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  • CHIPO Partner Highlight: United States Coalition for African Immigrant Health

    … of hepatitis screening and linkage to care at the local, state, and federal levels? Do you think more could be done in these spheres to address this problem? This is a big concern and one of the steps we have recently taken to address this is hosting a roundtable discussion intended to educate healthcare providers and professionals about hepatitis B and how to care for community members who might be living with HBV. Better provider education and linkage to care needs to be the order of the day. Community-based organizations should be supplementing the services that providers are offering. One big important change that can occur is for electronic medical records to include an automatic question about hepatitis B screening for all patients. All of this can be done with additional funding and support from the federal and state levels. Do you see this issue as being connected to other concerns facing African immigrant communities? Yes, there are a variety of health concerns that face AI communities in the U.S, many of which require similar approaches of cultural sensitivity and community and provider awareness to address. These include diabetes, heart disease, hypertension, and various forms of cancer. What are your favorite parts about your job? What got you interested in this work? I am passionate about hepatitis B and that is what actually got me into public health. I came into this work having previously led an HIV project at another organization. I love every aspect of my work! My favorite moments are in organizing conferences because they move so fast, have many moving parts, and are SO rewarding! These conferences are widely recognized as the premier gathering for discussing AI health - many organizations of all types are interested in presenting and sharing their work. The conference planning is tremendously collaborative and is an all-volunteer effort. Now, as Executive Director, I can see the whole picture of the conferences and the organization as a whole

    http://www.hepb.org/blog/chipo-partner-highlight-united-states-coalition-african-immigrant-health/
  • Navigating Our Emotions When We’re First Diagnosed with Hepatitis B

    … to talk about your anger with counselors or friends, get some exercise to work off your tension and avoid situations—including drugs or alcohol—that can ignite festering emotions. It’s normal to feel sad, and sometimes the sadness doesn’t go away quickly. If you feel prolonged sadness, anxiety, or fear, or find you’re gaining or losing weight or sleeping more or less than usual, it’s time to talk to someone who can help. Fear and anxiety are common because we don’t know what’s going to happen next. If you’ve just been diagnosed, you may have to wait six months for another test to show whether you were recently infected and have acute (short-term) or were infected as a child and have chronic (long-term) hepatitis B. That wait can be insufferable. Our stress can cause a host of physical symptoms, ranging from headaches to fatigue, that may have nothing to do with hepatitis B. It’s important to talk to your doctor about these symptoms so you know what is hepatitis B-related, and what’s caused by worry and fears. At this early stage, many of us want to get rid of the virus as soon as possible and we’re willing to try any supplement or treatment available, even if our doctors tell us we’re healthy and don’t need any treatment. At this early diagnosis point, we just need to take care of ourselves, eat healthy foods, avoid alcohol and cigarettes, and get monitored regularly, even though what we really want is a magic pill that will make this infection go away. In normal grief cycles, there is a point of acceptance. But I’m not sure we totally ever accept this loss of our “perfect” health, and our ability to have sexual relations, give birth, or drink a glass of wine without thinking of the shadow hepatitis B casts over these activities. As a wise friend has pointed out, we need to accept that hepatitis B is part of us, but it doesn’t have to define us. Perhaps getting to that realization is the journey we begin when we read that

    http://www.hepb.org/blog/navigating-emotions-first-diagnosed-hepatitis-b/
  • Other Tests

    Additional Hepatitis B Blood Tests Hepatitis B can be a complicated liver infection to understand, so additional blood tests may be ordered so your health provider has a better understanding of what kind of care and follow-up is needed. Anti-HBc IgM or anti-HBc IgG (anti-hepatitis B core IgM or IgG) Sometimes an anti-HBc IgM or anti-HBc IgG blood test may be ordered to clarify if a person has a new “acute” hepatitis B infection or “chronic” infection. A positive/reactive anti-HBc IgM test result usually indicates a new acute infection. A positive/reactive anti-HBc IgG test usually indicates a chronic infection. These test results must be explained by your health care provider because they can be confusing. For example, sometimes the liver of a person who is chronically infected with hepatitis B may become more inflamed than usual (this is called a “liver flare”). So a chronically infected person could also test positive for the anti-HBc IgM blood test, although this usually indicates a new infection Thus, it is important to be seen by a health care provider who understands hepatitis B so you get the right diagnosis and the right care and follow-up.   HBeAg (Hepatitis B e-Antigen) - This is a viral protein made by the hepatitis B virus and is released from the infected liver cells into the blood. This test detects how much virus is in the blood as a result of very active viral replication. A negative test result indicates the virus may not be actively reproducing in the liver. In general, a person is considered very infectious when the test is positive, and less infectious when the test is negative. The loss of e-Antigen can occur naturally or as a result of drug treatment. Sometimes a negative test result can indicate a mutant hepatitis B virus is present. So, the absence of e-Antigen does not always mean there is little or no active viral replication. The doctor can confirm with additional tests. A positive HBeAg indicates high levels of virus in the blood and a person is considered infectious. A negative HBeAg indicates very low to no virus in the blood and a person is usually considered less infectious; sometimes this can indicate a person has a mutant hepatitis B virus (see below). The hepatitis B e-antigen test result is often used to monitor the effectiveness of many hepatitis B drug therapies that aim to change a chronically infected person’s e-antigen status from “positive” to “negative.” By achieving a “negative” e-antigen result, this means that the hepatitis B drug successfully stopped or slowed down the virus replication. Although this is not a cure, stopping or slowing down the virus will result in less damage to the liver, which decreases the risk of developing serious liver disease in the future. Some people with chronic hepatitis B naturally lose e-antigen and develop e-antibody, even without treatment. To make things a bit more confusing, however, there are some chronically infected patients with a high viral load who are untreated and still test “negative” for the hepatitis B e-antigen. So, the absence of e-antigen does not always mean there is no active viral replication. Instead, these persons have a mutant hepatitis B virus that does not produce the e-antigen. As a result, treating someone who is e-antigen negative (but with a high viral load) is difficult because the mutant hepatitis B virus is more resistant to the current drugs. In addition, the absence of e-antigen makes it harder to evaluate whether a drug is working or not. anti-HBe or HBeAb (Hepatitis B e-Antibody) - This is not a protective antibody. It is made in response to the hepatitis B e-antigen. Chronically infected individuals who stop producing e-antigen sometimes produce e-antibodies. The clinical significance of this result is not fully understood, but it is generally considered to be a good thing. For those with e-antigen negative chronic hepatitis B infections (meaning they have a mutant virus), the presence of anti-HBe may still be associated with active viral replication. Hepatitis B Virus DNA Quantification (“viral load”) – This blood test measures the amount of hepatitis B virus DNA (or viral load) in the blood of chronically infected patients. The blood is tested using a Polymerase Chain Reaction (PCR) technique that is highly sophisticated and accurate. The hepatitis B “viral load” provides important information, but should only be considered in relation to other information such as your e-antigen status and liver enzymes test results (see below). The viral load is usually measured in “international units per milliliter” (IU/mL), but may also be measured in “copies per milliliter”(cp/ml). There are approximately 5 copies in one international unit. HBsAg Quantitative (quantitative hepatitis B surface antigen / qHBsAg) – This blood test measures the actual amount of hepatitis B surface antigen in the blood. When used in combination with the HBV DNA test, qHBsAg can provide a liver specialist with additional insights to an individual’s HBV infection. It can also be used in predicting and monitoring treatment response. Hepatitis B Drug Resistance, Genotype, and BCP/PreCore Mutation – This blood test is not commonly ordered. A liver specialist may order the test to determine a patient’s hepatitis B virus genotype (A-H) for research purposes and to detect a viral mutation that may be associated with resistance to current treatments. This is a Polymerase Chain Reaction test, which again, is not readily available or used  outside large teaching hospitals.   Liver Related Blood Tests The hepatitis B virus specifically attacks the liver, so health care providers will order blood tests to monitor the health of your liver. Some of the most common liver related blood tests are described below. These blood tests measure potential liver damage (or liver inflammation). If a person is infected with the hepatitis B virus, the liver cells can be injured by the virus and then the liver enzymes can leak into the bloodstream. The higher the number, the greater the risk of potential liver damage. ALT (alanine aminotransferase) is found almost exclusively in the liver and is monitored most closely in a chronic hepatitis B infection. This test is useful in deciding whether a patient would benefit from treatment or for evaluating how well a person is responding to therapy. The upper limits of normal for ALT in healthy adults is 35 U/L for men and 25 U/L for women. AST (aspartate aminotransferase) is found in the liver, heart and muscle so is less accurate than the ALT in measuring liver damage. But this enzyme is often ordered to help monitor potential liver damage from the hepatitis B virus. AFP (Alpha-FetoProtein) - This is a normal protein produced in the developing fetus, thus, pregnant women will have elevated AFP. Other adults, however, should not have elevated AFP in their blood. This test is used to screen for primary liver cancer patients with chronic hepatitis B. Patients should have their AFP levels monitored at every visit since hepatitis B is the leading cause of liver cancer. If the AFP level is high, the health care provider will order more blood tests and imaging studies. Ferritin - Iron is stored in the liver in the form of ferritin. Increased levels of ferritin indicate that a high level of iron is being stored. This could result from an increased iron intake in the diet (vitamin supplements, food cooked in iron pots, etc.). For people living with chronic hepatitis B, a high level can indicate liver damage since ferritin is leaked into the bloodstream as liver cells are injured by the virus.   Additional Blood Tests Your Doctor May Order If you have been diagnosed with chronic hepatitis B, your doctor may order a Hepatic Function Panel (Liver Function Tests, (LFTs), liver profile) and a Complete Blood Count (CBC).  A number of the blood test results included in these panels are useful in evaluating liver disease, in general, and are not necessarily specific to hepatitis B. Your doctor will be able to explain your personal results in detail, but the chart below provides a quick reference for interpreting your test results.  Test Normal Range Abnormal RangeMild-Moderate Abnormal RangeSevere  Liver Enzymes   Aspartate aminotransferase (AST)30 IU/mL for men and 19 IU/mL for women40-200 IU/L>200 IU/lLAlanine aminotransferase(ALT)35 IU/mL for men and 25 IU/mL for women40-200 IU/L>200 IU/LGamma-glutamyl transferase (GGT)<60 IU/L60-200 IU/L>200 IU/LAlkaline phosphatase<112 IU/L112-300 IU/L>300 IU/L Liver Function Tests   Total Bilirubin<1.2 mg/dL(<20.5 umol/L) 1.2-2.5 mg/dL(20.5-43 umol/L) >2.5 mg/dL(42.8 umol/L)Albumin3.5-4.5 g/dL3.0-3.5 g/dL<3.0 g/dLProthrombin time<14 seconds14-17 seconds>17 seconds Blood Count    White blood count(WBC) >60003000-6000<3000Hematocrit (HCT)>4035-40<35Platelets>150,000100,000-150,000<100,000 Key   IU= International UnitL=literdL=decilitermg=milligramsumol=micromole     

    https://www.hepb.org/prevention-and-diagnosis/diagnosis/other-tests/
  • Sometimes I feel sad and depressed because of my hepatitis B status, what should I do?

    We are so sorry that your hepatitis B infection is causing distress. Do understand that you are not alone! Many people living with hepatitis B feel the same, but because hepatitis B is still stigmatized, and doesn’t receive the proper support that it deserves, people often feel isolated and alone. Know that there are things you can do to help yourself and others in this fight. Educate yourself about hepatitis B. Knowledge is power, and when you have the power, you can defeat the disease by taking the right steps to support your health. To start, you will need to regularly monitor your hepatitis B infection and the health of your liver and discuss with your doctor whether you need to take antivirals. Here are several resources to increase your knowledge about hepatitis B: Hepatitis B Foundation website is a comprehensive link to all areas related to hepatitis B. From there you can connect to numerous resources including preventing, diagnosing, treating and managing hepatis B, along with language chapters in different languages. Questions and answers page. This is a comprehensive collection of the most frequently asked questions by people living with hepatitis B and their friends and family members. Learn about the physical, social, and emotional impact of living with chronic hepatitis B, and how this impacts people like you around the globe and what to do about it. B-Heppy Podcast is great tool to listen and learn about topics that matter to people living with hepatitis B. Hepatitis B Foundation Blog: this is a great resource for day-to-day life issues that matter to hep B patients, like disclosing to a partner, learning about the virus and ways to get involved, etc. Hepatitis B Information Guide is a good resource for quick information about hepatitis B and might be helpful to share with others. HBV Patient Education Hub (CME Outfitters) CDC Hepatitis B Patient Education Resources: This website has a great deal of information in the form of questions and answers. Join the Hep B Community, an online hep B community for people living with hepatitis B! It is a global interactive community, and it is free. The journey with hepatitis B is a long one, and it is important to experience it with good company. There, you can chat with people from around the world – those living with hepatitis B, scientists, and clinicians. The aim is to support people living with hepatitis B worldwide and connect them with health experts, scientists and others living with the hepatitis B virus. Additionally, researchers often share their latest hepatitis B research on this forum, in a patient-friendly format, which gives you heads up on latest hepatitis B research updates. Watch personal stories by real people impacted by hepatitis B: Many living with hepatitis B share their story and how they handled some of the challenges they face. Make a conscious decision to live a healthy lifestyle to support your liver. You’ve got this; you are in control! You can support your liver by not drinking alcohol, not smoking and maintaining a healthy weight by eating a well-balanced diet and getting regular exercise. Here is more information on how to maintain a healthy liver. Also, be very careful with medications or herbal remedies and supplements. Some supplements and herbs can do more harm than good. This podcast is strongly recommended: what a person with hepatitis B should eat. You may also find this guide helpful. Think about who you would like to inform about your diagnosis and when. You don’t have to disclose your hepatitis B status to the entire world, but we all have people in our close circle, with whom we would like to share our tough moments. Please read our guide about when and how you should disclose your hepatitis B diagnosis. Finally, if you feel you cannot get the help and support from your partner, family or circle of friends, please consider seeking professional help from a trained counselor or trusted community leader. Please talk to your doctor to refer you to a professional consultant. If you are thinking about harming yourself, please find help immediately here globally and in the US dial 988. Please know that people with hepatitis B have bright futures and long lives ahead of them – they can go to school, have careers, date, marry, have children, and live a normal life. We know it is hard to stay optimistic, but it is important to always keep a positive attitude. Do that and you’ll live a happy, fulfilling life!   Find more Frequently Asked Questions here.    Page updated 12/27/2022

    https://www.hepb.org/what-is-hepatitis-b/faqs/sometimes-i-feel-sad-and-depressed-because-of-my-hepatitis-b-status-what-should-i-do/
  • Hepatitis B and Social Security Disability Benefits

    Please welcome guest blogger, Ram Meyyappan, senior editor of Social Security Disability Help as he provides advice on applying for Social Security Disability Insurance or Supplemental Security  Income should your HBV prevent you from working. Hepatitis B (HBV)  is often referred to as a "silent infection" because those chronically infected may have few or no symptoms, or may not be unaware of their infection for decades. However, over time, the risk of serious liver disease is certainly possible and symptoms can range from mild to severe.  Severe symptoms rarely occur with an acute HBV infection, but can have very serious outcomes.  If your condition is severe to the point that you can no longer continue to work, you may qualify for SSDI (Social Security Disability Insurance) or Supplemental Security Income (SSI) benefits from the Social Security Administration (SSA). You can learn more about SSDI and SSI here Hepatitis B and Qualifying for Benefits When you submit an application for Social Security Disability benefits an adjudicator will review your file and compare your condition with a listing of conditions known as the SSA Blue Book (http://www.ssa.gov/disability/professionals/bluebook/). This Blue Book contains a listing of conditions and qualifying criteria that may qualify an individual for Social Security Disability benefits. Unfortunately Hepatitis B does not have its own listing in the Blue Book. You may still be able to qualify for disability benefits, however, if you are able to prove that you suffer from an associated condition (such as depression) that is included in the Blue Book. Some of the conditions that may qualify an individual for Social Security Disability benefits that are listed in the Blue Book and that may be associated with Hepatitis B include: 5.05 Chronic liver disease 5.08 Unexplained weight loss 5.09 Liver transplant 12.04 Affective disorders If you are applying for disability benefits based on an associated condition that is

    http://www.hepb.org/blog/hepatitis-b-and-social-security-disability/
  • High HBV Viral Load Tied to Low Serum Vitamin D Levels

    An interesting study published in Healio Hepatology:  "High HBV viral load tied to low serum vitamin D levels" discusses the relationship between the HBV viral load and vitamin D levels. In fact is shows seasonal fluctuations of HBV viral load associated with vitamin D levels. Vitamin D has been on the radar for years, but this interesting correlation between HBV virus flucuations and vitamin D levels warrants additional research to investigate how adequate vitamin D levels can positively impact treatment for those living with chronic HBV. Please refer to earlier blogs, Hepatitis B and Vitamin D and Got HBV? Adding Vitamin D to Your Diet for additional information.  As always, please talk to your doctor and have your serum vitamin D levels checked before making any drastic changes to your diet or supplements you may be taking. Don't forget that vitamin D is the sunshine vitamin, so be sure to keep in mind the impact of the seasons on your levels.  Patients with chronic hepatitis B who also were vitamin D deficient had significantly higher HBV DNA levels than patients with adequate vitamin D concentrations in a recent study. In a retrospective study, researchers measured the serum levels of 25-hydroxyvitamin D (25OHD) in 203 treatment-naive patients with chronic hepatitis B seen between January 2009 and December 2012. Patients with 25OHD levels less than10 ng/mL were considered severely deficient, levels below 20 ng/mL were considered deficient, and levels of 20 ng/mL or greater were considered adequate. Patients’ samples were collected upon initial presentation, except 29 participants whose samples were taken at antiviral therapy initiation. The mean 25OHD concentration for the cohort was 14.4 ng/mL. Forty-seven percent of participants were considered 25OHD deficient; 34% were severely deficient. 25OHD levels were similar between Caucasians (14.38 ng/mL) and non-Caucasians (14.59 ng/mL) (P=.7). An inverse correlation was observed between levels of HBV DNA

    http://www.hepb.org/blog/high-hbv-viral-load-tied-to-low-serum-vitamin-d-levels/
  • Welcome to Hepatitis Delta Connect!

    A dedicated program of the Hepatitis B Foundation to increase awareness about hepatitis delta - a serious virus that coinfects hepatitis B patients - and to promote screening and testing, and provide information and support for those affected.      Clinical Trial Finder - Find A Clinical Trial Near You!                                                                                                         Check Out Our Latest Podcast! Bright and Evangeline sit down with Dan to talk about his experience with hepatitis Delta. We talk about his initial feelings surrounding the diagnosis, his treatment, how he got involved with the Hepatitis B Foundation, and his hope for the future of all people living with hepatitis B and Delta. Listen here today! Join us for our next hepatitis delta webinar in June! This will be a two-part series. Part 1, happening on June 8th, 2023 at 10am Eastern Time, will feature a panel discussion about hepatitis delta in the European context, the status of approvals of Hepcludex (bulevirtide) around the continent, and how the medication is changing the HDV landscape. We will be joined by panelists from the UK, Spain, Romania, France, and Italy. Part 2, taking place on June 15th, 2023 at 10am Eastern Time, will explore the epidemiology of hepatitis delta in areas of the world in which bulevirtide has not yet been approved, as well as challenges with diagnostics and management of the virus in different contexts. We will be joined by panelists in North America, Africa, Asia, and Australia. Hope to see you there! Please click here to register for part 1 and click here to register for part 2! We would love to hear from you! Complete the survey to sign up! Please note: This survey link is specifically for those living with hepatitis delta, or those who are caretakers of people living with hepatitis delta. Take our brief survey & sign up to receive updates on clinical trials, info about hepatitis delta monitoring, management & care + more! Sign up today! Please note: This survey link is specifically for healthcare providers caring for people living with hepatitis delta. We've educated 13,000 people in 111 countries!   News & Updates March 2023 Blog Post: Why Is Hepatitis Delta So Hard to Eliminate? December 2022 Blog Post: What You Need to Know About the 2022 Liver Meeting and How it Relates to Hepatitis Delta September 2022 Blog Post: What's the Difference? Herbal Remedies and Supplements vs. Western Medicine July 2022 Blog Post: Results from Hepatitis Delta Clinical Trials Announced at 2022 International Liver Congress View our webinar, "The Lived Experience of Hepatitis Delta" recording here. 05/17/2023: The Many Functions Of The Hepatitis D Antigen Proteins 05/16/2023: Hundreds of NHS patients in England and Wales offered access to first treatment conditionally licensed for the most aggressive form of viral hepatitis 05/15/2023: With NICE nod, Gilead clears another regulatory hurdle in Europe for Hepcludex 05/10/2023: RNA Gymnastics: How Does Hepatitis Delta Virus Replicate? 05/05/2023: After FDA rejection, Gilead's Hepcludex looks set for full EU nod 04/06/2023: Molecular and Clinical Features of Hepatocellular Carcinoma in Patients with HBV-HDV Infection 04/06/2023: Hepatitis D double reflex testing of all hepatitis B carriers in low HBV and high HBV/high HDV prevalence countries 03/20/2023: Real-world studies show efficacy, safety of BLV monotherapy in patients with HDV-related compensated cirrhosis 03/17/2023: Hepatitis Delta, Aisf and Simit specialists present joint and updated document 03/14/2023: Scottish Medicines Consortium accepts treatment for chronic hepatitis delta virus 03/2023: Improved hepatitis delta virus genome characterization by single molecule full-length genome sequencing combined with VIRiONT pipeline 01/21/2023: Bulevirtide in the Treatment of Hepatitis Delta: Drug Discovery, Clinical Development and Place in Therapy 01/11/2023: Identifying and Screening At-Risk Patients for Hepatitis Delta Virus: A Case Report 01/03/2023: A 3-Year Course Of Bulevirtide Monotherapy May Cure HDV Infection In Cirrhotics 01/2023: Effect of variants in LGP2 on MDA5-mediated activation of interferon response and suppression of hepatitis D virus replication 01/2023: D is for Diagnosis, Whom to Screen for hepatitis Delta virus Get Connected   

    https://www.hepb.org/research-and-programs/hepdeltaconnect/
  • Got HBV? Adding Vitamin D to Your Diet

    … and other vitamins. (There’s a great reason for the fortification of dairy with vitamin D - absorption is enhanced in the presence of calcium.) It is also found in smaller amounts in egg yolks. Naturally all of this needs to be balanced with the concerns of farm raised fish and possible exposure to PCBs, or mercury levels found in tuna, pollution of our oceans, raising your cholesterol levels due to focusing on the yolks, possible toxic levels of vitamin A with cod liver oil  (in Western countries where foods are fortified with vitamin A), or simply the bad, fishy taste associated with cod-liver oil. It’s a tough balance, but it’s important to work through some of the risks versus benefits in your own mind. Sunshine is another readily available source of vitamin D (vitamin D3, cholecalciferol), but you need to be sure to balance it with the risk of over-exposure to the sun’s rays. And of course in the north, during the winter months, it may be difficult to get adequate sunshine to boost your vitamin D levels. You can get adequate sun exposure with 10-15 minutes in the sun, 3-5 times per week, with the exposure of face and arms. Naturally this will vary based on the sun’s intensity, how much skin is exposed and each individual’s skin tone, since the amount of necessary sun increases with the amount of melanin (pigment) in the skin.  Just to confuse matters, a recent study shows a possible link of higher levels of vitamin D to non-melanoma skin cancer, even though higher levels are thought to reduce the risk of basal cell cancer. Clearly more studies need to be done, but until that time, just keep reminding yourself that balance is important. Sometimes it’s tough to get adequate vitamin D levels from natural sources such as food and sunshine, so there is the option for vitamin D supplements. This is where my anxiety levels intensify. Bad enough I have to worry about my food sources - PCBs from farm raised fish and such things, but now I have to choose

    http://www.hepb.org/blog/got-hbv-adding-vitamin-d-to-your-diet/
  • Acute vs. Chronic Hepatitis B

    A hepatitis B infection can result in either an acute infection or a chronic infection. When a person is first infected with the hepatitis B virus, it is called an "acute infection" (or a new infection). Most healthy adults that are infected do not have any symptoms and are able to get rid of the virus without any problems. Some adults are unable to get rid of the virus after six months and they are diagnosed as having a "chronic infection." A simple blood test can diagnose an acute or chronic hepatitis B infection. The risk of developing a chronic hepatitis B infection is directly related to the age at which a person is first exposed to the hepatitis B virus. The younger a person is when they are first infected, the greater the risk of developing a chronic hepatitis B infection: More than 90% of infants that are infected will develop a chronic hepatitis B infection Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection 5-10% of healthy adults 19 years and older who are infected will develop a chronic hepatitis B infection (that is, 90% will recover from an exposure) Most pregnant women do not know whether they are infected with hepatitis B and can unknowingly pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is so high, both the World Health Organization and the U.S. Centers for Disease Control and Prevention recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. The recommendation for hepatitis B vaccination of babies and children is so important because they are at the greatest risk of developing a chronic infection if they are not protected against the hepatitis B virus as soon as possible.    Acute Hepatitis B Infection An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. A simple blood test can let a person know if the hepatitis B virus is in their blood or if they have successfully gotten rid of the virus. The doctor should periodically test your blood over the six-month period to monitor the health of your liver and check progress towards recovery. In a person who has recovered from an acute hepatitis B infection, a blood test taken six-months after initial diagnosis will show that there is no more hepatitis B virus in your blood. Being diagnosed with acute hepatitis B can be difficult. As you move through the initial six-month period, there are tips and strategies to help. Until your health care provider confirms that the blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact) get tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should also start the hepatitis B vaccine series.    Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 90 days or 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. If treatment for an acute hepatitis B infection is required, a person may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during a new infection is to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about your prescriptions, over-the-counter medications and ask any other questions you may have during this time. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver.   Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. Acute hepatitis B infections have few, if any, lasting effects. However, recovery from an acute infection means that while the virus is no longer in your blood, it is still living in the liver in an inactive state. You cannot infect anyone else, and you are not considered to be infected. However, the virus that is in your liver can be re-activated in the future if you take medications that suppress the immune system. This can be dangerous for the liver. Therefore, it is important that you tell all of your health care providers that you had a past hepatitis B infection. This way, if you need immune-suppressing medication, your provider can take precautions to prevent the hepatitis B virus from re-activating. This simple fact sheet can help you better understand this. You can print this fact sheet and bring it to your health care provider’s office. Chronic Hepatitis B Infection People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. The risk of developing a chronic hepatitis B infection is also directly related to the age at which one first becomes exposed to the hepatitis B virus: 90% of infected newborns and babies  will develop a chronic hepatitis B infection Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. There are effective drug therapies that can control and even stop the hepatitis B virus from further damaging a liver. There are also promising new drugs in the research pipeline that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risks. Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver through blood tests or diagnostic imaging Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer. It is important to understand that not everyone is a candidate for treatment, but everyone with chronic HBV benefits from regular monitoring  Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life Avoid or limit alcohol and smoking since both cause a lot of stress to your liver Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver To learn more about other ways to protect your liver and your health click here. 

    https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/acute-vs-chronic/
  • Visiting Your Doctor

    When you first visit your doctor, he/she will take your medical history and give you a physical exam. They will also take some blood for tests and perhaps order an ultrasound of the liver. To prepare for your doctor’s visit, take a list of questions (see below) with you bring copies of your previous blood test results invite a friend or family member along for support try to take notes while you talk to the doctor so that you have important information written down Questions to Ask Your Doctor What kind of hepatitis B infection do I have: a new "acute" infection, or a "chronic" infection? Could you please explain each hepatitis B blood test result, and any additional test results (ultrasound)? Please make copies of my test results for my own personal files. Where can I get my family, spouse or sexual partner tested and vaccinated for hepatitis B? What do I need to do to protect them until they are completely vaccinated? Am I a good candidate for treatment? If not, why not? If yes, please explain why and tell me about the treatment options? If I am not eligible for medical treatment, what do I need to do to monitor my hepatitis B?  Do I need to be regularly screened for liver cancer? If yes, how often?  Could you tell me about clinical trials? Do you offer any clinical trials for hepatitis B? If so, could you please explain them to me? For young women: If I want to have children, should I wait to start treatment? If I need to start treatment now, at one point can I consider having children? How will having hepatitis B affect my job or ability to work? How will having hepatitis B affect my health insurance or my ability to get health insurance? Here are the names of the medications that I currently take – are they safe for my liver? What over the counter medications or herbal supplements can I safely take for pain, cold symptoms, etc.? Should I be tested for other liver diseases, such as hepatitis C or D? Should I be vaccinated to protect myself against hepatitis A?  

    https://www.hepb.org/treatment-and-management/adults-with-hepatitis-b/visiting-your-doctor/