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Living with Hepatitis B

Update on the Adoption of a Waiting Child with Hepatitis B

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We are very pleased to share a very special update on the status of William, a waiting child  living with chronic hepatitis B, who captured the hearts of the Hepatitis B Foundation staff. This update comes from Nathalie, Adoption Advocacy Director at An Orphan’s Wish…

“I am thrilled to report that William is in the process of being adopted by his forever family, where he will join his new, wonderful Mom and Dad and his two-new sisters. William’s youngest sister is also adopted from China. When William’s mother contacted An Orphan’s Wish to inquire about him, she had some questions about the implications of daily living with an HBV positive child, and how it affects the child’s life and the life of other family members. The information the Hepatitis B Foundation provided was extremely helpful in answering the family’s questions, and in providing them with enough knowledge to ask informed questions of health care providers. Information provided by the Hepatitis B Foundation allowed this prospective family to have peace of mind about William’s hepatitis B diagnosis, realizing that it is a manageable chronic condition. This enabled them to focus on the specifics of William rather than his HBV. William’s family very quickly responded with more questions for me about his personality, his likes and his dislikes, his dreams and his hopes, rather than focusing on his HBV. They were adopting a son they were thrilled to parent, and thought little of his HBV diagnosis.

As an adoption advocate, the information provided by the Hepatitis B Foundation has been invaluable in educating me about hepatitis B, and HBV positive children. I feel that I have a much better understanding of this chronic condition, and I am in a much better position to answer questions from families considering the adoption of an HBV positive child. I will continue to refer families inquiring about hepatitis B positive children to the Hepatitis B Foundation. They are a wonderful resource! “

Nathalie

The Hepatitis B Foundation wishes only the best for William, his new family, adoption advocates like Nathalie, and all of the children out there who are waiting, living with HBV.

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Gateway to Care: A Hepatitis B Public Health Program in Haimen City, China

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The Hepatitis B Foundation launched its Gateway to Care public health program on April 8, 2011. The program has been up and running ever since.  An introduction to the program, followed by a quarterly update by Dr. Gang Chen, seems important, so others are aware of this successful program.  The Haimen City project is led by Gang Chen, MD, PhD, and Director of China Programs for HBF. Dr. Chen was born in Haimen City and received his training from the Shanghai Medical School approximately 60 miles from Haimen City, in Shanghai. For the past 15 years, Dr. Chen has been traveling bi-annually to continue data collection for the Haimen City cohort study. He was the perfect candidate to lead the Gateway to Care public health campaign.

The Gateway to Care campaign, Haimen City, was made possible by a $400,000 educational grant from the Bristol-Myers Squibb Foundation. Haimen City was selected because it has one of the highest HBV and liver cancer rates in China. Over 10% of the population are hepatitis B carriers.

The goal of the Gateway to Care campaign is to educate and help raise HBV and liver cancer awareness among its one million residents.  The project has three primary goals focusing on raising public awareness, providing target group education and providing hepatitis B management for pregnant women. Ultimately the main goal of the campaign is to create a model program that can readily be adapted and duplicated in other cities throughout China, where the hepatitis B and liver cancer burden is also enormous.

Public health programs like the Haimen City, Gateway to Care campaign must be carefully created based on the culture and the population and the language. China is a large, diverse country. Materials must be developed that address the needs of the community and will be accepted. It’s not a speedy process, but one that must be slowly integrated into the fabric of the community. The goals of the program were emphasized through community events, giveaways, public displays, public screenings, and the education of local doctors, who are the community’s front line physicians. Because HBV is very effectively transmitted vertically from HBV infected mom to her baby at birth, an HBV management program was also put into place specifically for pregnant women, which also includes both a retrospective and a prospective study.

A project logo was created emphasizing the key message and creating a brand. Standard playing cards with 15 key messages pertaining to HBV transmission, prevention, testing and treatment were also printed on the cards making them both functional and educational. Pamphlets and billboards with more detailed information were created and displayed or distributed at community events along with the cards.  A bi-monthly health education publication featured important knowledge about hepatitis B was delivered to every household, or a total of 280,000 households, reaching the one million residents of the city. These are very effective modes of outreach in the Haimen City community.

Stay tuned for the next update from Dr. Chen on more detailed specifics of the Gateway to Care, public awareness part of the public health campaign.

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Help Us Choose the Round 2 Winner of the “B A Hero” PSA Video Contest!

Round 2 of the “B A Hero” PSA Video Contest is over and there are two great PSA videos that have been created! View and cast your vote for your favorite. Both videos are awesome! Vote once, or better yet, vote once per day through March 30th!

We can’t post the videos directly, or you won’t be able to vote, so just click here, and you will be directed to the application that will allow you to view the videos and choose your favorite! Make sure you’re logged into your facebook account, and don’t forget to invite your friends!

Now that you know how cool the videos are, how about joining the fun and raising HBV awareness by creating your own “B A Hero” PSA video?  Round 3 is open and will close on April 13th! Join the fun. Here’s how…

 

 

 

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Simple Impediments to Hepatitis B and C Screening

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There was an article in the Baltimore Sun a couple of weeks ago that discussed screening for hepatitis B and C.  Approximately 600 million people around the world and five million people in the U.S. are infected with viral hepatitis. According to the Annals of internal Medicine, the CDC reports that there are more deaths attributed to HCV than HIV in the U.S.

The Baltimore doctor believes that ideally, everyone should be tested for hepatitis B and C. Although he is not alone in his thinking, there are many physicians that may not be as aware of the need for screening, and even those in high risk groups may be inadvertently missed. And should a physician decide to screen, there is no ICD code, or International Classification of Diseases code for high-risk based HCV or HBV screening. Insurance companies use these codes to determine if services and payment is warranted. An insurance company may actually deny payment for HBV or HCV testing if they do not believe there is a valid reason for screening.  For example, elevated ALT levels might prompt a physician to “legitimately” screen for viral hepatitis. There is also no problem with ICD codes if you are already diagnosed with HBV or HCV, but you can’t readily be screened using a convenient code. Viral hepatitis does not discriminate. There are certainly high risk groups where HBV or HCV may be more prevalent, but that should not discourage a doctor from screening a patient if she feels it is warranted.

How might a doctor get around a lack of adequate diagnostic codes? We asked a physician who cares for Asian-Americans. This group is at particular risk for HBV infection and should be screened whether they have elevated ALTs or not. He circumvents the lack of an official ICD code with a work-around. He uses the “CMS code V15.85 – Contact with and (suspected) exposure to potentially hazardous body fluids”. This works, but some physicians may not be as comfortable as others with this work-around. Sadly, this likely equates to fewer across-the board screenings for hepatitis B and C.

New HCV testing recommendations are to be released sometime this year by the CDC, and the US Preventive Services Task Force will weigh in on the HCV screening debate as well. Thus, there might be an ICD code for routine HCV screening code available in the near future. Despite established HBV screening guidelines, there are currently no ICD codes for routine HBV screening and to my knowledge, none are to be proposed. Would more patients be routinely screened for HBV if the process were more straight forward? Probably. It is unfortunate that an important screening may be impeded by the lack of a simple diagnostic code. Naturally this is not the only problem, but it is one that should be easy to resolve.

If you think you are at risk for HBV, or wish to be screened for HBV, please tell your doctor that you want to be sure about your HBV status. If you insist, I’m sure he will comply with your wishes and work around any issues regarding inadequate diagnostic screening codes for hepatitis B. Speak up and be your own advocate!

Hepatitis B Prevention

Love Safely This Valentine’s Day

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Please be sure to love safely this Valentine’s Day.  Are you living with HBV or hoping to avoid living with HBV? HBV is a vaccine preventable disease that is effectively transmitted sexually. If you are not infected with HBV, why not get vaccinated and protect yourself for life? The HBV vaccine is a safe and effective, 3 shot series. If you think you might be in a high risk group for HBV, talk to your doctor about first being screened for HBV before being vaccinated.

If you already have HBV, the vaccine won’t protect you. You need to talk to your doctor about your HBV status and whether or not you would benefit from treatment at this time (Not everyone needs treatment, but you need blood work interpreted by an HBV knowledgeable doctor to be sure).

Show the love by protecting yourself and your sexual partners by wearing a condom. They protect the mouth, vagina or rectum from infected semen if used consistently and correctly.  Keep in mind that the riskiest sexual activity is unprotected receptive anal intercourse. This is because the lining of the rectum is very thin and more likely to bleed leading to the possibility of infection with blood borne pathogens like HBV, HCV and HIV, along with other sexually transmitted diseases. Receptive vaginal intercourse is the next highest risk. Although the lining of the vagina is stronger than the rectum, inflammation, infection, or microscopic scrapes make the vagina vulnerable to unprotected intercourse. The likelihood of blood borne pathogen transmission with oral sex is least risky, but that is because the risk of blood contact is much lower. However, any kind of intimate sharing of bodily fluids presents some degree of risk of transmitting blood borne pathogens like HBV, HCV and HIV, and may effectively transmit other sexually transmitted diseases.

It’s important if you’re living with HBV, not living with HBV, or not quite sure of your infectious disease status. If you are living with HBV, properly wearing a condom keeps you safe from becoming co-infected with another infectious disease. No one wants a co-infection.  It complicated and dangerous for your health.  If you do not have HBV, then avoid getting an infection by you or your partner wearing a condom. HBV is vaccine preventable, but HCV, HIV and other STDs are not vaccine preventable. 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. Why take the risk? Love safely, get vaccinated against HBV, and wear a condom consistently and correctly. “Share affection, not infection”.

Hepatitis B Prevention

Considering the Transmission of HBV Through Tattooing or Piercing

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This month’s Clinical Infectious Diseases evaluated the transmission of HCV through tattooing and piercing. It is important to note that HBV is also of great concern when considering a tattoo or piercing. Unless you are vaccinated against hepatitis B, you are at risk for HBV if you are tattooed or pierced under unsterile conditions. The net-net is if you have a tattoo or piercing in a professional parlor – one that follows infection control practices and uses single-use items whenever possible and sterilizes re-used equipment using ultrasonic cleaning and sterilization with an autoclave , there does not appear to be an increased risk, though additional study is warranted. However, tattoos or piercings in prisons, or other settings that are not performed under sterile conditions are a serious danger.

The process of tattooing entails repeated injections of tiny drops of ink. That’s thousands of tiny needle sticks per minute, and a very effective transmission route for blood borne pathogens like HBV, HCV and HIV. This does not mean getting a tattoo will expose you to infectious disease, but if you choose a tattoo parlor that is not well regulated and safely follows all infection control practices, then you greatly increase your risk of infection.

Here’s the problem with tattoo parlors in the United States. They are not carefully or consistently regulated. There are no federal regulations. For the most part they are state regulated, with each state having its own rules and regulations.  Regulated states require that tattoo parlors have permits, and be inspected. Who inspects the parlor? – Sometimes it’s the State Department of Health, and sometimes it’s the local health department, so the inspections vary. There are some states with local regulations within the state, and even a few states with NO regulations. That is worrisome and dangerous. What are the rules and regulations for your state on this unofficial list? (Please read the site disclaimer) Do the research on the rules in regulations in your state, or city before looking for a tattoo parlor.

What does this mean if you’re considering a tattoo? Your tattoo is a personal decision that will live with you for the rest of your life. You don’t want to contract an infectious disease that may also live with you for the rest of your life and potentially threatens your life.  Shop for a clean, parlor that treats each tattoo like a mini, out-patient procedure – with all infection control practices followed. You want a tattoo parlor that uses single-use needles, ink, ink cups, and gloves. You want to see these tools come out of their sterile packaging –right in front of your eyes. You want a tattoo parlor with a functioning, inspected autoclave so that re-usable tools such as tattoo machines and needle bars can be properly sterilized. You want a tattoo parlor that is clean and an artist that washes his hands and wears gloves. If the shop is dirty, keep looking.  Speak up and ask the artist questions about his shop and his infection control practices. Don’t forget to ask to see the autoclave. If anything makes you wary about the visit, look else-where.

 

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Create, Submit, & Win The B A Hero PSA Video Contest! Help Raise HBV Awareness!

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Hep B Free Philadelphia “B A Hero” PSA Video Contest 2012

Channel your creativity and skills for a good cause and win prizes!

Raise HBV awareness!

 

Hep B Free Philadelphia and Hepatitis B Foundation invite you to create a 30-second Public Service Announcement (PSA) to raise awareness about hepatitis B. Finalists will receive prize money and the winner’s PSA will be shown at Hep B Free Philadelphia’s annual media event as well as ** drum rolls** the 2012 Philadelphia Asian American Film Festival! Thousands will get to see your creative brainchild!

Hepatitis B is a serious infection that affects about 2 million people in the United States. About 1 in 10 Asian Americans and Pacific Islanders are chronically infected—with African immigrants approaching a similar ratio as well. About 1 in 4 of the chronically infected individuals will die of liver cancer or cirrhosis.

Many infected individuals are not aware of their status because hepatitis B doesn’t usually produce symptoms for decades, and when the symptoms start showing it is often too late for treatment—it is a silent killer!

Help us raise awareness by entering the “B A Hero” PSA Video Contest and submitting a PSA made by you! Videos should highlight hepatitis B and include the “B A Hero” theme.

5 Easy Steps:

1. Make a 30-second video to raise awareness and B a hero
2. Check the fact sheet below to make sure all your HBV information is correct
3. Submit the PSA through Facebook
4. Get all your friends to vote for your PSA
5. Win prizes and B famous!

Submission deadlines:

Round 1 – February 17

Round 2 – March 16

Round 3 – April 13

Register NOW at Hep B Free Philadelphia’s Facebook Page!!

Submissions can also be emailed toPSAContest@hepb.org.

For the official contest guidelines, please click here

For the hepatitis B fact sheet, please click here

Questions? Please contact Hep B Free Philadelphia program manager Daniel Chen at Daniel.chen@hepb.org

Three finalists will win $100 each!

One Grand Prize winner will win an additional $150
AND have their video shown at the 2012 Philadelphia Asian American Film Festival!

B a hero! Make a PSA Video and raise HBV awareness!

There are some excellent HBV PSA videos on YouTube. Here’s an example of a great one, but feel free to visit Hep B Free Philadelphia’s Facebook Page and scroll down for more examples!

Hepatitis B Diagnosis & Monitoring, Liver Cancer

Statins May Prevent Liver Cancer For Those With HBV

Good news for those with chronic hepatitis B that are taking cholesterol-lowering statins.  Results published in Jan. 23 Journal of Clinical Oncology show statins may actually lower the risk of liver cancer for those living with chronic HBV in a dose dependent manner. The study monitored 33,413 hepatitis B patients for hepatocellular carcinoma (HCC) between 1997 and 2008 and tracked the number of HCC cases since 1999.

These are important findings because chronic hepatitis B significantly increases the risk of liver cancer, which causes 80% of primary liver cancers (HCC) worldwide. In the U.S., HCC is the second deadliest cancer with a five year survival rate of less than 10%. Those with chronic HBV are 100 times more likely to develop liver cancer than those without HBV. There are a number of contributing risk factors such as age, gender, ethnic background, family history, smoking history, and extent of liver damage. Despite the known risks, it is impossible to predict without regular liver cancer screening.  Be sure to discuss the guidelines for liver cancer screening with your doctor, as there are specific risk factors that may make monitoring sooner and more frequent, important.  Make liver cancer screening part of your bi-annual or annual monitoring of your HBV and liver health.

So, how do statins reduce the risk of liver cancer for those with Chronic HBV?  The mechanism has not been determined and will require further study.  Statins may reduce the risk of HCC, but it is important to carefully discuss the use of statins with your liver specialist and other treating physicians. Monitoring of your liver enzymes while taking statins is important for those without HBV, but it is even more critical if you have HBV.  Start with a baseline of your liver enzymes (ALT/AST) before beginning statin use, followed by testing at 6 and 12 week intervals.  You want to ensure your ALT/AST levels do not increase by more than three times the upper limits of normal.  Any spikes in your ALT/AST levels will likely occur in the first three months of statin use.  Elevated levels may require a discontinuation of one statin and a simple switch to another.  With the help of your treating physician(s) you will determine what is best for your unique situation to ensure the benefits of statin use outweigh the risks.

And if you are taking a daily statin, don’t forget the importance of eating a well-balanced diet. Sitting down to a big-ole cowboy steak with your statin is probably not what the doctor had in mind when he prescribed cholesterol-lowering medication!

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention

Join the Fun! We’d Love Your Help!

There’s a contest going on and we’d love your help! Facebook is having a little competition to see who can get the most “likes” on their facebook page.  The Hepatitis B Foundation wants to help jump-start Hep B Free Philadelphia’s Facebook page, and help them win “facebook Ad cash” in the process.  What will Hep B Free Philly do with those Facebook  Ad dollars? Well, Hep B Free Philly will use those Ad dollars to possibly raise donations, but perhaps more importantly, it’s another way to use one of our favorite social media channels to help promote hepatitis B awareness.

Here’s what you need to do….

  • Visit Hep B Free Philadelphia’s Facebook page and like their page. The like button is at the top of the page.
  • That’s it!  If you really want to help Hep B Free Philly win, ask your friends or family to “like” the page.  It’s that simple!
  • Use the little “Facebook share button” at the top of this blog to share it with your facebook friends!
  • This little competition ends March 31, 2012, so please don’t delay!

While you’re there, feel free to check out the page and see what Hep B Free Philadelphia’s community-owned public health campaign is doing in Philadelphia to educate and raise public awareness, along with increasing testing and vaccination in the fight against hepatitis B and liver cancer.  You can also check out Hep B Free Philly’s website! They’ve got a lot of great activities going on!

Finally, the Hepatitis B Foundation also joined the competition. At this time our facebook page has 684 “likes” of our page! We’d like to win some of those free Facebook Ad dollars and see how we can use them to  raise HBV global awareness.  So, if you haven’t already, be sure to “like” HBF’s Facebook page!

Thanks!

Hepatitis B Advocacy

Hepatitis Health Action Alert: Stop the Attacks on Prevention and Public Health Fund

Action Alert! The Hepatitis Community Responds to Health Care Reform. Tell Congress Not To Cut The Prevention and Public Health Fund

The Prevention and Public Health Fund is under attack in Congress once again. Some leaders in the House of Representatives would like to make drastic cuts to the Fund as part of negotiations on a long-term deal on the payroll tax cut and Medicare payments rates to medical providers.

The Prevention and Public Health Fund, part of the Affordable Care Act, provides money each year for vital prevention and public health services. The fund will grow each year until it eventually provides $2 billion/year.

This fund is extremely important to the nation’s fight against the viral hepatitis epidemic. Later this year, the Department of Health and Human Services is expected to allocate $10 million from the Fund for viral hepatitis screening, testing, and education programs. This initiative will greatly help efforts to identify the millions of Americans who have chronic hepatitis B or C and link them to care and treatment.

Please take a few minutes to call Congress in support of this lifesaving program!

What YOU can DO:

Please call your U.S. House Representative and two U.S. Senators immediately. We are hearing directly from Congressional staff that phone calls are the most effective form of communication. 

Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your United States Representative. When you reach your Representative’s office, tell whoever answers the phone that you are a constituent and that you would like to speak to the staff person who handles health care issues. Whether you speak to the staff person live or leave a voicemail, tell him/her:

“My name is _______________ and I live in (city/state). I am calling in strong support of the Prevention and Public Health Fund, which is an important part of the Affordable Care Act. This Fund is a great opportunity to provide badly needed funding for viral hepatitis prevention, testing, and screening programs and must be preserved. I urge Representative_____________ to oppose any efforts to cut the Fund as part of the payroll tax/Medicare physician reimbursement negotiations.”

After you speak to your Representative’s office, call the Capitol Switchboard again and deliver the same message to the health care staff person in your two U.S. Senators’ office.

Thank you for taking the time to make a difference! Please spread the word.

Get involved with Hepatitis Health Action!

  • Join Hepatitis Health Action’s Facebook group:  http://tinyurl.com/hephealthfacebook where you can participate in discussions with other advocates and share your ideas and strategies.

Hepatitis Health Action is a campaign led by viral hepatitis advocates working to make sure that health care reform addresses hepatitis B and C.

Baruch S. Blumberg Institute