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Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Hepatitis B and Chocolate

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Planning on digging into your favorite dark-chocolate stash, or biting the ears off of a dark-chocolate bunny this weekend?  Dark chocolate is popping up everywhere.  Even some old favorites have a new, dark chocolate wrapper, replacing the now-passé milk chocolate.  Recently, studies have extolled the benefits of dark chocolate, and how it potentially prevents heart disease, reduces the risk of brain damage after a stroke, lowers the risk of heart failure, lowers blood pressure, reduces heart disease, has anti-cancer benefits, slows dementia, raises libido, and last but not least, is mood enhancing.  What about those suffering hepatitis B associated liver disease?

Last year there was a study out of Spain that investigated the benefits of dark chocolate to patients with liver disease – specifically patients with cirrhosis.  Cirrhosis causes portal pressure to rise, potentially resulting in damage to blood vessels in the liver.  Eating causes an additional rise in pressure, which becomes more dangerous as liver disease progresses.  Half of the study participants were given white chocolate, and the other dark chocolate.  The dark chocolate group saw a larger decrease in the blood pressure of the liver, and increased blood flow.  Keep in mind that this was a small study with only 21 participants.

The good news is that dark chocolate, specifically the cocoa component, is rich in antioxidants called flavonoids, and other beneficial components such as  phenylethylamine, theobromine,  anandamide, magnesium, copper, and vitamins E and B.  That’s certainly a mouth-full, but it is these key components that provide all the benefits of chocolate.

Here’s the bad news.  Many of us enjoy milk chocolate, or even the dreaded white chocolate, which has little or no benefit due to the processing of the cocoa, and the resulting loss of flavonoids.   In fact, the lighter the chocolate, the fewer the benefits.  In a perfect world we would be eating unsweetened, cocoa powder right out of the tin, or a chocolate bar with upwards of 85% cocoa.  That can be a pretty biting chocolate.  The chocolate many of us enjoy has a larger quantity of white sugar , which is not beneficial to the liver, or any other organ, nor is the additional butterfat, which is added to lighter chocolate.  However, if you can adjust your tastes a little and learn to adapt to less sugar and butterfat, dark chocolate is great addition to your diet.

Aren’t most of us looking for an excuse to add chocolate to our diets?  Ultimately, all things in moderation is the key.  A small amount (roughly 6.7 grams) of dark chocolate added to your daily diet is certainly not going to hurt you, and may in fact reduce abdominal pressure and portal pressure in the liver.  Perhaps the greatest redeeming quality of chocolate is it’s mood enhancing qualities.  If it feels good, and eaten in moderation, then why not reap the benefits of dark chocolate and enjoy your improved mood.

Hepatitis B Diagnosis & Monitoring

Do You Have Hepatitis B?

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Have you been told you may be infected with  hepatitis B?  Did you get a letter following a blood donation, or receive lab results indicating infection?  It’s important you relax, educate yourself, and don’t let the news scare you.  The next step is to determine if you are infected, and if so, do you have an acute or chronic infection.

You’ll want to talk with your doctor, and have a hepatitis B blood panel run.  It is essential that you do not ignore the possibility of infection.  That being said, it’s equally important that you not panic.

When you get your lab results, ask your doctor to explain them to you.  It’s possible that you are not infected, but if you are, then you will need follow-up testing.  Be sure to ask for copies of your labs for your own records.  The test results are initially confusing, so you will want to refer back to the hard-copy results.

It is important to determine if you have an acute or chronic infection, but this may take some time.  If you were infected with HBV as an adult, there is a good chance you are acutely infected.  Fortunately, 90% of infected adults resolve the virus on their own. Recently infected adults may have flu-like symptoms, fatigue, yellowing of the eyes, or they may have no symptoms at all.  The answer is in the lab work.  Your doctor may run an HBc-IgM test, which will tell you if the infection is newly acquired. If it is a new infection, you will be monitored for the next one to six months to see if the HBV infection clears, and to ensure you are safe.  During this time, you are infectious to others, so it is important to practice standard precautions and ensure household members are vaccinated.  It is important to eat properly, rest, and avoid alcohol and tobacco. Talk to your doctor about the use of prescription and OTC drugs.  Hopefully your body will be able to mount an appropriate immune response, and you will be able to rid yourself of the virus.  If you remain surface antigen positive (HBsAg+) for more than six months you will be considered chronically infected.

Ten percent of those infected with HBV as an adult, will not clear the virus, and will become chronically infected.  Another group of adults that may just be learning of their Hepatitis B status, are those that acquired HBV at birth.  HBV infected mothers may unknowingly transmit HBV to babies.  Transmission can be prevented with vaccination at birth, but in many countries where HBV is endemic, a cycle of HBV transmission may exist where vaccination has not been available, and the virus is passed unknowingly from one generation to the next. Unfortunately, 90% of those infected at birth are chronically infected, even though it may not be determined until adulthood.  HBV is usually an uncomplaining disease, so it may be picked up accidently with blood-work , or when liver disease progresses due to decades of chronic infection.

Keep in mind that being vaccinated against hepatitis B will not protect you against the virus if you were infected with HBV prior to vaccination.  This can be confusing since most people are not screened prior to vaccination, and is  especially pertinent in high risk groups where the likelihood of mother to child transmission is greater.

The Hepatitis B Foundation has a step-by-step, comprehensive, yet-easy-to-understand tutorial that leads you through the process of determining your hepatitis B status, specific test results, and practical advice for coping with your HBV diagnosis.

Hepatitis B Advocacy

The Hepatitis B Community Loses Cherished Friend and Advocate

It is with great sadness and heavy hearts that we notify the hepatitis B community of the passing of Dr. Baruch S. Blumberg.  Dr. Blumberg died suddenly on Tuesday, April 5, 2011.  His discovery of the hepatitis B virus and invention of the first vaccine against hepatitis B, which resulted in the Nobel Prize for medicine in 1976, have been among the most important in the history of science and medicine.  In addition to serving as Senior Advisor to the President of Fox Chase Cancer Center, Dr. Blumberg co-founded the Hepatitis B Foundation and served the Foundation as a Trustee Distinguished Scholar.  His ongoing acts of support to the Foundation will always be remembered and admired.

“It has been one of the greatest professional privileges of my life to have known and to have worked with Dr. Blumberg.  He was a wonderful mentor to me, and to all of us at the Hepatitis B Foundation, who had the honor of knowing him.  His curiosity and enormous intellect was always so motivational.  He made it clear to all of us at the Foundation, how one life can do so much to benefit the world.  Nothing will be the same without him, but so much has changed because of him.  He will always be an example and inspiration for us all.” –  Dr. Timothy Block, President of the Hepatitis B Foundation

Please join us in remembering our dear friend, colleague, advocate and champion of the hepatitis B cause, Dr. Blumberg.  Our thoughts and prayers are with the Blumberg family.

Baruch S. Blumberg

1925-2011

 

 

Hepatitis B Diagnosis & Monitoring, Living with Hepatitis B

Who’s On Your HBV Team?

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No matter where you are with your hepatitis B – chronically infected since birth, or recently learned you are HBV positive, you want to be sure you are surrounded by all of the right people to give you the medical guidance and emotional support you need.

Start with your primary care physician (PCP).  You want a doctor that listens to you and is willing to work with your liver specialist.  Your PCP’s office may be coordinating your annual or bi-annual lab work for HBV monitoring and is your first line of care .

HBV can be complicated when it comes to making decisions about whether or not you need monitoring, treatment, or monitoring for liver cancer (HCC).  There are many phases of HBV, and you want to be sure you are followed through ALL phases.  You need a liver specialist that has experience working with patients infected with HBV.  This doctor is nearly always a Gastroenterologist (GI doc) or a Hepatologist.  If the patient is a child, you need a pediatric GI doctor or hepatologist.  Although well qualified, an infectious disease doctor is not really the best fit because of the involvement of the liver.  Once again, experience with HBV infected patients is crucial.  These specialists are often found at large, or University Hospital centers.

Check out this directory of liver specialists in your area.   Keep in mind that living a couple of hours from your liver specialist should be fine.  Visits are typically annual or bi-annual.  Visits may increase depending on treatment you may require.  Lab work can usually be coordinated with your local lab via your PCP.

Get to know your local pharmacist.  They are a wonderful source of information on everything from prescribed HBV medications to choosing the best OTC cold medicines, or pain relievers.  I am on a first name basis with my pharmacist, and try to visit when the volume of customers is low, so no one feels rushed.

Living with a chronic illness can take its toll on your mental health.  Each patient is unique, but generally all patients cycle through initial fear or denial, isolation, worry, and acceptance.  If you feel you are depressed and need help coping with your HBV, seek advice from your PCP, liver specialist, or a mental health expert.

Consider joining a support group.  Sometimes it’s lonely dealing with a complicated, chronic illness like HBV.   Support groups are a great forum for addressing the many concerns when dealing with various aspects of your HBV, from the best treatment protocols to sex and dating.  I belong to two HBV support groups and I find the interactions extremely informative, and the list members caring and very supportive of members in all stages of their HBV.

Take a look at The Hepatitis B Foundation’s website.  There’s a multitude of information from simple HBV basics to in-depth information from world-renowned liver specialists and researchers, along with personal stories.  Ask away if you have any questions.  HBF is here to help, and we hope to be part of your team.

Baruch S. Blumberg Institute