Baruch S. Blumberg, who won the Nobel Prize in Medicine for identifying the hepatitis B virus and developing a vaccine to prevent it. This year also marks the 50th anniversary of the discovery of the hepatitis B virus – a discovery that has literally saved hundreds of millions of lives.
Continue reading "Celebrate World Hepatitis Day By Making Hepatitis B History" →

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

Expert Calls for Viral Load Testing in All Pregnant Women with Hepatitis B

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Dr. Ravi Jhaveri, an infectious disease specialist at the University of North Carolina at Chapel Hill School of Medicine, talks to parents.
Dr. Ravi Jhaveri, an infectious disease specialist at the University of North Carolina at Chapel Hill School of Medicine, talks to parents.

Today, all pregnant women are routinely screened for hepatitis B, but a growing number of doctors say this single test doesn’t go far enough to protect the health of women and children.

In a commentary published in the medical journal Pediatrics,  infectious disease specialist Dr. Ravi Jhaveri calls for a mandatory second test in pregnant women infected with hepatitis B. This test would measure the amount of hepatitis B virus (HBV) in her body (called viral load).

When women have high viral loads, their newborns can become infected even if they are immunized at birth and treated with HBIG (hepatitis B antibodies) to prevent infection. Continue reading "Expert Calls for Viral Load Testing in All Pregnant Women with Hepatitis B" →

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

Four Things Fathers Affected by Hepatitis B Can Do for Themselves and Their Families

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Image courtesy of photostock at FreeDigitalPhotos.net
Image courtesy of photostock at FreeDigitalPhotos.net

Father’s Day, June 21, is a day to celebrate the contributions men make in their children’s lives. It’s also a good day for fathers to acknowledge how valuable they are to their families and how important it is to take care of their health.

Living with chronic hepatitis B can be challenging. Here are some things dads can do to take care of themselves or family members infected with hepatitis B.

1. Get outside and soak in some sunlight and some vitamin D. People with hepatitis B who have vitamin D deficiencies have higher rates of liver damage, cirrhosis and cancer. A healthy diet provides vitamin D, but 80 percent of our vitamin D comes from 15 minutes of exposure to sunlight two to three times a week. So get outside and walk, garden, exercise and soak in some healthy sunlight.

Continue reading "Four Things Fathers Affected by Hepatitis B Can Do for Themselves and Their Families" →

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WHO’s New HBV Guidelines to Help Combat Africa’s Growing Hepatitis B Crisis

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The World Health Organization (WHO) will release their first management guidelines for hepatitis B virus (HBV) by the end of 2014. For the first time, the guidelines will be geared towards resource-constrained countries, where the disease burden is high but resources are lacking. The new guidelines will be particularly welcome in African nations, where the incidence of viral hepatitis is increasing.

The overall scope of the World Health Organization’s new management guidelines for hepatitis B will include prevention, screening, and treatment of chronic hepatitis B and will be geared towards resource-constrained countries. Thus, WHO’s guidelines will be valuable for countries where the disease burden is high but resources are lacking.

The WHO Global Hepatitis Programme established a Guideline Development Group of external experts in 2013, which includes Hepatitis B Foundation (HBF) executive director Joan Block, and is co-chaired by Dr. Brian McMahon, who also serves on the HBF Scientific and Medical Advisory Board.

The new WHO guidelines will be particularly welcome news to African nations, where the incidence of viral hepatitis is increasing.

According to the WHO Global Hepatitis Survey 2013, the prevalence of chronic hepatitis B virus (HBV) infection on the African continent is up to 8% of the general population, and 75% of the population may have had prior exposure to the virus.

Yet, only two of the African member states that responded to the WHO Survey have a written national strategy to prevent and control viral hepatitis.

In Ghana, where the incidence of viral hepatitis is increasing, the sero-prevalence rate is high among blood donors (6.7%), pregnant women (6.5%) and school
aged children (15.6%), according to Mr. Theobald Owusu-Ansah, president of the Theobald Hepatitis B Foundation and the Hepatitis B Coalition in Ghana.

Compounding the lack of public health plans and national investment are factors common in many low-resource countries: limited awareness of hepatitis B among the public and providers, poor access to care, expensive therapies, and few liver specialists.

Global agencies are beginning to recognize the urgency of the situation. In addition to the WHO, the World Health Assembly is taking steps to combat the growing crisis. The Assembly adopted a second resolution on viral hepatitis in May 2014 that advises governments on how to prioritize and coordinate public health efforts.

But governments cannot tackle these problems alone, Mr. Owusu-Ansah believes. He urges governments to partner with commercial and nonprofit organizations to mobilize much-needed expertise and resources.

Continue reading "WHO’s New HBV Guidelines to Help Combat Africa’s Growing Hepatitis B Crisis" →

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HBV Journal Review – November 2014

ChrisKHBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
 latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:

  • Experts Say Breastfeeding While Taking Antivirals Is Safe
  • Doctors Fail to Adequately Treat HBV-Infected Women After Childbirth
  • Doctors Continue to Fail to Screen Asian-Americans for Hepatitis B
  • Statins Protect Hepatitis B Patients Against Heart Disease and Liver Cancer
  • New Study Finds Antivirals Lower Liver Cancer Risk
  • Studies Find Tenofovir Lowers Viral Load Faster Than Entecavir
  • Liver Transplants Safe in Older Hepatitis B Patients
  • Scientists Develop Micro Weapon to Disable HBV’s Cancer-Causing X Protein
  • Foreign-Born U.S. Residents Less Likely to Be Immunized
  • Antivirals Can Safely Replace HBIG Following Liver Transplantation
  • All Hepatitis B Patients Appear at Risk from Chemotherapy

Continue reading "HBV Journal Review – November 2014" →

Living with Hepatitis B

Hepatitis B Positive Speakers Discuss HepB with Geraldine Doogue

Heartfelt discussion with the “Hepatitis B Positive Speakers Group”, led by Australia’s Geraldine Doogue, ABC TV and Radio. Join Yvonne, David, Trevor, Linh and “Tina”, as they discuss their personal hepatitis B experiences -living with the stigma, and discrimination you can both see and “not quite put your finger on”, and their willingness to give back, and to increase community awareness.

If you’re on the Hepatitis B Information and Support Listserve, you may recognize Yvonne, one of the list moderators who mentions the emotional support she gets from her her cyber friends. 

Thank you Hepatitis Australia for sharing this discussion! 

 

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‘Think Again’ About Hepatitis – World Hepatitis Day Events in Ghana

imagesTheobald Owusu-Ansah of the Theobald Hepatitis B Foundation works tirelessly to raise the profile of hepatitis B in Ghana, where the HBV prevalence is approximately 30% in blood donors. Through collaboration with others, and heightening awareness with Ghanaian celebrities, Theobald and others were able to raise viral hepatitis awareness, and provide free screening and HBV vaccination during their World Hepatitis Day event this year. Read his account below and check out Theobald and the work he and his foundation are doing at the www.theobaldhepb.org or find THBF on Facebook. 

Viral hepatitis is the leading cause of liver cancer, which is the second most common cause of cancer deaths in Africa. On World Hepatitis Day, we urged the government to take actions ASAP to improve hepatitis awareness, monitoring, prevention and treatment.
 ASAP is a blue print framework for Global action, developed by the WHO to guide national government on the effective ways to prevent and control the transmission of viral hepatitis. This framework has four axes:

1.  Awareness raising, partnership promotion and resource mobilization,
2.  Scientific evidence that drives policies and actions,
3.  Access to immunization and information to prevent transmission,
4.  Provision of screening, care and treatment.

Thousands of Ghanaians live with viral hepatitis. About a third of Ghanaians living with viral hepatitis are unaware of their status and are not receiving care and treatment for the condition. It is estimated that hepatitis B kills over 1 million people each year, and an estimated 1 in 12 persons are currently infected and have to face life with chronic liver disease.

Ghana belongs to one of the areas where the prevalence of chronic HBV infection is high (≥8%), and that of hepatitis C is from 5-10%. There is high prevalence in approximately 30% among blood donors.
 In the year ending 2010, the incidence of viral hepatitis in Ghana was 43/100,000 population, with 102 deaths, which represents a 30% increase as compared to the year 2006 incidence of 30/100,000 population. (Source: www.theobaldhepb.org)

Ghana is rated a high-risk country for hepatitis B & C with between 10 and 15 percent prevalence rate. Out of every 100 Ghanaians, 13 may test positive for hepatitis B, which is far more prevalent than HIV/AIDS.

On the 20th July 2014, Celebrities in Ghana united to raise funds to support free Hepatitis B screening and vaccination. The program was under the theme “Celebrities Car Wash”.  Celebrities including Okyeame Kwame, Ghana Rap Doctor, former national black stars captain Stephen Appiah, Ghanaian actor Van Vicker and others volunteered to wash public cars for a fee to raise funds to support the programme.

The staff of Theobald Hepatitis B Foundation, Okyeame Kwame Foundation and other medical officials joined the celebrities for the car washing fundraising event. Members of the public took advantage of the celebrities’ car wash to bring their cars to be washed by their favorite’s celebrities. Celebrities expressed their interest in becoming viral hepatitis ambassadors in Ghana.

The event showed that you don’t need a big bank account to be able to make a difference, but with a bit of vision, one can create awareness.

On that day, we are calling on the government to develop and implement coordinated national action plans to fight viral hepatitis. The Theobald Hepatitis B Foundation in collaboration with the Hepatitis Coalition of Ghana, Okyeame Kwame Foundation together with MDS Lancet Laboratories, Roche and Ridge Hospital RPD on Saturday 26th July, 2014, offered free hepatitis B screening and vaccination to hundreds of people at James Town – Mantse Abgona in Accra. Out of 359 people screened, 49 people tested positive and they received counseling on what to do and what not to do, in terms of treatments and other biochemical tests they needed to undergo.

The Rapper observed that the youth turned out for the screening this year and expressed appreciation for the turnout. “I am really glad to see most of the young people come for the screening. This is to say that the youth is giving attention to health and this also indicates that we are moving in the right direction as a people,” says Okyeame Kwame.

The president of the Theobald Hepatitis B Foundation, Mr. Theobald Owusu Ansah delivered his speech for the occasion on the theme: “HEPATITIS: THINK AGAIN”, calling on the government to give much attention to Hepatitis B.

Thank you to all World Hepatitis Day supporters, sponsors and the media who volunteered their time, supplies, and/or funds to support this year’s events, and raising the profile of viral hepatitis in Ghana.

 

Hepatitis B Advocacy

Hepatitis is Still the Silent Killer

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Great way to wrap up World Hepatitis Day events with a commentary from our viral hepatitis champions on Capitol Hill. A big thank you to Senator Mazie K. Hirono and Representatives, Michael M. Honda, Hank Johnson, and Bill Cassidy for their tireless efforts. Viral Hepatitis is a problem we cannot ignore!

Roll Call (online) By Sen. Mazie K. Hirono, and Reps. Michael M. Honda, Hank Johnson, and Bill Cassidy. July 31, 2014, 5 a.m.

Although the price of a revolutionary new hepatitis C treatment has made headlines recently, the real hepatitis crisis continues largely unreported. A more immediate problem for many Americans is not how much one hepatitis C treatment might cost; it is how many Americans are infected with viral hepatitis and do not even know it.

World Hepatitis Day, July 28, reminds us that more than 5 million Americans — or 2 percent of the population — are living with viral hepatitis. Yet the Centers for Disease Control and Prevention (CDC) estimates as many as 75 percent of these Americans are unaware they have the virus. This “silent killer” goes undetected because the virus often remains asymptomatic until it has already wreaked havoc on the liver, causing cirrhosis, end-stage liver disease, or liver cancer. According to the CDC, more than 30 percent of infected individuals will develop one of these conditions.

Meanwhile, since the majority of infected individuals don’t realize they have hepatitis, they do not take the necessary precautions and can unknowingly transmit the virus to others. More Americans die every year from hepatitis C than HIV.

Without effective intervention, it is estimated that deaths due to the hepatitis C virus will double, or even triple, in the next 20 years. Baby boomers — Americans born between 1945 and 1965 — make up 75 percent of Americans with hepatitis C, and are five times more likely to have the virus than the general population.

Hepatitis disproportionately affects communities of color. One in 12 Asian-Americans has chronic hepatitis B, and rates are increasing in African immigrant and Latino populations as well. Hepatitis C is twice as prevalent in African-Americans as in the general U.S. population. Despite the pervasiveness of viral hepatitis, and its potentially deleterious consequences for those infected, testing is not nearly as prevalent as it should be.

The Viral Hepatitis Testing Act, introduced both in the House of Representatives and the Senate, would create the first coordinated national system to address and combat viral hepatitis. It would expand hepatitis education, testing and care, with the priority of reaching those most at-risk. Most importantly, the legislation would help to halt the spread of viral hepatitis by strengthening health care coordination to ensure that patients who test positive are connected with the counseling they need to control their disease and prevent transmission. Through the Viral Hepatitis Testing Act, we can increase the number of individuals who are aware of their status from 25 percent to 75 percent in just two years.

Awareness is the antidote to this silent epidemic. Early diagnosis, determined through a simple blood test, can reduce the spread of viral hepatitis simply by making individuals aware of the infection and helping to connect them with education about the risks of transmission. Organizing our outreach and prevention to be culturally competent and available in different languages will help us reach those communities that are disproportionately affected. The CDC estimates that one-time testing of baby boomers alone would identify 800,000 undiagnosed hepatitis C cases nationwide, and prevent more than 120,000 deaths. We need action at the federal level to make viral hepatitis testing a national priority.

The true cost of viral hepatitis is not measured in the cost of one drug. It is how this epidemic will continue to grow if policymakers do nothing. We urge our fellow lawmakers to enact the Viral Hepatitis Testing Act and establish hepatitis awareness as a national priority.

We cannot ignore this problem.

Mazie Hirono is a Democratic United States Senator from Hawaii. Michael M. Honda is a seven-term Democratic congressman representing the 17th District of California, better known as Silicon Valley. Hank Johnson is five-term Democratic Congressman representing Georgia’s 4th District in the suburbs of Atlanta. Dr. Bill Cassidy is a three-term Republican Congressman representing the 6th District of Louisiana, including Baton Rouge and Houma.

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The Public Health Popularity Contest: Why You’ve Never Heard of Hepatitis B

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charlotte_lee_hep_b-1Please welcome guest blogger Charlotte Lee, a pre-med Duke University Senior who has a passion for global health. Charlotte recently learned first hand how viral hepatitis  disproportionately impacts her community and how it tragically touched her own family.  

I walked into the first day of my internship ready to take on what I thought were the major public health crises of the world – malaria, AIDS, avian flu. Instead, my supervisor gave me a hefty stack of literature on hepatitis B. Sure, as a premed student I knew that hepatitis had something to do with the liver, but I was shocked to find out that hepatitis B was the most common serious liver infection in the world—one that chronically affects over 350 million people worldwide, including 1 in 12 Asian Americans—and I had never heard of it.

As a 21-year old Asian American who is passionate about global health, I felt cheated to only now discover that there is an infectious disease disproportionately affecting my community. Somebody should have told me about this! To then find out that it was completely vaccine-preventable – somebody should have told everyone about this!

About halfway through my internship, I found out that my grandfather died from viral hepatitis that he contracted through a blood transfusion. Suddenly the disease had a face, and it was a smiling man with wide rimmed glasses who used to sit me on his lap and feed me popcorn. It now feels like my duty to spread the word.

Hepatitis B is transmitted through blood or body fluids and causes deadly liver disease, including liver cancer, in 1 out of every 4 chronically infected people. Meanwhile, the famous West Nile Virus causes serious illness in less than 1% of infected people.

So, what makes this disease so easy to ignore? Hepatitis B is unfortunately an invisible disease; it can take up to 20-30 years before symptoms appear, at which time cirrhosis or liver cancer may have already developed. Hepatitis B is a silent killer and it affects a population invisible to the media and policy.  Anyone can get hepatitis B; however, people born in countries outside the US that have not instituted a strong hepatitis B testing and vaccine program have a large population (2 out of 3 people) who are unaware they are infected. Most get the disease at birth from their mothers who are chronically infected with hepatitis B. Many are impoverished and disenfranchised. Asian Americans make up more than half of hepatitis B cases in the US, but those from many other countries around the world are also at risk for having the disease.

However, the “it won’t happen to me, so I don’t care” rule doesn’t work for all diseases. Most people in the US don’t consider themselves at risk for AIDS, malaria, or tuberculosis, yet those diseases have plenty of name recognition.

One thing that AIDS, malaria, and tuberculosis all have in common is their deadliness. AIDS killed 1.47 million people in 2010. But did you know that viral hepatitis (hepatitis B & C combined) killed 1.44 million that same year?

Its symptomless nature also makes it hard to visualize. While other diseases invoke graphic images of illness, hepatitis devastates the liver. Most people probably don’t really know where their liver is located.

What frustrates me most is that it is a preventable disease, one that we can eradicate. The hepatitis B vaccine is one of the safest and most effective immunizations available, and it protects you for life. The CDC recommends all babies receive the vaccination at birth, yet many major hospitals in NYC are not immunizing newborns, with some vaccination rates as low as 20%.

Hepatitis B needs public health champions to get it into the spotlight. Policies need to be passed to fund much-needed education, surveillance, and treatment programs. Doctors should be educated about it, tests should be automatically ordered, and the government should pay for everyone to be vaccinated. This system doesn’t yet exist, but thankfully there are people working tirelessly towards it.

Monday was World Hepatitis Day 2014. This year, the Viral Hepatitis Testing Act was introduced in the House and Senate to provide $80 million over three years for prevention, testing, and linkage to care. This is the second term this bill has been introduced, and now it’s time to pass it. Locally, the New York City Council just introduced a $750K viral hepatitis initiative for 2015. And just last week, Councilwoman Margaret Chin was on NBC talking about the first ever NYC Hepatitis B Awareness Week. My internship will soon end, but advocacy never rests. There is always more to be done.

charlotte_leeCharlotte Lee is a premed Duke University senior, where she studies Public Policy with minors in Global Health and Chemistry. This summer, she has been working on hepatitis B policy issues at the Charles B. Wang Community Health Center in New York City, where she was co-coordinator of the first-ever NYC Hepatitis B Awareness Week. She is passionate about health disparities and aspires to be an OB/GYN and women’s health advocate. Her biggest claim to fame is that she may have discovered a new species of sand fly last summer in the Peruvian Amazon (confirmation still pending). 

Baruch S. Blumberg Institute