By Christine Kukka
When we have chronic hepatitis B, knowing our family medical history can give us an inside edge to fight this infection.
Hepatitis B is an infection that often runs in families. Knowing how our parents, grandparents and aunts/uncles responded to this liver disease can give us insider information about our own genetic prospects with hepatitis B.
Experts estimate that more than half of us worldwide became infected at birth. Our mothers may have been infected with hepatitis B. Immunization, which can prevent infection if administered within 12 hours of birth, was not available to us as newborns, nor to our mothers or grandmothers.
So if we suspect or know our parents have or had hepatitis B, it’s important to find out if our aunts and uncles or grandparents were also infected and had signs of liver damage. Did anyone get liver cancer or die from liver-related problems? Or, did our relatives live long lives due to strong genes, healthy lifestyle choices, and avoiding smoking and alcohol?
Knowing how our genetic predecessors handled this infection gives clues about:
- How often we should be screened for liver cancer? We should be screened earlier and more often if we have a family history of cancer.
- How soon should we start treatment? If our predecessors had liver damage at a young age, perhaps we should start treatment sooner rather than wait and endure long periods of liver damage and high viral loads.
- How effective are our family’s genes in fighting this infection? Did many family members with hepatitis B have liver damage or cancer, or did they have relatively long and healthy lives?
- What effect did the hepatitis B virus’ strain or genotype play? Depending on the HBV genotype that infects us, we may have different experiences with hepatitis B. We may we develop the hepatitis B “e” antibody earlier if we have certain HBV genotypes. Knowing our relatives’ health history gives us some insight into this.
- What effect does gender play? Did women experience liver damage or did it only happen to men? The female hormone estrogen is believed to confer some protection against hepatitis B. It may be that men in your family are at highest risk of liver damage and need more frequent monitoring and earlier treatment.
There are other factors besides genes that affect a multi-generational experience of hepatitis B. Did our grandparent who developed liver cancer suffer poor nutrition for extended periods in their country of origin that weakened their immune system? Did the uncle who had cirrhosis also smoke, drink or suffer exposure to chemicals at work? Could a grandparent who died of liver disease eat moldy rice or corn that contained aflatoxin, which severely damages the liver?
Taken together, all of these factors give us clues to medical conditions that may run in our families, and this knowledge isn’t limited to just hepatitis B. By identifying family patterns of medical problems such as diabetes, heart disease, high blood pressure or breast cancers, healthcare providers can determine if we and our children are at increased risk of a particular condition.
Because knowing your family’s health history is such a powerful tool, the Surgeon General created a free website to help everyone create a portrait of their family’s health at My Family Health Portrait.
After completing the questions, the website creates a personalized “family health tree” that can be saved to a home computer. From there, families may update the information any time. The tool can be shared with other family members, who can add their health information to the portrait. It’s also important to share this portrait with your doctor.
The Surgeon General has declared Thanksgiving to be National Family Health History Day. But whenever your family gathers for a holiday, ask about their medical history. It just might save your life.