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• Ten Things You Should Know About Hepatitis B and Do in 2017

  … for liver cancer. So take charge of your health and ask for a liver cancer screen, which includes a semi-annual blood test and an ultrasound.  Hepatitis B-infected Asian men (or of Asian descent) over age 40 years and Asian women over age 50 years, patients with a family history of liver cancer, patients with cirrhosis, and Africans over the age of 20 should all be screened. Think you’re not at risk for cancer because you take antivirals? Think again. Antivirals help reduce liver damage, but if you’ve had cirrhosis or are older, the risk of liver cancer remains. If someone promises a new cure or treatment that sounds too good to be true….it probably is. In our search to be rid of hepatitis B, we may be tempted to yield to clever marketing and try a supplement that promises to cure us. But first, do your homework and practice precaution. To check out an herbal supplement, visit the National Center for Complementary and Integrative Health’s website to see what scientific evidence exists for a supplement and talk to your doctor. There is no magic bullet that will cure hepatitis B. Experts hope to find one soon, but for now be patient and stay skeptical. If you want to safeguard your health, eat healthy foods and avoid alcohol and cigarettes. Pregnant with hepatitis B? Get your viral load tested and ask your doctor about antivirals. The American Association for the Study of Liver Disease (AASLD) recommends that pregnant women with viral loads (HBV DNA) higher than 200,000 IU/mL (or 1 million copies/mL) receive an antiviral (either tenofovir or telbivudine). The antivirals won’t hurt you or your baby and will reduce the risk that your baby will be infected with hepatitis B to nearly zero, as long as your baby gets the first dose of the hepatitis B vaccine and a dose of HBIG (hepatitis B antibodies) within 12 hours of birth. Fight discrimination against hepatitis B and know your rights. Hepatitis B should never be a barrier to the education or job you want.

  http://www.hepb.org/blog/ten-things-know-hepatitis-b-2017/
• Know Your Rights: If You Suffer Severe Liver Damage from Hepatitis B, You May Qualify for SSDI or SSI

  Image courtesy of Stuart Miles at FreeDigitalPhotos.net The majority of people infected with hepatitis B lead healthy and normal lives. However, a small number of people may develop liver disease that will dramatically affect their quality of life and their ability to work on a short-term or long-term basis. They may not be able to work for several weeks because of side effects from pegylated interferon treatment, or progressive liver damage could make it impossible to work and support themselves and their families even after treatment. Below is information that can help you, your family members, or someone you advocate for apply for disability benefits to help them during when they can't work due to hepatitis B-related health problems. The first step is to find out if you can meet the Social Security Administration’s (SSA’s) medical eligibility requirements to receive disability support. With hepatitis B, you may qualify for one of SSA’s two disability programs: Social Security Disability Insurance (SSDI) is available to qualified, disabled workers who paid into the Social Security system through taxes over the course of their employment history. Supplemental Security Income (SSI) is a program with financial or “need-based” eligibility requirements. If you have limited income and other financial resources, you may meet SSI requirements. To qualify f0r either of these programs, your hepatitis B must meet medical eligibility rules and program-specific requirements. Additionally, your hepatitis and complications must have stopped you from working for 12 months or be expected to prevent employment for at least a year, despite treatment. Qualifying under Blue Book's hepatitis listing The SSA’s Blue Book outlines medical conditions that meet disability requirements. There is a listing for hepatitis in this manual. It appears in section 5.05, which covers chronic liver disease. To meet the listing, your hepatitis B must be unresponsive to treatment,

  http://www.hepb.org/blog/know-your-rights-if-you-suffer-severe-liver-damage-from-hepatitis-b-you-may-qualify-for-ssdi-or-ssi/
• Taking Antivirals Long-Term for Hepatitis B? Should You Worry About Bone Loss?

  Image courtesy of Sira Anamwong at FreeDigitalPhotos.net. By Christine Kukka To prevent liver damage and cirrhosis and reduce the risk of liver cancer--especially in older patients who’ve had hepatitis B for decades--doctors often prescribe long-term antiviral treatment. But some antivirals cause minor bone loss, which poses a problem for older patients with osteoporosis. According to experts, the risk of bone loss from long-term antiviral treatment is low, and in fact some antivirals do not cause any bone loss at all. But if you are starting antivirals at an older age, or if you have been on antivirals long-term, experts recommend you monitor your potassium and vitamin D levels and regularly test for bone loss in the hip area so you know if you are experiencing bone loss and need a calcium or vitamin D supplement. Antivirals affect bone health by causing a reduction in the amount of phosphorus in your body; a mineral that is essential to bone health. Historically, the antivirals lamivudine (Epivir-HBV) and adefovir (Hepsera) were widely used and adefovir specifically was linked to bone loss. Neither of those antivirals are currently recommended for first-line treatment. Today, the antivirals entecavir and tenofovir are recommended for most patients. Here is how these two antivirals affect bone health. Entecavir (Baraclude) appears to cause no bone loss, according to hepatitis B expert Dr. Robert Gish, medical consultant to the Hepatitis B Foundation and professor consultant of gastroenterology and hepatology at Stanford University. This antiviral, which recently became available as a less-expensive generic, has proven highly effective in reducing viral load (HBV DNA) and reducing liver damage in patients who are taking an antiviral for the first time. If you are an older patient, have signs of bone loss, and have never been treated with an antiviral before, your doctor may recommend this daily antiviral pill. However, entecavir is not an option if you’ve

  http://www.hepb.org/blog/taking-antivirals-long-term-should-you-worry-about-bone-loss/
• Navigating Our Emotions When We’re First Diagnosed with Hepatitis B

  … had the virus and infected us. Try 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

  http://www.hepb.org/blog/navigating-our-emotions-when-were-first-diagnosed-with-hepatitis-b/
• Ten Things People with Hepatitis B Need to Know in 2016

  … which includes a semi-annual blood test and an ultrasound.  Hepatitis B-infected Asian men (or of Asian descent) over age 40 years and Asian women over age 50 years, patients with a family history of liver cancer, patients with cirrhosis, and Africans over the age of 20 should all be screened. Think you’re not at risk for cancer because you take antivirals? Think again. Antivirals help reduce liver damage, but if you’ve had cirrhosis or are older, the risk of liver cancer remains. If someone promises a new cure or treatment that sounds too good to be true….it probably is. In our search to be rid of hepatitis B, we may be tempted to yield to clever marketing and try a supplement that promises to cure us. But first, do your homework and practice precaution. To check out an herbal supplement, visit the National Center for Complementary and Integrative Health’s website to see what scientific evidence exists for a supplement and talk to your doctor. There is no magic bullet that will cure hepatitis B. Experts hope to find one soon, but for now be patient and stay skeptical. If you want to safeguard your health, eat healthy foods and avoid alcohol and cigarettes. Experts say a cure is coming … so stay informed about new drug developments and clinical trials. There is lots happening on the research front. To find out what drugs are in the development pipeline, visit the Hepatitis B Foundation’s Drug Watch page for the latest news. You can also find out if you qualify for a clinical trial. Expensive blood work, treatment medications, and doctor's visits are usually free-of-charge for those accepted into a study. The foundation features a list of hepatitis B-related clinical trials that are recruiting patients in the U.S. and around the world at its Clinical Trials page. You could become part of the cure. Pregnant with hepatitis B? Get your viral load tested and ask your doctor about antivirals. In November, the American Association for the Study of Liver

  http://www.hepb.org/blog/ten-things-people-with-hepatitis-b-need-to-know-in-2016/

• 一般信息  什么是乙型肝炎?乙型肝炎是世界上最常见的肝脏感染。它是由乙型肝炎病毒 (HBV) 引起的，该病毒会攻击和伤害肝脏。它通过血液、无保护性行为、共用或重复使用的针头传播，在怀孕或分娩期间由受感染的母亲传染给新生婴儿。大多数感染的成年人能够毫无问题地消除乙型肝炎病毒。然而，一些成年人和大多数受感染的婴儿和儿童无法消除这种病毒，并将发展为慢性（终生）感染。 好消息是已有安全的疫苗可以预防乙型肝炎感染，和针对已感染人士的新治疗方法。 有多少人受乙型肝炎影响？全世界 20 亿人（3 人中就有 1 人）已感染乙型肝炎；2.57 亿人为慢性感染（这意味着他们无法消除这种病毒）。据估计，每年有 70 万人死于乙型肝炎及其并发症。 为什么乙型肝炎在世界某些地区更常见？乙型肝炎可以感染任何年龄或种族的任何人，但是来自世界上乙型肝炎较为常见的部分地区（如亚洲、非洲和南美洲部分地区、东欧以及中东）的人，受感染的风险要高得多。出生（或其父母出生）在这些地区的美国人中，乙型肝炎也较为常见。 乙型肝炎在世界上某些地区更为常见，因为在这些地区有更多的人已经感染乙型肝炎。虽然乙型肝炎并非“亚洲疾病”或者“非洲疾病”，但它影响着来自这些地区的数亿人——因此，这里有更多的人会将乙型肝炎病毒传给他人。这增加了您受感染的风险。因为有较小一部分的受感染者为西方人，这一群体的感染风险较低。 在乙型肝炎较为常见的地区，人们通常在新生儿时期就受到感染——在分娩过程中由母亲不知不觉地将病毒传给婴儿。如果幼儿与受感染的家庭成员在日常生活中接触密切，他们也面临风险。婴儿和儿童更容易发展为慢性乙型肝炎感染，因为他们未成熟的免疫系统难以消除这种病毒。 如果您，或者您的家人，来自地图上的深蓝色区域，您可能会面临更大的乙型肝炎感染风险，并且应该和医生谈谈关于接受测试的事宜。 为什么我应该关心乙型肝炎？慢性乙型肝炎可以导致严重的肝脏疾病，如肝硬化或肝癌。接受测试十分重要，因为早期的诊断可以使您尽早治疗，从而可以挽救您的生命。另外，感染者可以将病毒传播给其他人。因为大多数人不知道自己受感染，所以他们会不知不觉地将之传播给其他许多人。如果人们不接受测试，乙型肝炎病毒可以在一个家庭的几代人和整个社区中传播下去。 一个常见误区是，乙肝可以“遗传”，因为一个家族中几代人可能都受感染。但乙型肝炎不是遗传性疾病——乙型肝炎是由病毒引起的，通常因母婴传播或者意外的居家血液接触而在家庭成员之间传播。通过接受测试、接种疫苗和治疗，家庭可以打破乙型肝炎感染的循环。 为什么乙型肝炎如此危险？乙型肝炎有危险，因为它是一种“无声的感染”，可以使人不知不觉地受到感染。大多数乙型肝炎感染者未觉察自己感染，会不知不觉地通过自己的血液和已感染的体液将病毒传给他人。对于那些慢性感染者，在以后的生活中，发展为肝功能衰竭、肝硬化和/或肝癌的风险会增加。该病毒可以悄无声息、持续不断地长年攻击肝脏而不被发觉。 什么是急性乙型肝炎？急性乙型肝炎感染可持续多达六个月（有症状或无症状），感染者可在此期间将病毒传给他人。 急性感染的症状可能包括食欲减退、关节和肌肉疼痛、低烧和可能胃痛。虽然大多数人不会体验到症状，但症状会在感染后的 60-150 天出现，平均为 3 个月。有些人可能出现更严重的症状，如恶心、呕吐、黄疸（眼睛和皮肤发黄），或者胃胀，这些可能导致他们去看卫生保健提供者。 仅需简单的验血即可辨别一个人的血液中是否存在乙型肝炎病毒。如果您已被诊断为急性乙型肝炎，医生需要在 6 个月后再次测试您的血液，以确定您是已康复，还是发展为慢性乙型肝炎感染。在您的卫生保健提供者确认您的验血表明您的血液中不再存有乙型肝炎病毒之前，保护其他人避免感染可能性是十分重要的。让您的性伴侣和家庭成员（或与您密切接触的家属）接受乙型肝炎测试也是十分重要的。如果他们尚未受感染，而且尚未接受乙型肝炎疫苗接种，那么他们就应该开始注射乙型肝炎疫苗系列。 急性乙型肝炎患者不会被建议采用特定的乙型肝炎治疗方法——没有可以消除急性乙型肝炎感染的治疗方法，而且大多数人在成年时期受到感染，可自行痊愈。有时，症状严重者可能会住院接受一般支持。休息和控制症状是这一医疗保健的主要目标。一种名为“暴发型肝炎”的罕见、危及生命的病症，会伴随新的急性感染出现，并且需要立即、紧急的医疗护理，因为患者可能会突然出现肝衰竭。 急性乙型肝炎感染期间照顾您的肝脏的简单技巧就是要避免酒精，停止或限制吸烟，食用健康食物，避免油腻或高脂肪的食物，以及与您的卫生保健提供者谈论您正在服用的任何药物（处方药、非处方药物、维生素或草药补充剂），以确保它们对您的肝脏是安全的。您如有任何其他疑问，这是提问的好时机。使用维生素和肝脏健康补充剂可能不会帮助您恢复健康，实际上对肝脏的影响可能弊大于利。 务必去您的卫生保健提供者处复诊，以接受确认您是否从急性感染中恢复所需的任何其他验血。 什么是慢性乙型肝炎？乙型肝炎病毒测试呈阳性超过六个月者（在其首次验血结果之后）被诊断为患慢性感染。这意味着他们的免疫系统无法消除乙型肝炎病毒，而且该病毒仍然存在于他们的血液和肝脏中。已有治疗和控制慢性感染的有效方法，但是没有治愈方法。如果您是慢性感染者，很可能在您的余生中病毒都会留在您的血液里。 慢性乙型肝炎患者会不知不觉地将病毒传给他人。慢性乙型肝炎也可以导致严重的肝脏疾病，如肝硬化或肝癌。并非每位慢性感染者都会发展为严重的肝脏疾病。然而，他们的可能性比未感染者更大。 发展为慢性乙型肝炎感染的风险与首次感染乙型肝炎病毒的年龄有关： 90% 受感染的新生儿和婴儿会发展为慢性乙型肝炎感染 高达 50% 受感染的儿童（1-5 岁）会发展为慢性乙型肝炎感染 5%-10% 受感染的成年人会发展为慢性乙型肝炎感染（即，90% 会恢复） 获悉自己患有慢性乙型肝炎感染会非常令人沮丧。因为大多数人没有症状，并在他们最初接触乙型肝炎病毒后数十年被诊断出来，所以被诊断为患有慢性乙型肝炎感染会令人感到震惊和意外。好消息是，大多数慢性乙型肝炎患者预计会活得健康长寿。 受感染的孕妇可以在分娩期间将病毒传给新生儿。因此，由于新生儿在出生时患慢性感染的风险很高，世界卫生组织 (WHO) 和美国疾病控制和预防中心 (CDC) 建议，所有婴儿在出生后 12-24 小时内接受首剂乙型肝炎疫苗接种。如果您已怀孕并且您知道自己受感染，则您可以确保您的宝宝在分娩后的 12-24 小时内接受首剂乙型肝炎疫苗接种！ 尽管慢性乙型肝炎感染没有治愈方法，但已有有效的药物疗法可以控制乙型肝炎病毒并阻止它损害肝脏。还有处于研究阶段的有前景新药，可以在不久的将来提供治愈方法。尽管慢性乙型肝炎患者发展为严重肝病或肝癌的风险高于未感染者，但仍有许多简单的事情可以帮助降低他们的风险。 每六个月（或至少每年）安排一次与乙型肝炎知识渊博的肝脏专家或卫生保健提供者的定期就诊，以便他们可以监测您的肝脏健康。 与您的卫生保健提供者讨论您的慢性乙型肝炎感染治疗是否有助于预防严重的肝脏疾病或肝癌。 确保您的卫生保健提供者在您的定期就诊期间对您进行肝癌筛查，因为早发现等同于治疗选择更多和生命更长久。 避免或限制酒精和吸烟，因为二者都会对您的肝脏造成巨大压力。 合理健康饮食，吃大量蔬菜，因为油炸、油腻的食物会苛待您的肝脏。 成为“慢性携带者”意味着什么？当某人患有慢性乙型肝炎感染时，他们的医生可能会称其为“慢性携带者”。作为“慢性携带者”意味着您患有慢性乙型肝炎感染，可以将病毒传给他人，并且您应该由医生来控制您的感染。 乙型肝炎有治愈方法吗？大多数成年人无需药物治疗，急性感染即可自行痊愈。对于发展为慢性乙型肝炎感染的成年人、儿童和婴儿，目前没有治愈方法。但好消息是，有一些治疗方法可以通过使病毒减速来帮助减缓慢性感染者的肝病进展。如果产生的乙型肝炎病毒较少，那么对肝脏的损伤就会较少。 凭着所有令人振奋的新研究，有很大希望在不久的将来找到慢性乙型肝炎的治愈方法。访问我们的 Drug Watch（药品观察 获取研发中的其他有前景药物的清单。治疗我的乙型肝炎有哪些选择？对于急性感染，除了休息和支持性措施来控制任何症状外，一般没有其他治疗方法。 对于慢性乙型肝炎，有几种可用的治疗方法。重要的是要了解并非每位慢性乙型肝炎患者都需要治疗。您的医生会帮助您决定您是需要药物治疗，还是可以等待并监控您的病情。 有几种抗病毒药物可以减缓或阻止乙型肝炎病毒的复制，从而减少肝脏炎症和损伤。这些抗病毒药物为丸剂，每天服用一次，疗程至少 1 年，通常更久。目前有 6 种经美国 FDA 批准的抗病毒药物，但是只有 3 种“一线”抗病毒药物获得推荐：替诺福韦酯（Viread/TDF）、替诺福韦艾拉酚胺（Vemlidy/TAF）和恩替卡韦（Baraclude）。推荐使用一线抗病毒药物，因为它们更安全、最有效。对一线抗病毒治疗无应答或无法获取一线抗病毒治疗的患者可使用其他选择：替比夫定（Tyzeka，Sebivo）、阿德福韦酯（Hepsera）和拉米夫定（Epivir-HBV，Zeffix，Heptodin）。 尽管 FDA 已经批准这些用于慢性乙型肝炎的抗病毒药物，但它们不能提供彻底治愈。然而，它们可以大大减少发展肝损伤和肝癌的风险。抗病毒药物不能随意停止和开始，这就是在开始治疗慢性乙型肝炎之前需要由知识渊博的医生进行彻底评估是如此重要的缘由。 还有免疫调节药可以增强免疫系统，以帮助控制乙型肝炎病毒。它们在 6 个月至 1 年的时间里以注射方式给药。最常见的处方药物包括干扰素 alfa-2b (Intron A) 和聚乙二醇干扰素 (Pegasys)。 您和您的医生在决定哪种治疗选择（若有的话）最适合您之前需要讨论各种治疗选择。对许多人来说，这些药物会减少或阻止乙型肝炎病毒。这导致病人在数月内感觉良好，这是因为病毒对肝脏的损伤有所减缓，或者经长期服用后甚至在某些情况下出现逆转。 如需获取经 FDA 批准的药物和其他处于研发中的有前景药物的完整清单，请访问我们的 Drug Watch（药品观察。   General Information What is hepatitis B?Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B. How many people are affected by hepatitis B?Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world?Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B?Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous?Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected. What is acute hepatitis B?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. 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 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. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your 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 with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms 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 an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. 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. What is chronic hepatitis B?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. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected.The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with 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. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase 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 risk. 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. 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. 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. What does it mean to be a “chronic carrier”?When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B?Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. But the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. What options are there to treat my hepatitis B?For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three “first-line” antivirals are recommended: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic hepatitis B. There are also immunomodulator drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.  

  https://www.hepb.org/languages/chinese-simplified/general-info/
• "التعايش مع التهاب الكبد "ب

  Will I recover from a hepatitis B infection? Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus.  Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B.  Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection. Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus.  What is the difference between an "acute" and a "chronic" hepatitis B infection? A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection.   If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.  Will I become sick if I have acute hepatitis B? Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu.   Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized.   How will I know when I have recovered from an "acute" hepatitis B infection? Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B? If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment. All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important.   Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B.   What tests will be used to monitor my hepatitis B? Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B? Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.  With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B? Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators:   Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta.   Do these drugs provide a “cure” for chronic hepatitis B?
 Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication? It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B.  Is it safe to take herbal remedies or supplements for my hepatitis B infection? Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these produces, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection.  There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm.   What healthy liver tips are there for those living with chronic hepatitis B? People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver. Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.  Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.   Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals.  Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer. Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.  Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B?  No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection. هل سأتعافى من عدوى التهاب الكبد "ب"؟ يتعافى معظم البالغين المصابين حديثًا ممن يتمتعون بصحة جيدة دون حدوث أي مشكلات. ولكن قد لا يمكن للرضع والأطفال الصغار التعافي من الفيروس بنجاح.  البالغون – 90% من البالغين الذين يتمتعون بصحة جيدة يتعافون من الفيروس دون حدوث أي مشكلات؛ بينما يصاب 10% منهم بفيروس التهاب الكبد "ب" المزمن.  الأطفال الصغار – يصاب ما يصل إلى 50% من الأطفال الصغار الذين تتراوح أعمارهم بين سنة وخمس سنوات بعدوى التهاب الكبد "ب" المزمنة. الرضع – يُصاب 90% من الرضع بالعدوى المزمنة؛ بينما يتعافى 10% منهم فقط من الفيروس.  ما الفرق بين عدوى التهاب الكبد "ب" "الحادة" و"المزمنة"؟ تُعد عدوى التهاب الكبد "ب" "حادة" خلال الأشهر الستة الأولى بعد الإصابة بالفيروس. وهذا هو متوسط الفترة الزمنية المستغرقة للتعافي من عدوى التهاب الكبد "ب". وإذا كانت نتيجة اختبار فيروس التهاب الكبد "ب" لا تزال إيجابية بعد مرور 6 أشهر (+HBsAg)، فأنت مصاب بعدوى "مزمنة" لالتهاب الكبد "ب"، حيث قد تستمر مدى الحياة.  هل سأشعر بالتعب إذا كنت مصابًا بالتهاب الكبد "ب" الحاد؟ يعتبر فيروس التهاب الكبد "ب" "عدوى صامتة" لأنه غالبًا لا يتسبب في ظهور أي أعراض، إذ يشعر معظم الأشخاص أنهم بصحة جيدة ولا يعرفون أنهم مصابون، مما يعني إمكانية نقلهم للفيروس للآخرين دون علمهم. وقد يعاني آخرون من أعراض خفيفة مثل الحمى أو التعب أو آلام المفاصل أو العضلات أو فقدان الشهية، لذلك قد يحدث خلط بين هذه الأعراض وأعراض الإنفلونزا العادية. وتتضمن الأعراض الأقل شيوعًا ولكن الأكثر خطورة حالات شديدة من الغثيان والقيء واصفرار العين والجلد (يسمى "اليرقان") وانتفاخ المعدة - تتطلب هذه الأعراض عناية طبية فورية وقد يحتاج الشخص إلى دخول المستشفى.   كيف أعرف أنني قد تعافيت من عدوى التهاب الكبد "ب" "الحادة"؟ بمجرد أن يؤكد طبيبك من خلال اختبار الدم أنك قد تخلصت من الفيروس وأن جسمك قام بتطوير الأجسام المضادة الواقية (+HBsAb)، فأنت بذلك تكون محميًا من أي عدوى محتملة في المستقبل بالتهاب الكبد "ب" ولن تنقل العدوى للآخرين بعد ذلك. ماذا أفعل إذا تم تشخيصي بالتهاب الكبد "ب" المزمن؟ إذا كانت نتيجة اختبار التهاب الكبد "ب" إيجابية لمدة تزيد عن 6 أشهر، فهذا يدل على أنك مصاب بعدوى مزمنة بالتهاب الكبد "ب". ويتعين عليك تحديد موعد مع طبيب الكبد (أخصائي أمراض كبد)، أو أخصائي أمراض الجهاز الهضمي، أو طبيب العائلة المتخصص في أمراض فيروس التهاب الكبد "ب"، حيث سيطلب منك الطبيب اختبارات الدم وربما فحص بالموجات فوق الصوتية للكبد لتقييم مدى نشاط التهاب الكبد "ب" في جسمك، ولمتابعة الحالة الصحية للكبد. وقد يطلب الطبيب رؤيتك مرة أو مرتين سنويًا على الأقل لمتابعة حالة التهاب الكبد "ب" وتحديد مدى استفادتك من العلاج. ويجب أن يفحص الطبيب جميع الأشخاص المصابين بعدوى مزمنة مرة واحدة سنويًا على الأقل (أو بصورة متكررة) من أجل الحصول على رعاية طبية مناسبة ومتابعة منتظمة، سواء بدؤوا العلاج أم لا. وحتى إذا كان الفيروس في مرحلة أقل نشاطًا مع حدوث أضرار قليلة أو عدم حدوث أي أضرار، فيمكن أن يتغير ذلك بمرور الوقت، وهذا هو السبب وراء أهمية المتابعة المنتظمة.   ويمكن أن يتوقع معظم المصابين بعدوى مزمنة بالتهاب الكبد "ب" عيش حياة طويلة وحالة صحية مستقرة. بمجرد تشخيصك بالتهاب الكبد "ب" المزمن، قد يبقى الفيروس في دمك وكبدك مدى الحياة. ومن المهم معرفة أنه بإمكانك نقل الفيروس للآخرين، حتى ولو لم تشعر أنك مريض. ولهذا السبب فإنه من المهم للغاية التأكد من أن جميع الأشخاص الذين تتعامل معهم من الأسرة عن قرب والزوجة/الزوج قد أخذوا لقاحًا ضد التهاب الكبد "ب".   ما الاختبارات التي سأجريها لمتابعة حالتي بالإصابة بالتهاب الكبد "ب"؟ الاختبارات الشائعة التي يطلب الأطباء إجراءها لمتابعة حالة التهاب الكبد "ب" تتضمن فحوصات الدم الخاصة بالتهاب الكبد "ب"، واختبارات وظائف الكبد (تحليل ALT، وتحليل AST)، وفحص المستضد "e" لالتهاب الكبد "ب" (HBeAg)، والجسم المضاد "e" لالتهاب الكبد "ب" (HBeAb)، وقياس كمية الحمض النووي (DNA) لفيروس التهاب الكبد "ب" (الحِمل الفيروسي)، والأشعة التصويرية للكبد (باستخدام الموجات فوق الصوتية أو الفيبروسكان [التصوير الإلستوجرافي العابر] أو الأشعة المقطعية (CT)). هل يوجد علاج لالتهاب الكبد "ب" المزمن؟ لا يوجد علاج لفيروس التهاب الكبد "ب" المزمن في الوقت الراهن، ولكن الخبر السار هو أن هناك علاجات يمكن أن تساعد في إبطاء انتشار أمراض الكبد عند المصابين بالعدوى المزمنة من خلال إبطاء تكاثر الفيروس. إذا كان هناك انتشار أقل لفيروس التهاب الكبد "ب"، فسيقع ضرر أقل على الكبد. وفي بعض الأحيان، يمكن أن تساعد هذه الأدوية في التعافي من الفيروس، على الرغم من أن هذا الأمر ليس شائعًا.  وبوجود كل تلك الأبحاث الجديدة المثيرة للاهتمام، هناك أمل كبير في العثور على علاج لالتهاب الكبد "ب" المزمن في المستقبل القريب. يُرجى زيارة قسم Drug Watch (قائمة الأدوية الخاضعة للمراقبة) للاطلاع على قائمة بالأدوية الواعدة قيد التطوير. هل توجد أدوية معتمدة لعلاج التهاب الكبد "ب" المزمن؟ تنقسم العلاجات الحالية لالتهاب الكبد "ب" إلى فئتين عامتين، هما الأدوية المضادة للفيروسات ومُنظِّمات المناعة: الأدوية المضادة للفيروسات - هي الأدوية التي تعمل على إبطاء تكاثر فيروس التهاب الكبد "ب" أو إيقافه؛ مما يقلل التهاب الكبد وتضرره. وتؤخذ هذه الأدوية على هيئة حبة مرة واحدة في اليوم لمدة سنة على الأقل، وعادة ما تكون المدة أطول من ذلك. تتوفر 6 مضادات للفيروسات معتمدة من قِبل إدارة الغذاء والدواء الأمريكية (FDA)، ولكن يُنصح باستخدام ثلاثة فقط من الخيارات الأولى من مضادات الفيروسات: تينوفوفير ديسوبروكسيل (فيريد/TDF)، تينوفوفير ألفيناميد (فيمليدي/TAF)، إينتيكافير (باراكلود). يُوصى باستخدام الخيارات الأولى من مضادات الفيروسات لأنها أكثر أمانًا وفاعلية. كما أن لها خاصية مقاومة أفضل من الأدوية الأقدم المضادة للفيروسات؛ مما يعني أنه عند تناولها على النحو الموصوف، تكون هناك فرص أقل لحدوث طفرات ومقاومة. ومن المعروف أن مقاومة الجسم تزيد من صعوبة علاج الفيروس والسيطرة عليه. الأدوية المناعية - هي الأدوية التي تقوي جهاز المناعة حيث تساعد على السيطرة على فيروس التهاب الكبد "ب". ويتم تناولها على هيئة حقن على مدى يتراوح من 6 أشهر إلى سنة. تتضمن الأدوية التي غالبًا ما تُوصف للمرضى "إنترفيرون ألفا-2ب" (إنترون "أ") و"بيغ-إنترفيرون" (بيغاسيس). وهذا هو العلاج الوحيد الموصى به للمرضى المصابين بفيروس التهاب الكبد دلتا (المعروف أيضًا بالتهاب الكبد "د").   هل تعتبر هذه الأدوية بمثابة "علاج" لالتهاب الكبد "ب" المزمن؟ على الرغم من أن الأدوية الحالية لا تعتبر علاجًا كاملاً، إلا أنها تعمل على إبطاء تكاثر الفيروس وتقلل من خطر الإصابة بأمراض الكبد الأكثر خطورة في مرحلة لاحقة من الحياة. ويؤدي ذلك إلى شعور المرضى بالتحسن خلال بضعة أشهر بسبب تباطؤ تلف الكبد الناتج عن الفيروس، أو حتى بسبب عكس تأثيره في بعض الحالات، عند تناول الأدوية على المدى الطويل. ليس من المفترض أن يتم إيقاف مضادات الفيروسات وتناولها مرة أخرى، وهذا هو سبب الأهمية البالغة للخضوع إلى تقييم شامل على يد طبيب واسع الاطلاع قبل البدء في علاج فيروس التهاب الكبد "ب" (HBV) المزمن. إذا كنتُ مصابًا بعدوى التهاب الكبد "ب" المزمن، فهل يجب أن ألتزم بتناول دواء معين؟ من المهم أن تدرك أنه ليس كل مصاب بالتهاب الكبد "ب" المزمن يحتاج إلى تناول أدوية. لذا، يتعين عليك التحدث مع طبيبك عما إذا كانت حالتك تستدعي العلاج بالأدوية أم لا. وسواء قررت أنت وطبيبك أنه يجب عليك بدء العلاج أم لا، فيجب أن تتابع حالتك بانتظام مع طبيب متخصص أو طبيب مُطّلع على حالات الإصابة بفيروس التهاب الكبد "ب".  هل من الآمن تناول العلاجات العشبية أو المكملات الغذائية لعلاج التهاب الكبد "ب"؟ يرغب الكثيرون في استخدام العلاجات العشبية أو المكملات الغذائية في سبيل تقوية أجهزة المناعة الخاصة بهم وحماية الكبد. ولكن المشكلة تكمن في عدم وجود قواعد محددة تعتمد عليها الشركات التي تصنع هذه المنتجات؛ مما يعني عدم وجود اختبارات صارمة للسلامة أو النقاء. ولذلك، قد تختلف جودة العلاجات بالأعشاب أو المكملات الغذائية من شركة إلى أخرى. كما يمكن أن تتعارض بعض العلاجات العشبية مع الأدوية التي تتناولها لعلاج التهاب الكبد "ب" أو أي حالات أخرى؛ إذ يمكن لبعضها أن يؤدي إلى تلف الكبد. ولن تُداوي هذه العلاجات العشبية عدوى التهاب الكبد "ب" المزمنة.  وهناك الكثير من الشركات التي تقدم وعودًا كاذبة على الإنترنت وعبر وسائل التواصل الاجتماعي بشأن منتجاتها. وهناك ادعاءات تُنشر عبر الإنترنت وشهادات للمرضى على منصة فيسبوك مضللة وكاذبة، وتُستخدم لخداع الأشخاص لشراء العلاجات العشبية والمكملات باهظة الثمن. لذا، تذكر أن المنتجات التي يتم الحديث عن جودتها بشكل مبالغ فيه وبدرجة تفوق حد التصديق ليست فعالة كما يُقال. فيما يلي مصادر موثوقة للمعلومات المتعلقة بالأعشاب العلاجية والأدوية البديلة. وهذه المعلومات مبنية على أدلة علمية، وليست مجرد وعود كاذبة. تأكد أن المكونات الفعالة في العلاجات العشبية أو المكملات الغذائية حقيقية وآمنة على الكبد. أهم شيء هو حماية الكبد من أي إصابة أو ضرر إضافي. ما النصائح التي يمكن تقديمها للتمتع بكبد صحي بالنسبة للأشخاص الذين يعانون من فيروس التهاب الكبد "ب" المزمن؟ قد يحتاج الأشخاص المصابون بعدوى التهاب الكبد "ب" المزمن إلى علاج دوائي، وقد لا يحتاجون لذلك. ولكن هناك الكثير من الأمور الأخرى التي يمكن للمرضى فعلها لحماية كبدهم وتحسين مستوى صحتهم. فيما يلي قائمة بأفضل عشرة خيارات صحية يمكن أن تبدأ باتباعها اليوم! حدد مواعيد منتظمة لزيارة أخصائي الكبد أو مقدم الرعاية الصحية للحفاظ على صحتك وصحة الكبد "ب" بأفضل حالة ممكنة. تناول لقاح التهاب الكبد "أ" لحماية نفسك من أي فيروس آخر يمكن أن يهاجم الكبد. تجنب شرب الكحول والتدخين لأن كليهما سيتسببان في إلحاق الضرر بكبدك المصاب بالفعل بفيروس التهاب الكبد "ب". تحدث إلى طبيبك قبل البدء في تناول أي علاجات عشبية أو فيتامينات مكملة لأن بعضها يمكن أن يتعارض مع أدوية علاج فيروس التهاب الكبد "ب" الموصوفة طبيًا أو قد تتسبب حتى في إتلاف الكبد. استشر الصيدلي بشأن أي أدوية لا تستلزم وصفة طبية (مثل "أسيتامينوفين" و"باراسيتامول") أو الأدوية غير الموصوفة طبيًا لعلاج التهاب الكبد "ب" قبل تناولها للتأكد من أنها آمنة على الكبد، إذ إن العديد من هذه الأدوية تمر عبر الكبد.  تجنب استنشاق الأبخرة الناتجة عن الدهانات ومخففات الدهان والغراء ومنتجات التنظيف المنزلية ومزيلات طلاء الأظافر والمواد الكيميائية السامة الأخرى التي يمكن أن تتلف الكبد. اتّبع نظامًا غذائيًا صحيًا يعتمد على تناول الفواكه والحبوب الكاملة والأسماك واللحوم قليلة/منزوعة الدهون والكثير من الخضراوات. لقد ثبت أن "الخضراوات الكرنبية"، وبالتحديد الكرنب والبروكلي والقرنبيط، تساعد في حماية الكبد من المواد الكيميائية البيئية.  تجنب تناول الأطعمة البحرية الصدفية النيئة أو غير المطهوة جيدًا (مثل الجندوفلي وبلح البحر والمحار والإسكالوب) لأنها يمكن أن تكون ملوثة ببكتيريا تسمى فيبريو فولنفيكوس (الضمة الجارحة)، التي تُعد شديدة السمية على الكبد ويمكن أن ينتج عنها ضرر كبير. تحقق من علامات العفن على سطح المكسرات والذرة والحبوب والفول السوداني والذرة الرفيعة والذرة البيضاء قبل تناول أي من هذه الأطعمة. من المرجح أن يتسبب العفن في حدوث مشكلات في حالة تخزين الطعام في أجواء تتسم بالرطوبة وغير مُحكمة الغلق على النحو الصحيح. قد يعني وجود عفن أن الطعام يمكن أن يكون ملوثًا بمركبات "أفلاتوكسين"، التي تعتبر من عوامل الخطر المعروفة التي تسبب سرطان الكبد. خفّف من مستويات التوتر في حياتك من خلال تناول الأطعمة الصحية وممارسة الرياضة بصفة منتظمة والحصول على قسط كافٍ من الراحة.  ضع في اعتبارك أن كل ما تأكله أو تشربه أو تستنشقه أو تمتصه عبر الجلد يتم ترشيحه في النهاية عن طريق الكبد. لذا، يجب عليك حماية كبدك وصحتك! هل يمكنني التبرع بالدم إذا كنتُ مصابًا بالتهاب الكبد "ب"؟  لا، لن يقبل بنك الدم أي دم تعرض لفيروس التهاب الكبد "ب"، حتى إذا كنت قد تعافيت من الإصابة بعدوى حادة

  https://www.hepb.org/languages/arabic/page-595/
• ما هو التهاب الكبد "ب"؟

  What is hepatitis B? Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B. How many people are affected by hepatitis B?Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world?Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested.   Why should I be concerned about hepatitis B?Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous?Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected. What is acute hepatitis B?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. 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 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. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your 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 with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms 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 an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. 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. What is chronic hepatitis B?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. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected. The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with 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. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase 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 risk. 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. 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. 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. What does it mean to be a “chronic carrier”?When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B?Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. But the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. What options are there to treat my hepatitis B?For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three “first-line” antivirals are recommended: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic hepatitis B. There are also immunomodulator drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch. ما هو التهاب الكبد "ب"؟ التهاب الكبد "ب" هو أكثر أنواع العدوى التي تصيب الكبد شيوعًا في العالم، وينتج عن فيروس التهاب الكبد "ب" (HBV)، الذي يهاجم الكبد ويؤذيه. ينتقل الفيروس عن طريق الدم، أو ممارسة الجنس دون وقاية، أو مشاركة استخدام الإبر أو إعادة استخدامها، ومن الأم المصابة إلى طفلها أثناء الحمل أو الولادة. ويستطيع معظم البالغين المصابين بفيروس التهاب الكبد "ب" التعافي من الفيروس دون أي مشاكل. ومع ذلك، فإن بعض البالغين ومعظم الرضع والأطفال المصابين لا يستطيعون التعافي من الفيروس وسيصابون بعدوى مزمنة (مدى الحياة). والخبر السار هو أن هناك لقاحًا آمنًا للوقاية من عدوى التهاب الكبد "ب" وتتوفر أيضًا علاجات جديدة للمصابين بالفعل بالتهاب الكبد "ب".  كم عدد الأشخاص المصابين بفيروس التهاب الكبد "ب"؟ يبلغ عدد مصابي التهاب الكبد "ب" 2 مليار شخص (1 من كل 3 أشخاص) في جميع أنحاء العالم؛ كما أصيب 257 مليون شخص بعدوى مزمنة (مما يعني أنهم غير قادرين على التعافي من الفيروس). وتشير التقديرات إلى أن هناك 700000 شخص يموتون كل عام بسبب التهاب الكبد "ب" ومضاعفاته. لماذا يُعد التهاب الكبد "ب" أكثر شيوعًا في بعض أنحاء العالم؟ يمكن أن يصيب التهاب الكبد "ب" أي شخص في أي عُمر أو من أي عِرق، ولكن الأشخاص من مناطق معينة من العالم التي يكون فيها التهاب الكبد "ب" شائعًا، مثل آسيا وأجزاء من إفريقيا وأمريكا الجنوبية وأوروبا الشرقية والشرق الأوسط، هم أكثر عرضة للإصابة بهذا المرض. التهاب الكبد "ب" شائع أيضًا بين الأمريكيين الذين ولدوا في هذه المناطق (أو ولد آباؤهم أو أمهاتهم فيها).  يُعد التهاب الكبد "ب" أكثر شيوعًا في مناطق معينة من العالم نظرًا لوجود عدد أكبر من الأشخاص المصابين بالفعل بهذا الفيروس في هذه المناطق. وعلى الرغم من أن التهاب الكبد "ب" ليس "مرضًا آسيويًا" أو "مرضًا إفريقيًا" في الأصل، إلا أنه يؤثر على مئات الملايين من الأشخاص في هذه المناطق - حيث إن هناك المزيد من الأشخاص الذين يمكنهم نقل فيروس التهاب الكبد "ب" إلى الآخرين. وهذا يزيد من خطر الإصابة بالعدوى. ونظرًا لأن عدد الغربيين المصابين بهذا المرض أقل، فإن تعرضهم لخطر الإصابة بهذا الفيروس أقل.  وفي المناطق التي ينتشر فيها الالتهاب الكبدي "ب"، عادةً ما يصاب الأشخاص بالعدوى مثل حديثي الولادة - من الأم التي تنقل الفيروس دون علم إلى طفلها أثناء الولادة. كما أن الأطفال الصغار معرضون لخطر الإصابة إذا كانوا يعيشون بالقرب من أحد أفراد الأسرة المصابين ويتعاملون معه عن قرب أيضًا. ومن المرجح أن يتعرض الرضع والأطفال للإصابة بعدوى مزمنة من التهاب الكبد "ب" لأن أجهزتهم المناعية الصغيرة تواجه صعوبة في التعافي من الفيروس. إذا كنت أنت أو عائلتك من منطقة محددة باللون الأزرق الداكن على الخريطة، فقد تكون أكثر عرضة للإصابة بالتهاب الكبد "ب" ويجب عليك التحدث مع الطبيب بشأن إجراء الفحص. لماذا ينبغي أن أكون حذرًا بشأن التهاب الكبد "ب"؟يمكن أن يؤدي التهاب الكبد "ب" المزمن إلى أمراض الكبد الخطيرة مثل تليف الكبد أو سرطان الكبد. من المهم إجراء الفحص لأن التشخيص المبكر يمكن أن يؤدي إلى علاج مبكر يمكن أن ينقذ حياتك. ويمكن أيضًا للأشخاص المصابين نقل الفيروس إلى الآخرين. وبما أن معظم الأشخاص لا يعرفون أنهم مصابون به، فهم ينقلون العدوى إلى العديد من الأشخاص الآخرين دون علم. إذا لم يخضع الأشخاص للفحص، يمكن أن ينتقل التهاب الكبد "ب" عبر عدة أجيال في عائلة واحدة وفي جميع أنحاء المجتمع. تنتشر بعض المعتقدات التي تقول إن التهاب الكبد "ب" قد يكون "وراثيًا" بسبب إصابة عدة أجيال في عائلة واحدة. ولكن التهاب الكبد "ب" "ليس" مرضًا وراثيًا - بل ينتج عن العدوى بفيروس، والذي ينتقل غالبًا بين أفراد الأسرة بسبب انتقاله من الأم إلى الطفل أو الملامسة غير المقصودة لدم أحد أفراد الأسرة المصاب بالفيروس. ويمكن للعائلات كسر حلقة الإصابة بعدوى التهاب الكبد "ب" من خلال إجراء الفحوصات واللقاح والعلاج. لماذا يُعد التهاب الكبد "ب" خطيرًا للغاية؟ يُعد التهاب الكبد "ب" خطيرًا لأنه "عدوى صامتة" يمكن أن تصيب الأشخاص دون معرفتهم. ومعظم المصابين بالتهاب الكبد "ب" لا يدركون إصابتهم بالمرض ويمكنهم نقل الفيروس إلى آخرين دون علم من خلال الدم وسوائل الجسم المتضمنة للإصابة. بالنسبة للمصابين بعدوى مزمنة، فهناك خطر متزايد يتمثل في حدوث فشل في الكبد و/أو تليف الكبد و/أو سرطان الكبد في مرحلة لاحقة من حياتهم. ويمكن للفيروس مهاجمة الكبد على نحو بسيط ومستمر على مدى سنوات عديدة دون أن يتم اكتشافه.  ما هو التهاب الكبد "ب" الحاد؟ قد تستمر عدوى التهاب الكبد "ب" الحاد لمدة تصل إلى ستة أشهر (مع ظهور أعراض أو بدون أعراض)، ويمكن للأشخاص المصابين نقل الفيروس إلى الآخرين خلال هذه المدة.  قد تتضمن أعراض الإصابة الحادة فقدان الشهية وألم المفاصل والعضلات وحمى خفيفة وألمًا محتملاً في المعدة. وعلى الرغم من أن معظم الأشخاص لا يعانون من أعراض، إلا أنها قد تظهر بعد حوالي 60 إلى 150 يومًا من الإصابة، بمتوسط 3 أشهر. وقد يعاني بعض الأشخاص من أعراض أكثر حدة مثل الغثيان أو القيء أو اليرقان (اصفرار العينين والجلد) أو انتفاخ المعدة الذي قد يتطلب الرجوع إلى مقدم الرعاية الصحية. ويمكن لاختبار الدم البسيط تحديد ما إذا كان فيروس التهاب الكبد "ب" موجودًا في دم الشخص أم لا. إذا تم تشخيص إصابتك بالتهاب الكبد "ب" الحاد، فسيحتاج الطبيب إلى فحص دمك مرة أخرى في غضون 6 أشهر لمعرفة ما إذا كنت قد تعافيت، أو إذا أصبت بعدوى مزمنة بالتهاب الكبد "ب" أم لا. ومن الضروري حماية الآخرين من العدوى المحتملة، حتى يؤكد مقدم الرعاية الصحية المتابع لحالتك أن اختبار الدم يُظهر أنه لم يعد هناك فيروس التهاب الكبد "ب" في دمك. ومن المهم أيضًا فحص الزوج أو الزوجة وأفراد أسرتك (أو أولئك الذين تكون على اتصال وثيق معهم) للكشف عن التهاب الكبد "ب". وفي حالة عدم إصابتهم وعدم تلقي لقاح التهاب الكبد "ب" - يجب بدء سلسلة اللقاح بلقاح التهاب الكبد "ب". لا يتم وصف علاج محدد للأشخاص المصابين بالتهاب الكبد "ب" الحاد – حيث إنه لا يوجد علاج للتعافي من التهاب الكبد "ب" الحاد، ويتعافى معظم الأشخاص البالغين المصابين بالعدوى بمفردهم. وفي بعض الأحيان، قد يتم نقل شخص يعاني من أعراض حادة إلى المستشفى لتلقي الدعم العام. وتُعد الراحة ومعالجة الأعراض هي الأهداف الأساسية لهذه الرعاية الطبية. وقد تحدث حالة نادرة ومهددة للحياة تسمى "التهاب الكبد الخاطف" مع عدوى حادة جديدة، وتتطلب عناية طبية فورية وعاجلة، إذ يمكن أن يصاب المريض بفشل كبدي مفاجئ. من النصائح البسيطة التي يجب اتباعها لرعاية الكبد أثناء الإصابة بعدوى التهاب الكبد "ب" الحادة: تجنب تناول الكحول، والإقلاع عن التدخين أو الحد منه، وتناول الأطعمة الصحية، وتجنب الأطعمة الدسمة أو الدهنية، والتحدث إلى مقدم الرعاية الصحية المتابع لحالتك عن أي أدوية تتناولها (الوصفات الطبية أو الأدوية التي لا تحتاج إلى وصفة طبية أو الفيتامينات أو المكملات العشبية) للتأكد من أنها آمنة للكبد. هذا هو الوقت المناسب لطرح أي أسئلة أخرى قد تكون لديك. من المرجح ألا يساعد استخدام الفيتامينات والمكملات الغذائية لصحة الكبد على التعافي، وقد يسبب ذلك ضررًا أكثر من نفعها للكبد. تأكد من المتابعة مع مقدم الرعاية الصحية لإجراء أي اختبارات دم إضافية مطلوبة لتأكيد تعافيك التام من الإصابة الحادة.   ما هو التهاب الكبد "ب" المزمن؟ يتم تشخيص حالة الأشخاص الذين ثبتت إصابتهم بفيروس التهاب الكبد "ب" لأكثر من ستة أشهر (بعد نتيجة اختبار الدم الأولى) على أنهم مصابون بعدوى مزمنة. وهذا يعني أن جهازهم المناعي لم يكن قادرًا على التعافي من فيروس التهاب الكبد "ب" ولا يزال الفيروس موجودًا في الدم والكبد. وتتوفر طرق فعالة للتحكم في حالة العدوى المزمنة والتعامل معها، ولكن لا يوجد علاج نهائي لها. فإذا كنت مصابًا بعدوى مزمنة، فمن المحتمل أن يظل الفيروس في دمك طوال حياتك. ويمكن للأشخاص الذين يعانون من التهاب الكبد "ب" المزمن نقل الفيروس إلى الآخرين دون علم. يمكن أن يؤدي التهاب الكبد "ب" المزمن أيضًا إلى أمراض الكبد الخطيرة مثل تليف الكبد أو سرطان الكبد. لن تحدث لكل شخص مصاب بالعدوى المزمنة مضاعفات خطيرة في الكبد. ولكن احتمالات إصابتهم أكبر من الشخص غير المصاب. يرتبط خطر الإصابة بالتهاب الكبد "ب" المزمن بالعمر الذي يصاب فيه الشخص أول مرة بفيروس التهاب الكبد "ب": تتفاقم حالة 90% من حديثي الولادة والأطفال الصغار المصابين بالفيروس إلى عدوى التهاب الكبد "ب" المزمن.تتفاقم حالة ما يصل إلى 50% من الأطفال المصابين (1-5 سنوات) إلى عدوى التهاب الكبد "ب" المزمنتتفاقم حالة 5-10% من البالغين المصابين إلى عدوى التهاب الكبد "ب" المزمن (أي أن 90% سيتعافون) قد تكون معرفة أنك مصاب بعدوى التهاب الكبد "ب" المزمن مُحزنة للغاية. ولأن معظم الأشخاص لا يعانون من أي أعراض ويمكن تشخيصهم بعد عقود من إصابتهم الأولي لفيروس التهاب الكبد "ب"، فقد يكون من المفاجئ أن يتم تشخيص الإصابة بعدوى التهاب الكبد "ب" المزمن. ومن الأنباء السارة أن معظم المصابين بالتهاب الكبد "ب" المزمن يجب أن يتوقعوا أن يعيشوا حياة طويلة وصحية. يمكن للنساء الحوامل المصابات نقل الفيروس إلى أطفالهن حديثي الولادة أثناء الولادة. ولذلك، بما أن خطر إصابة الأطفال حديثي الولادة بالعدوى المزمنة مرتفع، توصي كل من منظمة الصحة العالمية (WHO) والمركز الأمريكي لمكافحة الأمراض والوقاية منها (CDC) بأن يتلقى جميع الأطفال الجرعة الأولى من لقاح التهاب الكبد "ب" في غضون 12-24 ساعة بعد الولادة. إذا كنتِ حاملاً وتعلمين أنكِ مصابة، يمكنك التأكد من حصول طفلك على الجرعة الأولى من لقاح التهاب الكبد "ب" في غضون 12-24 ساعة بعد الولادة! وعلى الرغم من عدم توفر علاج نهائي لالتهاب الكبد "ب" المزمن، فتتوفر علاجات دوائية فعالة يمكنها السيطرة على فيروس التهاب الكبد "ب" ومنعه من إتلاف الكبد. وتتوفر أيضًا أدوية جديدة واعدة في مرحلة البحث قد توفر علاجًا في المستقبل القريب. وعلى الرغم من أن خطر الإصابة بمرض كبدي خطير أو سرطان الكبد أعلى بالنسبة لأولئك الذين يعانون من التهاب الكبد "ب" المزمن من الذين لم يصابوا به، فهناك العديد من الأشياء البسيطة التي يمكن للشخص القيام بها للمساعدة في تقليل خطر الإصابة به. حدد مواعيد زيارات منتظمة كل ستة أشهر (أو كل عام على الأقل) مع أخصائي الكبد أو مقدم الرعاية الصحية الملمّ بما يتعلق بالتهاب الكبد "ب" حتى يتمكن من مراقبة صحة الكبد لديك. تحدث مع مقدم الرعاية الصحية المتابع لك بشأن ما إذا كان الحصول على علاج للعدوى المصاب بها من التهاب الكبد "ب" المزمن سيكون مفيدًا في الوقاية من أمراض الكبد الخطيرة أو سرطان الكبد. تأكد أن مقدم الرعاية الصحية المتابع لك يجري فحصًا لك للكشف عن سرطان الكبد أثناء الزيارات المنتظمة، حيث إن الاكتشاف المبكر يوفر المزيد من خيارات العلاج وتقليل احتمالات المضاعفات والوفاة. تجنب تناول الكحول والتدخين، حيث إن كليهما يسبب الكثير من الإجهاد على كبدك. اتبع نظامًا غذائيًا صحيًا يحتوي على الكثير من الخضراوات لأن الأطعمة المقلية والدهنية تكون ثقيلة على كبدك.   ماذا يُقصد بـ"حامل العدوى المزمنة"؟ عندما يصاب الشخص بعدوى من التهاب الكبد "ب" المزمن، فقد يشير الطبيب إلى أنه "حامل عدوى مزمنة". وكونك "حامل عدوى مزمنة" يعني إصابتك بعدوى من التهاب الكبد "ب" المزمن، ويمكنك نقل الفيروس إلى الآخرين، ويجب أن يقوم طبيب بمتابعة حالة إصابتك بالعدوى.    هل يوجد علاج لالتهاب الكبد "ب"؟ سيتعافى معظم البالغين من العدوى الحادة المصابين بها بمفردهم دون الحاجة إلى تناول الأدوية. لا يوجد علاج حاليًا للبالغين والأطفال والرضع الذين يصابون بعدوى من التهاب الكبد "ب" المزمن. ولكن الخبر السار هو أن هناك علاجات يمكن أن تساعد في تقليل سرعة تفاقم مرض الكبد عند المصابين بعدوى مزمنة من خلال إبطاء تأثير الفيروس. إذا كان هناك انتشار أقل لفيروس التهاب الكبد "ب"، فسيقع ضرر أقل على الكبد.  وبوجود كل تلك الأبحاث الجديدة المثيرة للاهتمام، هناك أمل كبير في العثور على علاج لالتهاب الكبد "ب" المزمن في المستقبل القريب. يُرجى زيارة قسم Drug Watch (قائمة الأدوية الخاضعة للمراقبة) للاطلاع على قائمة بالأدوية الواعدة قيد التطوير. ما الخيارات المتاحة لعلاج التهاب الكبد "ب"؟ فيما يتعلق بالعدوى الحادة، لا يتوفر علاج بشكل عام سوى الراحة والتدابير الداعمة للتحكم في أي أعراض. أما في حالة التهاب الكبد "ب" المزمن، فيتوفر العديد من العلاجات. من المهم فهم أنه ليس كل مصاب بالتهاب الكبد "ب" المزمن يحتاج إلى علاج. سيساعدك الطبيب على تحديد ما إذا كنت بحاجة إلى دواء أو إذا كان بإمكانك الانتظار ومتابعة حالتك.  يتوفر العديد من الأدوية المضادة للفيروسات التي تبطئ تكاثر فيروس التهاب الكبد "ب" أو توقفه، مما يقلل من التهاب الكبد وتليفه. تؤخذ هذه الأدوية المضادة للفيروسات على هيئة حبة مرة واحدة في اليوم لمدة سنة على الأقل، بل وعادةً ما يكون ذلك لمدة أطول. تتوفر 6 مضادات للفيروسات معتمدة من قِبل إدارة الغذاء والدواء الأمريكية (FDA)، ولكن يُنصح باستخدام ثلاثة فقط من "الخيارات الأولى" من مضادات الفيروسات: تينوفوفير ديسوبروكسيل (فيريد/TDF)، تينوفوفير ألفيناميد (فيمليدي/TAF)، إينتيكافير (باراكلود). يُوصى باستخدام الخيارات الأولى من مضادات الفيروسات لأنها أكثر أمانًا وفاعلية. وفيما يتعلق بالأشخاص الذين لا يستجيبون للخيارات الأولى من العلاجات المضادة للفيروسات أو الذين ليست لديهم إمكانية الوصول إليها، تتوفر خيارات أخرى: تيلبيفودين (تايزيكا، سيبيفو)، أديفوفير ديبيفوكسيل (هيبسيرا)، لاميفودين (إيبيفير-HBV، زيفيكس، هيبتودين).   وعلى الرغم من اعتماد إدارة الغذاء والدواء الأمريكية لهذه المضادات الفيروسية لعلاج التهاب الكبد "ب" المزمن، إلا أنها لا توفر علاجًا كاملاً. ومع ذلك، يمكنها أن تقلل إلى حد كبير من خطر الإصابة بتلف الكبد وسرطان الكبد. ليس من المفترض أن يتم إيقاف مضادات الفيروسات وتناولها مرة أخرى، وهذا هو سبب الأهمية البالغة للخضوع إلى تقييم شامل على يد طبيب واسع الاطلاع قبل البدء في علاج فيروس التهاب الكبد "ب" المزمن.   وتتوفر أيضًا الأدوية المناعية التي تعزز جهاز المناعة للمساعدة في السيطرة على فيروس التهاب الكبد "ب". ويتم تناولها على هيئة حقن على مدى يتراوح من 6 أشهر إلى سنة. تتضمن الأدوية التي غالبًا ما تُوصف للمرضى "إنترفيرون ألفا-2ب" (إنترون "أ") و"بيغ-إنترفيرون" (بيغاسيس).    ستحتاج أنت وطبيبك إلى مناقشة خيارات العلاج قبل تحديد أيها الأفضل لك، إن وجد. وفيما يتعلق بالعديد من الأشخاص، ستقلل هذه الأدوية من تكاثر فيروس التهاب الكبد "ب" أو توقفه. ويؤدي ذلك إلى شعور المرضى بالتحسن خلال بضعة أشهر بسبب تباطؤ تلف الكبد الناتج عن الفيروس، أو حتى بسبب عكس تأثيره في بعض الحالات، عند تناول الأدوية على المدى الطويل.   للاطلاع على القائمة الكاملة بالعقاقير المعتمدة من قِبل إدارة الغذاء والدواء (FDA) والعقاقير الواعدة الأخرى قيد التطوير لعلاج التهاب الكبد "ب"، تفضل بزيارة قسم Drug Watch (قائمة الأدوية الخاضعة للمراقبة).

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• ከሄፓታይተስ ቢ ጋር መኖር  ከያዘኝ ሄፓታይተስ ቢ መዳን እችላለሁ? እንደ አዲስ የተያዙት አብዛኞቹ ጎልማሶች ያለምንም ችግር ይፈወሳሉ፡፡ ነገር ግን ህፃናት እና ታዳጊዎች ቫይረሱን ስኬታማ በሆነ መልኩ ማስወገድ አይችሉም፡፡ ጎልማሶች– 90% የሚሆኑት ጤናማ ጎልማሶች ቫይረሱን በማስወገድ ያለምንም ችግር ሲፈወሱ፤ 10% የሚሆኑት ስር በሰደደ የሄፓታተስ ቢ ተይዘዋል. ታዳጊ ህፃናት– እድሜያቸው በ1 እና በ5 ዓመት ከሆናቸው መካከል እስከ 50% የሚሆኑት ታዳጊ ህፃናት ስር በሰደደው የሄፓታይተስ ቢ ተጠቅተዋል፡፡ ጨቅላ ህፃናት– 90% የሚሆኑት በከፍተኛ ደረጃ ሲጠቁ፤ 10% የሚጠጉት ብቻ ቫይረሱ ከሰውነታቸው ይወገዳል፡፡ "በጀማሪ" እና "ስር በሰደደ" ሄፓታይተስ ቢ መካከል ያለው ልዩነት ምንድን ነው? በሄፓታይተስ ቢ መያዝ "በመጀመሪያ ደረጃ" ላይ እንዳለ ተደርጎ የሚወሰደው ግለሰቡ ለቫይረሱ ከተጋለጠበት ጀምሮ ያሉት የመጀመሪያ 6 ወራትን ያካትታል፡፡ ከሄፓታይተስ ቢ መያዝ ለመዳን የሚወስደው ጊዜ በአማካይ ነው፡፡  ከ6 ወራት በኋላ ውጤትዎ የሄፓታይተስ ቢ ቫይረስ እንዳለ (HBsAg+) ካሳየ "ስር የሰደደ" ሄፓታይተስ ቢ እስከ እድሜ ዘመንዎ አብሮ እንደሚቆይ ያረጋግጣል፡፡  በመጀመሪያ ደረጃ ላይ ያለ የሄፓታይተስ ቢ ካለብኝ ልታመም እላለሁ? ሄፓታይተስ ቢ "ድምፅ አልባው በካይ” ይባላል፤ ለዚህም ምክንያቱ አልፎ አልፎ ምንም አይነት የበሽታው ምልክቶች አለመታየታቸው ነው፡፡ ብዙ ሰዎች ጤናማ እንደሆኑ ያስባሉ፤ በቫይረሱ ስለመያዛቸው አያውቁም፤ ይህም ማለት ባለማወቅ ወደ ሌሎች ሰዎች ያስተላልፋሉ ማለት ነው፡፡ ሌሎች ሰዎች የተወሰኑ ምልክቶች ማለትም እንደ ትኩሳት፣ ድካም፣ የመገጣጠሚያ እና ጡንቻ ህመም፣ የምግብ ፍላጎት ማጣትን ተከትሎ ወባ እንደሆነ ይገምታሉ፡፡  ብዙም የማይስተዋል ነገር ግን ጠንከር ያሉ ምልክቶች የሚያካትቱት የበዛ ንፍጥ፣ ማስመለስ፣ የአይንና ቆዳ ቢጫ መሆን (ጁአንዳይስ የሚባለው) እና የጨጓራ መነፋት ሲሆን እነዚህ ምልክቶች የታየበት በፍጥነት የሀኪም እርዳታ ማግኘት ያለበት ሲሆን ግለሰቡም ወደ በሆስፒታል እርዳታ ማግኘት አለበት፡፡ በመጀመሪያ ደረጃ ካለ የሄፓታይተስ ቢ መዳኔን እንዴት ነው ላውቅ የምችለው? ያንተ ዶክተር ባደረገልህ የደም ምርመራ ቫይረሱ ከሰውነትህ እንደወጣና ሰውነትህ ተከላካይ አንቲቦዲ (HBsAb+) እንደፈጠረ ካረጋገጠ ወደፊት ሊገጥምህ ከሚችል የሄፓታይተስ ቢ የተጠበቅክ ከመሆንህም በተጨማሪ ወደሌሎችም አታስተላልፍም፡፡ ስር የሰደደው ሄፓታይተስ ቢ በደሜ ከተገኘምንድን ነው ማድረግ ያለብኝ? ከ6 ወር በኋላ ባለው ጊዜ በተደረገ ምርመራ የሄፓታይተስ ቢ ቫይረስ መኖሩ ከተረጋገጠ ስር በሰደደው የሄፓታይተስ ቢ መያዝህን ያመላክታል፡፡ ከሄፓቶሎጂስት (የጉበት ስፔሻሊስት)፣ ከጋስትሮኢንተሮሎጂስት ወይም ስለ ሄታይተስ ቢ ከሚያውቅ የቤተሰብ ዶክተር ጋር ቀጠሮ መያዝ አለብዎት፡፡ ዶክተሩም የደም ምርመራ እንዲደረግ ሊያዝ፣ ምናልባትም የሄፓታይተስ ቢ ቫይረስ ምን ያህል በጉበት ውስጥ እየተዛመተ እንዳለ ለማወቅና የጉበትዎን ጤንነት ለመፈተሽ የጉበት አልትራሳውንድ ሊያዝም ይችላል፡፡ ዶክተርዎ ሄፓታይተስ ቢ ያለበትን ደረጃ ለማየት እና ከህክምናው ምን ያህል እንደጠቀሙ ለማየት በዓመት ውስጥ ቢያንስ አንዴ አሊያም ሁለት ጊዜ ሊያይዎት ይገባል፡፡ ሁሉም በፀና የታመሙ ሰዎች ህክምና ጀመሩም አልጀመሩም በዓመት ቢያንስ አንድ ግዜ (ወይም ደጋግመው) ወጥነት ላለው የህክምና ክትትል በዶክተሮቻቸው መታየት አለባቸው፡፡ ምንም እንኳን ቫይረሱ ደካማ በሚባል ደረጃ ላይ ያለ ከሆነና ትንሽ ወይም ምንም ጉዳት የማያመጣ ከሆነ፤ ይህ በጊዜ ሂደት ስለሚለወጥ ወጥነት ያለው ክትትል ያስፈልጋል፡፡ ብዙ ሰር በሰደደ የሄፓታይተስ ቢ የተያዙ ሰዎች ጤናማ ሆነው ብዙ አመታትን መኖር ይመኛሉ፡፡ ስር የሰደደው ሄፓታይተስ ቢ እንዳለብዎ ከታወቀ፣ ቫይረሱ በደምዎ ውስጥ ለረዥም አመታት አብሮ ይኖራል፡፡ የህመም ስሜት ባይሰማዎት እንኳን፣ ቫይረሱን ወደሌሎች ሊያስተላልፉ እንደሚችሉ ማወቁ ጠቃሚ ነው፡፡ ተጠጋግተው የሚኖሩ ሰዎችና የወሲብ ጓደኞች ለሄፓታይተስ ቢ መከተባቸውን እርግጠኛ መሆን ጠቃሚ ነው የሚባለው ለዚህ ነው፡፡   የእኔን ሄፓታይተስ ቢ ለመቆጣጠር የሚረዳኝ የትኛው ምርመራ ነው? ሄፓታይተስ ቢ ን ለመመርመር በዶክተሮች በብዛት ጥቅም ላይ የሚውሉት የምርመራ ኣይነቶች ሄፓታይተስ ቢ የደም ፓነል፣ ጉበት መስራቱን የሚያረጋግጥ ምርመራዎች (ALT፣ AST)፣ ሄፓታይተስ ቢ e-Antigen (HBeAg)፣ ሄፓታይተስ ቢe-Antibody (HBeAb) ፣ ሄፓታይተስ ቢ DNA quantification (ቫይራል ሎድ)፣ እና የጉበትን ገፅታ መመርመር (አልትራሳውንድ፣ ፊብሮስካን [ትራንሳይንት ኢላስቶግራፊ] ወይም ሲቲ ስካን)፡፡ ስር ለሰደደ ሄፓታይተስ ቢ መድሀኒት አለ? እስካሁን ስር ለሰደደ ሄፓታይተስ ቢ የሚሆን መድሀኒት የለም፤ ነገር ግን መልካም የሚባለው ዜና በፅኑ የታመመውን ግለሰብ የጉበት ህመም እንዳይባባስ ቫይረሶቹ እንዲዳከሙ የሚያደርጉ ህክምናዎች አሉ፡፡ የሚራቡት የሄፓታይተስ ቢ ቫይረሶች ቁጥር በቀነሰ ጊዜ በጉበት ላይ የሚደርሰው ጉዳትም ይቀንሳል፡፡ ብዙም የተለመደ ባይሆንም እነዚህ መድሀኒቶች ቫይረሱን ሲያስወግዱ ይታያሉ፡፡  ያሉት ተስፋ ሰጪ ምርምሮች ሲታዩ፣ ወደፊት ስር የሰደደውን ሄፓታይተስ ቢ ለማከም የመረዱ መድሀኒቶች እንደሚገኙ ታላቅ ተስፋ አለ፡፡ የእኛን ጎብኙ መድሀኒት ተመልከቱ በመምጣት ላይ ያሉት ሌሎች ተስፋ ሰጪ መድሀኒቶች ዝርዝር፡፡ ስር የሰደደውን ሄፓታይተስ ቢ ለማከም የሚረዱ የተረጋገጡ መድሀኒቶች አሉ? ሄፓታይተስ ቢ ን ለማከም የሚረዱት የአሁኖቹ መድሀኒቶች በጥቅሉ በሁለት የሚከፈሉ ሲሆኑ እነሱም አንቲቫይራል እና ኢሚዩን ሞዱሌተርስ ይባላሉ፦   አንቲቫይራል መድሀኒቶች - እነዚህ መድሀኒቶች የሄፓታይተስ ቢ ቫይረስን የሚያዳክሙ ወይም የሚያስቆሙ ብሎም የጉበትን መቃጠልና መጎዳት የሚቀንሱ ናቸው፡፡ እነዚህ በፒል መልስ ቢያንስ ለ 1 ዓመትና ከዚያም በላይ በቀን አንድ ግዜ የሚወሰዱ ናቸው፡፡ የአሜሪካው ኤፍ.ዲ.ኤ ያረጋገጣቸው 6 አንቲቫይራሎች ያሉ ሲሆን ከእነዚህም ውስጥ ሶስቱ በቀዳሚነት የተቀመጡት አንቲቫይራሎች ለህክምና ይመከራሉ፡፡ እነሱም ቲኖፎቪር ዲሶፕሮክሲል (ቪሬድ/ቲ.ዴ.ኤፍ)፣ ቲኖፎቪርአላፈናማይድ (ቬምሊዲ/ቲ.ኤ.ኤፍ) እና ኢንትካቪር (ባራክሉድ)፡፡ መጀመሪያው መስመር ላይ ያሉት አንቲቫይራሎች አስተማማኝና በጣም ውጤታማ በመሆናቸው ይመከራሉ፡፡ በበሽታው ላይ ተፅዕኖ በማድረስም ከአሮጌዎቹ አንቲቫይራል የተሻለ ፕሮፋይል ያላቸው ሲሆን በታዘዘው መሰረት ከተወሰዱበሽታው በቀላሉ ሊላመዳቸው አይችልም፡፡ መድሀኒቱን መላመድ እያደገ ከመጣ ቫይረሱን ለማከምና ለመቆጣጠር አስቸጋሪ ይሆናል፡፡ ኢሙዩኖሞዱሌተር መድሀኒቶች - እነዚህ መድሀኒቶች የሄፓታይተስ ቢ ቫይረስን ለመቆጣጠር የሚረዳው የሰውነት የመከላከል አቅም እንዲያድግ የሚያደርጉ ናቸው፡፡ ከ 6 ወር እስከ 1 ዓመት ባለው ጊዜ ውስጥ በመርፌ የሚሰጡ ናቸው፡፡ በብዛት የታዘዘው ኢንተርፌሮን አልፋ-2b (Intron A) እናፔጊሌትድ ኢንተርፌሮን (Pegasys) ናቸው፡፡ በሄፓታይተስ ዴልታ ለተጎዱ ሰዎች ይህ በብቸኝነት የሚታዘዝ ህክምና ነው፡፡   እነዚህ መድሀኒቶች ስር ለሰደደ የሄፓታይተስ ቢ በሽታ "ፈውስ" ይሰጣሉ? ምንም እንኳን የተሟላ ፈውስ ባይሰጡም አሁን ላይ ያሉ መድሀኒቶች ቫይረሱን በማዳከም በቀጣይ ጊዜያት የከፋ የጉበት በሽታ የመያዝ ስጋትን ይቀንሳሉ፡፡ በጥቂት ወራት ውስጥ ህመምተኛው የተሻለ ስሜት ይሰማዋል፤ ምክንያቱም ጉበቱ ላይ በቫይረሱ እየደረሰበት የነበረው ጉዳት እየቀነሰ ይመጣል፤ አሊያም ለረዥም ጊዜ ሲወሰድ ድጋሚ ሊያገረሽም ይችላል፡፡ አንቲቫይራል ዝም ብሎ የሚወሰድ አሊያም የሚቆም አይደለም፤ ለዚያም ነው ስለ ሄፓታይተስ ቢ ን እውቀት ያለው ዶክተር ስር በሰደደው የሄፓታይተስ ቢ ቫይረስ ላይ ክትትል አድርጎ ህክምናውን ይጀምር የሚባለው፡፡ ስር በሰደደ የሄፓታይተስ ቢ መያዜ ቢታወቅ መድሀኒት መውሰድ አለብኝ ማለት ነው? ማንኛውም ስር የሰደደ ሔፓታይተስ ቢ ያለበት ሰው ሁሉ መድሀኒት የማይወስድ መሆኑ ከግንዛቤ ውስጥ ማስገባት ጠቃሚ ነው፡፡ መድሀኒት ለመውሰድ ብቁ ስለመሆን አለመሆንህ ለማወቅ ዶክተርህን ማነጋገር አለብህ፡፡ እርስዎ አሊያም የእርስዎ ዶክተር ህክምና መጀመር እንዳለብዎት ወሰናችሁም አልወሰናችሁም፣ በጉበት ሴፔሻሊስት ወይም ስለ ሄፓታይተስ ቢ እውቀቱ ባለው ዶክተር አዘውትረው መታየት አለብዎት፡፡ ለሄፓታይተስ ቢ ከእፀዋት የተዘጋጁ መድሀኒቶችን መጠቀም አስተማማኝ ነው? በርካታ ሰዎች በሽታ የመከላከል አቅማቸውን ከፍ ለማድረግ ብሎም ጉበታቸውን ለማገዝ ከእፀዋት የተዘጋጁ መድሀኒቶችን ይጠቀማሉ፡፡ ችግሩ ያለው እነዚህን ምርቶች የሚያመርቱ ካምፓኒዎች ላይ የሚደረግ ቁጥጥር የለም፤ ይህም ጠንካራና አስተማማኝ የሆነ ምርምር እንዳይኖር አድርጓል፡፡ ስለሆነምየዕፀዋቱ ወይም ቫይታሚኑ ጥራት ከጠርሙስ ወደ ጡርሙስ የተለያየ ነው፡፡ ለሄፓታይተስ ቢ ተብሎ ከሚታዘዙ መድሀኒቶች ጎን ሌሎች ባህላዊ መድሀኒቶችን መጠቀም ጉበትን ለከፋ ጉዳት ይዳርጋል፡፡ እነዚህ ባህላዊ መድሀኒቶች ስር የሰደደ የሄፓታይተስ ቢ በሽታን አያክሙም፡፡ በኢንተርኔት እና በማህበራዊ ሚዲያ ላይ ስለ ምርታቸው የሚዋሹ ድርጅቶች ብዙ ናቸው፡፡ በፌስ ቡክ የኦንላይን ግዙን ጥያቄዎች እና የህሙማን ምስጋናዎች የውሸት ናቸው፤ ይህ ውድ የሆኑ ባህላዊ መድሀኒቶቻቸውንና ሌሎች ነገሮችን ለመሸጥ የሚጠቀሙበት ብልጠት ነው፡፡ አስታውስ፣ እውነት መሆኑ ጥሩ ቢሆንም፤ እውነት ሆኖ ላይገኝ ይችላል፡፡ ስለፆች እና ሌሎች ተያያዥ መድሀኒቶች ተዓማኒ የመረጃ ምንጮች ከዚህ እንደሚከተለው ቀርበዋል፡፡ ይህ መረጃ የተመሰረተው በሳይንሳዊ መረጃ ነው፣ በውሸት ቃል አይደለም፡፡ እርግጠኛ ሁን ዋነኛ ግብአቶቹ የምትጠቀምባቸው ባህላዊ መድሀኒቶችና ሌሎች ነገሮች ትክክለኛ እና ጉበትን የማይጎዱ ስለመሆናቸው፡፡ ዋናውና ጠቃሚው ነገር ጉበትህን ከሌላ ማንኛውም ጉዳት መጠበቅ ነው፡፡ የጤናማ ጉበት ምንነት ማሳያዎችይህ ስር ከሰደደ ሄፓታይተስ ቢ ጋር ለሚኖሩ ነው? ሰር ከሰደደ ሄፓታይተስ ቢ ጋር የሚኖሩ ሰዎች የመድሀኒት ህክምና ሊያስፈልጋቸው ላያስፈልጋቸውም ይችላል፡፡ ነገር ግን ታማሚው ጉበቱን ለመጠበቅ እንዲሁም ጤናውን ለማሻሻል ማድረግ ያለበት ነገሮች ብዙ ናቸው፡፡ ከዚህ ቀጥሎ ያሉት 10ሩ ጤናማ አማራጮች ዝርዝር ሲሆን ዛሬውኑ መጀመር ያለባቸው ናቸው፡፡ የጉበት ስፔሻሊስቱ ወይም የጤና ባለሙያው ጋር አዘውትረው በመሄድ ጤናዎን እንዲሁም የጉበትዎን ጤና ይጠብቁ፡፡ ጉበትዎን ከሚያጠቃ ሌላ ቫይረስ ለመጠበቅ የሄፓታይተስ ቢ ክትባትን ይውሰዱ፡፡ ቀድሞ በሄፓታይተስ ቢ ቫይረስ የተጎዳውን ጉበትዎን ከጉዳት ለመጠበቅ አልኮል መጠጣትንና ማጨስ ሁለቱም ጉበትን ስለሚጎዱ ያስወግዱ፡፡ የባህል መድሀኒት ወይም ተጨማሪ ቫይታሚኖችን መውሰድ ከመጀመርዎ በፊት ከሀኪምዎ ጋር መነጋገር አለብዎት፤ ምክንያም እነዚህ በሀኪም ከታዘዘልዎት የሄፓታይተስ ቢ መድሀኒት ጋር ስለሚቃረን አሊያም ጉበትን ሊጎዳ ለሚችል ነው፡፡ ስለሚቃረኑ መድሀኒቶች እርግጠኛ ለመሆን ፋርማሲስት ጋር ሄዶ ማረጋገጥ ያስፈልጋል፡፡ (ለምሳሌ አሲታሚኖፌን፣ ፓራሲታሞል) ወይም ለሄፓታይተስ ቢ ያልታዘዙ መድሀኒቶች በጉበት ላይ ምንም ጉዳት ስላለማስከተላቸው እርግጠኛ መሆን ያስፈልጋል፤ ለዚህ ደግሞ ዋናው ምክንያት አብዛኞቹ መደሀኒቶች ጉበት ላይ ሂደታቸውን ጠብቀው ስለሚያልፉ ነው፡፡  ወደ ውስጣችን ከአየር ጋር የምናስገባቸውን ከቀለም የሚወጡ ሽታዎችን፣ ቀለም ማስለቀቂያ፣ ሙጫ፣ የጥፍር ቀለም ማስለቀቂያ፣ እና ሌሎችም መርዛማ ኬሚካሎች ጉበትን ሊጎዱ ስለሚችሉ መጠንቀቅ ተገቢ ነው፡፡   እንደ ፍራፍሬ፣ ጥራጥሬ፣ አሳ፣ ጮማ ያልበዛበት ስጋ እና በርካታ አታክልት በመጠቀም ጤናማ አመጋገብን መከተል ያስፈልጋል፡፡ “ክሩሲፈረስ አታክልቶች” በተለይም- ጎመን፣ ብሮኮሊ፣ አበባ ጎመን፣ ከአካባቢያዊ ኬሚካል ጉበትን ለመከላከል ይረዳል፡፡  ጥሬ የሆነና ያልበሰለ አሳን መመገብን አርግፍ አድርጎ መተው ያስፈልጋል (ለምሳሌ ትንንሽ የባህር ውስጥ የአሳ ዝርያዎች መካከል እንደ ክላምስ፣ ሙሴልስ፣ ኦይስተርስ እና ስካሎፕስ የሚባሉት) ምክንያም በባክቴሪያ እንድንበከል ስለሚያደርጉ ቫይበሮ ቩልንፊከስ፣ በጣም መርዛማ በመሆኑ ጉበት ላይ በርካታ ጉዳት ያደርሳል፡፡ በእንደ ለውዝ፣ በቆሎ እና ማሽላ ያሉ ምግቦችን ከመጠቀማችን በፊት የሻጋታ ምልክት ስላለመኖሩ እርግጠኛ መሆን ያስፈልጋል፡፡ ሻጋታ በአብዛኛው በምግብ ላይ ችግር የሚሆነው ምግቡ እርጥበት ባለበት ቦታ ላይ ሲቀመጥና በአግባቡ ሳይታሸግ ሲቀር ነው፡፡ ሻጋታ ካለ ምግቡ በ “አፍላቶክሲንስ” የሚበከል ሲሆን ይህ ደግሞ የጉበት ካንሰር የመከሰት እድሉን ከፍ ያደርገዋል፡፡ የጭንቀትን መጠን ለመቀነስ ጤናማ አመጋገብን መከተል፣ አዘውትሮ እንቅስቃሴ መስራት እና በቂ እረፍት ማግኘት ተገቢ ነው፡፡  የምንመገበው፣ የምንጠጣው፣ የምንተነፍሰው ወይም በቆዳችን ወደ ውስጥ የሚገባው ሳይቀር በሂደት በጉበት ማጣራት እንደሚካሄድባቸው ሁሌ ልብ ማለት ያስፈልጋል፡፡ ስለሆነም ጤናዎን እና ጉበትዎን ይጠብቁ! ሄፓታይተስ ቢ እያለብኝ ደም መለገስ እችላለሁ? በጭራሽ፣ የደም ባንክ ለሄፓታይተስ ቢ የተጋለጠን ሰው ደም አይወስድም፤ እንዲያውም በመጀመሪያ ደረጃ ከተያዘና ከተሻለው ሰው እንኳን አይወስድም፡፡       Living with Hepatitis B Will I recover from a hepatitis B infection?Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B. Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection.Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus. What is the difference between an "acute" and a "chronic" hepatitis B infection?A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime. Will I become sick if I have acute hepatitis B?Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection?Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B?If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment.All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B?Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B?Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B?Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B?
Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication?It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection?Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these produces, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tips are there for those living with chronic hepatitis B?People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver. Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.  Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.  Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals.  Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer. Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.  Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.  

  https://www.hepb.org/languages/amharic/living/

• አጠቃላይ መረጃ   ሄፓታይተስ ቢ ምንድን ነው? ሄፓታይተስ ቢ በዓለም ላይ በብዛት ጉበትን ከጥቅም ውጭ የሚያደርግ ነው፡፡ የሚመጣውም ሄፓታይተስ ቢ (HBV) በሚባል ቫይረስ ሲሆን ቫይረሱ ጉበትን በማጥቃት ጉዳት ያደርሳል፡፡ የሚተላለፈው በደም፣ ጥንቃቄ በጎደለው የግብረ ስጋ ግንኙነት፣ መርፌዎችን በመጋራት ወይም ድጋሚ በመጠቀም እንዲሁም በበሽታው ከተያዘች እናት ወደ ልጅ በእርግዝና ወይም በወሊድ ወቅት ነው፡፡ በርካታ በበሽታው የተያዙ ጎልማሶች ሄፓታይተስ ቢ ን ያለምንም ችግር ከሰውነታቸው እንዲወገድ ማድረግ ችለዋል፡፡ ነገር ግን አንዳንድ ጎልማሶች እና በበሽታው በጣም የተጠቁ ህፃናት እና ታዳጊዎች ቫይረሱን ከሰውነታቸው ማስወጣት አለመቻላቸውን ተከትሎ በፀና ህመም ውስጥ ገብተዋል፡፡ መልካሙ ዜና ሄፓታይተስ ቢ ን ለመከላከል አስተማማኝ ክትባት መኖሩ ሲሆን፤ ሌላው ደግሞ ቀድሞውኑ በሄፓታይተስ ቢ ለተጠቁት በአዲስ መልኩ ህክምና መደረጉ ነው፡፡  በሄፓታይተስ ቢ የተጠቁት ሰዎች ምን ያህል ናቸው? በመላው ዓለም 2 ቢሊየን ሰዎች (ከ3 ሰዎች መካከል1) በሄፓታይተስ ቢ የተጠቁ ሲሆን 257 ሚሊየን የሚሆኑት ሰዎች ደግሞ በፀና የታመሙ ናቸው፡፡ (ይህም ማለት ቫይረሱን ከሰውነታቸው ማስወገድ አይቻልም) በሄፓታይተስና ከእሱ ጋር በተያያዘ 700,000 የሚጠጉ ሰዎች በየዓመቱ ለህልፈት ይዳረጋሉ፡፡ ሄፓታይተስ ቢ በአንዳንድ የዓለም ክፍሎች ለምን በብዛት ይከሰታል? ሄፓታይተስ ቢ የእድሜ እና የብሄር ልዩነት ሳያደርግ ሁሉንም ሰው ሊይዝ ይችላል፤ ነገር ግን ሄፓታይተስ ቢ በብዛት በሚከሰትባቸው ከተወሰኑ የዓለም ክፍሎች ያሉ ሰዎች ማለትም እንደ ኤሲያ፣ የአፍሪካ የተወሰኑ ክፍሎች፣ ደቡብ አሜሪካ፣ ምዕራብ አውሮፓ እና መካከለኛው ምስራቅ በበሽታው የመያዝ እድላቸው በእጅጉ ከፍ ያለ ነው፡፡ በነዚህ ቦታዎች በተወለዱ አሜሪካውያን (ወይም ቤተሰቦቻቸው በተወለዱት) ላይ ሄፓታይተስ ቢ በብዛት ይከሰታል፡፡ ሄፓታይተስ ቢ በተወሰኑ የኣለማችን ክፍሎች ላይ በብዛት የተለመደ ሲሆን፤ ለዚህ ደግሞ በምክንያትነት የሚጠቀሰው በቦታዎቹ ላይ ቀደም ብለው በሄፓታይተስ ቢ የተጠቁ ብዙ ሰዎች መኖራቸው ነው፡፡ ምንም እንኳን ሄፓታይተስ ቢ "የኤስያውን በሽታ" ወይም "የአፍሪካውያን በሽታ" ባይሆንም ከነዚህ ቦታዎች በመቶ ሚሊዮን የሚቆጠሩ ሰዎችን የበከለ ሲሆን፣ ይህን ተከትሎም በርካታ ቁጥር ያላቸው ሰዎችም የሄፓታይተስ ቢ ቫይረስን ወደሌሎች እንዲተላለፍ ምክንያት ሊሆኑ ይችላሉ፡፡ ስጋቱ በጨመረ ቁጥር በቫይረሱ ሊያዙ ይችላሉ፡፡ በቫይረሱ የተያዙ ምዕራባውያን ቁጥር ማነሱን ተከትሎ፣ ይህ ቡድንያለው የመያዝ እድሉ ዝቅ ያለ ነው፡፡ ሄፓታይተስ ቢ በብዛት በሚታይባቸው አካባቢዎች ያሉ ሰዎች በብዛት የሚያዙት በወሊድ ጊዜ ማለትም እናቶች ሲወልዱ ባለማወቅ ቫይረሱ ወደ ልጃቸው ይተላለፋል፡፡ ታዳጊ ህፃናት የሚኖሩት ቫይረሱ ካለበት የቤተሰቡ አባል ጋር በየቀኑ የቀረበ ግንኙነት የሚደርጉ ከሆነ የመያዝ እድል አላቸው፡፡ ህፃናትና ታዳጊዎች በሄፓታይተስ ቢ ከሌሎች በበለጠ በከፍተኛ ደረጃ ይጠቃሉ፤ ለዚህም ምክንያቱ ብዙም ያልጠነከረው በሽታን የመከላከል አቅማቸው ቫይረሱን ለማስወገድ ስለሚቸገር ነው፡፡ እርስዎ አሊያም የእርስዎ ቤተሰብ በካርታው ላይ በጥቁር ሰማያዊ የመጡ ከሆነ በሄፓታይተስ ቢ የመያዝ እድልዎ በእጅጉ ከፍ ያለ ስለሚሆን ምርመራ ለማድረግ ዶክተሮችን ማናገር አለብዎ፡፡   ስለ ሄፓታይተስ ቢ ለምንድን ነው ትኩረት መስጠት ያለብኝ?ስር የሰደደ ሄፓታይተስ ቢ የከፋ የጉበት ህመምን ማለትም እንደ ሰርሆሲስ ወይም የጉበት ካንሰርን ያስከትላል፡፡ ምርመራ ማድረግ ጠቃሚ ነው፤ ምክንያቱም ቀድሞ ምርመራ ማድረግ ቀድሞ ህክምና ለማግኘትና የግለሰቡንም ህይወት ለማዳን ያግዛል፡፡ በቫይረሱ የተያዙ ሰዎች ቫይረሱን ወደ ሌሎች ያስተላልፋሉ፡፡ በርካቶች አለመያዛቸውን ባለማወቃቸው የተነሳ፣ ሳያውቁ ቫይረሱን ወደ ብዙ ሰዎች ያስተላልፋሉ፡፡ ሰዎች ምርመራ ካላደረጉ በአንድ ቤተሰብ ውስጥ ሄፓታይተስ ቢ ወደ ተለያየ ትውልድ ብሎም ማህበረሰብ የሚተላለፍ ነው፡፡ በአንድ ቤተሰብ ውስጥ ያሉ የተለያዩ ትውልዶች መያዛቸውን ተከትሎ ሄፓታይተስ ቢ "በመወለድ የሚመጣ ነው" የሚል አንድ የተለመደ አባባል አለ፡፡ ነገር ግን ሄፓታይተስ ቢ በዘር የሚመጣ በሽታ አይደለም፣ ሄፓታይተስ ቢ የሚመጣው በቫይረስ፣ እንዲሁም በብዛት በቤተሰብ አባላት መካከል ከእናት ወደ ልጅ ወይም በድንገተኛ አጋጣሚ በተፈጠረ የደም ንክኪ ነው፡፡ ቤተሰቦች በሄፓታይተስ ቢ የመያያ ኡደትን በመመርመር፣ ክትባት በመከተብ እና ህክምና በመከታተል ማስቆም ይችላሉ፡፡ ሄፓታይተስ ቢ ለምንድን ነው እጅግ አደገኛ የሆነው? ሄፓታይተስ ቢ አደገኛ ነው፤ ምክንያቱም "ዝምተኛው በካይ" በመሆኑ ሰዎች ምንም ነገር ሳያውቁ ስለሚይዛቸው ነው፡፡  በሄፓታተስ ቢ የተያዙ በርካታ ሰዎች ስለመያዛቸው አለማወቃቸውን ተከትሎ ቫይረሱንበደማቸው እና በሌሎች በተበከሉ የሰውነታቸው ፈሳሾች ወደ ሌሎች ያዛምታሉ፡፡ በፀና የታመሙት ጉበታቸው ስራ የማቆም ስጋት እንዲሁም በስተመጨረሻም ሲርሆሲስ ወይም የጉበት ካንሰር የመከሰታቸው እድል ይጨምራል፡፡ ቫይረሱ ለብዙ ዓመታት ድምፁን አጥፍቶ ሳይለይ ከቆየ በጊዜ ሂደት በተከታታይ ዓመታት በጉበት ላይ ጉዳት ያደርሳል፡፡  በመጀመሪያ ደረጃ ያለ ሄፓታይተስ ቢ ምንድን ነው? የበመጀመሪያ ደረጃ ላይ ያለ ሄፓታይተስ ቢ እስከ ስድስት ወር (በምልክት ወይም ያለ ምልክት) ድረስ ያለውን ጊዜ የሚመለከት ሲሆን በዚሁ ጊዜም የተያዘው ግለሰብ ቫይረሱን ወደ ሌሎች ማስተላለፍ ይችላል፡፡ በጅማሮ ደረጃ ላይ ያለ ሄፓታይተስ ቢ ምልክቶች የምግብ ፍላጎት ማጣት፣ የመገጣጠሚያ እና ጡንቻ ህመም፣ ዝቅተኛ መጠን ያለው ትኩሳት እና የጨጓራ ህመምም ሊኖር ይችላል፡፡ ምንም እንኳን በርካታ ሰዎች ላይ ምልክቱ ባይታይም፣ በቫይረሱ ከተያዙ ከ60-150 ቀናት በኋላ ቫይረሱ ሊገኝባቸው የሚችል ሲሆን፤ ይህም በአማካይ 3 ወር ማለት ነው፡፡ አንዳንድ ሰዎች ጠንከር ያሉ ምልክቶች የሚታይባቸው ሲሆን ከነዚህም ውስጥ ንፍጥ፣ ማስመለስ፣ ጃውንዳይስ (የዓይን እና ቆዳ ቢጫ መሆን) አሊያም የጨጓራ መነፋት ሲሆኑ፣ ወደ ጤና ባለሙያ እንዲሄዱ ምክንያት ይሆናል፡፡ ቀላል የሚባል የደም ምርመራ ለአንድ ግለሰብ በደም ውስጥ የሄፓታይተስ ቢ ቫይረስ ስለመኖሩ ሊነግረው ይችላል፡፡ በመጀመሪያ ደረጃ ላለ ሄፓታይተስ ቢ ምርመራ አድርገው ከሆነ ከ6 ወራት በኋላ ዶክተሩ በድጋሚ ደሞትን በመመርመር እንደተሻለዎት አሊያም ሄፓታይተስ ቢ እንደፀናብዎት ማረጋገጥ አለበት፡፡ የጤና ድጋፍ ባለሙያው በደሞት ውስጥ የሄፓታይተስ ቢ ቫይረስ አለመኖሩን እስኪያረጋግጥልዎት ድረስ ወደሌሎች ላለማስተላለፍ ጥረት ማድረግ አለብዎት፡፡ የወሲብ አጋርዎ (አጋርዎችዎ) እና የቤተሰብ አባላት (በአንድ ቤት ውስጥ በጋራ የምትኖሩ) የሄፓታይተስ ቢ ምርመራ ማድረግ አለባቸው፡፡ ምናልባትም በቫይረሱ ያልተያዙ ከሆኑ እና የሄፓታይተስ ቢ ን ክትባት ያልወሰዱ ከሆኑ ክትባቱን በተከታታይ መውሰድ አለባቸው፡፡    በመጀመሪያ ደረጃ ሄፓታይተስ ቢ ላለባቸው ሰዎች የሚሰጥ የሄፓታይተስ ቢ ህክምና የለም፡፡ በመጀመሪያ ደረጃ ያለውን ሄፓታይተስ ቢ ለማስወገድ የሚደረግ ህክምና ስለሌለ የተያዙ ጎልማሶች በራሳቸው ጊዜ ይሻላቸዋል፡፡ አንዳንዴ ምልክቶቹ በፀና የሚታይበት ህመምተኛ ለአጠቃላይ ድጋፍ ሲባል ህክምና ሊደረግለት ይችላል፡፡ እረፍት እንዲያገኙ ማድረግ እና ምልክቶቹን መቆጣጠር የዚህ ህክምና ቀዳሚ ግቦች ናቸው፡፡ አልፎ አልፎ የሚከሰት፣ ህይወትን አደጋ ውስጥ የሚከተው “ፉልሚናንት ሄፓታይተስ”በመጀመሪያ ደረጃ የቫይረሱ መያዝ ወቅት ሊከሰት የሚችል ሲሆን፤ ይህም ግለሰቡን ለድንገተኛ የጉበት ስራ ማቆም ሊዳርገው ስለሚችል ወዲያውኑ በፍጥነት ፈጣን የህክምና እርዳታ እንዲያገኝ መደረግ አለበት፡፡ በመጀመሪያ ደረጃ ላለ የሄፓታይተስ ቢ ምልክቶች ጠቃሚ ከሆኑት ምክሮች መካከል አልኮልን አለመጠቀም፣ ሲጋራን አለማጨስ ወይም መቀነስ፣ ጤናማ አመጋገብን መከተል፣ ቅባት የበዛባቸውን ምግቦች አለመመገብ፣ ከጤና ባለሙያ ጋር በሚወስዷቸው ማናቸውም መድሀኒቶች ዙሪያ መመካከር (በትዕዛዞች፣ በመድሀኒት አወሳሰድ፣ በሚወስዷቸው ቫይታሚኖችና ሌሎች የባህል መድሀኒቶች ዙሪያ)፡፡ ይህ ያሏችሁን ማናቸውንም ሌሎች ጥያቄዎች ለመጠየቅ ጥሩ ጊዜ ነው፡፡ ቫይታሚኖችን እና በምግብ መልክ የሚወሰዱ መድሀኒቶች መጠቀም እንዳይድኑ ከማድረግ ይልቅ በጉበት ላይ የበለጠ ጉዳት እንዲደርስ ያደርጋሉ፡፡   በመጀመሪያ ደረጃ ላይ ካለ የቫይረሱ መያዝ ለመዳን በህክምና ባለሙያ የሚደረግልዎትን ማንኛውንም አይነት የደም ምርመራ በአግባቡ መከታተል አለብዎት፡፡   ስር የሰደደ ሄፓታይተስ ቢ ምንድን ነው? ከስድስት ወር በኋላ (ከመጀመሪያው የደም ምርመራ ውጤት በኋላ) የሄፓታይተስ ቢ ቫይረስ እንዳለባቸው ያወቁ ሰዎች በሽታው ስር ስለመስደዱ ለማረጋገጥ ምርመራ ማድረግ አለባቸው፡፡ ይህም ማለት የሰውነታቸው በሽታን የመከላከል አቅም የሄፓታይተስ ቢ ቫይረስን ለማስወገድ ባለመቻሉ በሰውነታቸው በደምና በጉበት ውስጥ እንዲቆይ ይሆናል፡፡ ስር የሰደደን ህመም ለማከምና ለማገዝ የሚደረግ ውጤታማ አሰራር ቢኖርም በሽታውን ግን ማዳን አይቻልም፡፡ በሽታው ስር ከሰደደ በቀሪው የህይወት ዘመንዎ ከቫይረሱ ጋር አብረው ይኖራሉ፡፡ ስር የሰደደ የሄፓታይተስ ቢ ያለባቸው ሰዎች ባለማወቅ ቫይረሱን ወደ ሌሎች ሰዎች ያስተላልፋሉ፡፡ ስር የሰደደ የሄፓታይተስ ቢ ወደ ጠነከረ የጉበት ህመም ማለትም ወደ ሰርሆሲስ ወይም የጉበት ካንሰር ያመራል፡፡ በፀና የታመመ ሰው ሁሉ የጠነከረ የጉበት ህመም ይይዘዋል ማለት አይደለም፡፡ ነገር ግን በበሽታው ምንም ካልተያዘው ሰው በበለጠ የመያዝ እድል አለው፡፡ ስር የሰደደ ሄፓታይተስ ቢ የመፈጠር እድሉ ግለሰቡ ለመጀመሪያ ጊዜ ለቫይረሱ በተጋለጠበት እድሜ ይወሰናል፡፡ 90% በሚሆኑትና በቫይረሱ በሚያዙት አዲስ የተወለዱ ጨቅላ ህፃናት እና ልጆች ላይ ሄፓታይተስ ቢ ስር ይሰዳል፡፡ እስከ 50% የሚደርሱትና በቫይረሱ የተያዙ ህፃናት (ከ1-5 ዓመት) ስር ለሰደደ የሄፓታይተስ ቢ ይዳረጋሉ፡፡ 5-10% የሚሆኑት በቫይረሱ የተያዙ ጎልማሶች ስር ለሰደደ የሄፓታይተስ ቢ ይጋለጣሉ (ከነዛ ውስጥ 90% ያገግማሉ) ስር የሰደደ የሄፓታይተስ ቢ እንዳለ ማወቅ በእጅጉ የሚረብሽ ይሆናል፡፡ ምክንያቱም አብዛኞቹ ሰዎች ምልክቶቹ ባለመታየታቸው ለሄፓታይተስ ቢ ምርመራ የሚያደርጉት በቫይረሱ ከተያዙ ከአስርት አመታት በኋላ በመሆኑ ስር ለሰደደው የሄፓታይተስ ቢ ምርመራ ማድረግ የሚያስደነግጥና የሚያስገርም ሊሆን ይችላል፡፡ መልካም የሚባለው ዜና አብዛኞቹ ስር ከሰደደ የሄፓታይተስ ቢ ጋር ያሉ ሰዎች ረዥምና ጤናማ ኑሮ እንደሚኖሩ መጠበቅ አለባቸው፡፡ በቫይረሱ የተያዘች ነፍሰ ጡር እናት በወሊድ ወቅት አዲስ ወደተወለደው ልጅዋ ቫይረሱን ልታስተላልፍ ትችላለች፡፡ ስለሆነም አዲስ የሚወለዱት ጨቅላ ህጻናት በወሊድ ወቅት የመያዝ እድላቸው ከፍ ስለሚልና ከተያዙም ስር ስለሚሰድባቸው፣ ዓለም አቀፉ ጤና ድርጅት እና በአሜሪካ የበሽታ መከላከልና መቆጣጠር ማዕከል ሁለቱም ሁሉም ህፃናት እንደተወለዱ በ 12-24 ሰአታት ውስጥ የሄፓታይተስ ቢ ክትባትን መውሰድ እንዳለባቸው በጋራ ይመክራሉ፡፡ ነፍሰ ጡር ከሆኑ እና በቫይረሱ መያዝዎትን ካወቁ የወለዱት ልጅዎ በተወለደ ከ12-24 ባሉት ሰዓታት የሄፓታይተስ ቢ ክትባት ማግኘት አለበት፡፡ የሄፓታይተስ ቢ በሽታን ማዳን ባይቻልም የሄፓታይተስ ቢ ቫይረስን የሚቆጣጠርና በጉበት ላይ ጉዳት እንዳያመጣ የሚስቆም ውጤታማ መድሀኒት አለ፡፡ በጥናት ላይ ያለና ወደፊት በሽታውን ማዳን እንደሚችል ተስፋ የተጣለበት አዲስ መድሀኒት ወደፊት ይመጣል፡፡ ምንም እንኳን ከባድ የጉበት ህመም ወይም የጉበት ካንሰር የመከሰቱ እድል በቫይረሱ ካልተያዙት በበለጠ ስር በሰደደ የሄፓታይተስ ቢ ህሙማን ላይ ቢታይም፤ ግለሰቡ ሊተገብራቸው የሚገቡና ችግሩን ለመቀነስ የሚረዱ ቀላል ተግባራት አሉ፡፡ በየስድስት ወሩ (አለበለዚያም በዓመት አንድ ግዜ) የጉበት ስፔሻሊስት ወይም ስለ ሄፓታይተስ ቢ እውቀቱ ወዳለው የጤና ባለሙያ በመሄድ የጉበትዎን ጤንነት ማስመርምር ያስፈልጋል፡፡ ከጤና ባለሙያዎ ጋር ስር ለሰደደው የሄፓታይተስ ቢ የሚደረግልዎት የህክምና ክትትል የከፋ የጉበት ህመም ወይም የጉበት ካንሰር እንዳይከሰት ለመከላከል እንደሚረዳ ተነጋገሩ፡፡ ወደ ጤና ተቋም በሚሄዱበት ጊዜ የጤና ባለሙያው ለጉበት ካንሰር እርስዎን መምረጡን እርግጠኛ መሆንዎ፤ ቫይረሱን ቀድሞ በመለየት የበለጠ ህክምና እንዲያገኙና ህይወትዎ እንዲረዝም ለማድረግ ስለሚረዳ ነው፡፡ በጉበትዎ ላይ በርከት ያሉ መጨናነቆችን ስለሚያስከትሉ አልኮል እና ማጨስን ያስወግዱ አሊያም ይቀንሱ፡፡ ቅባት የበዛባቸው ምግቦች ለጉበት ስለሚከብዱ፣ የበሰሉ አትክልቶችን በመመገብ ጤናማ አመጋገብይኑረን፡፡   “በሽታው ስር የሰደደበት” ማለት ምን ማለት ነው? የሆነ አንድ ግለሰብ በሄፓታይተስ ቢ በፅኑ ከታመመ፣ ዶክተሩ “በፅኑ የታመመ”ብሎ ወደ ሌሎች ይልከዋል፡፡ “በፅኑ የታመመ”ማለት ግለሰቡ ስር ሰደደ ሄፓታይተስ ቢ ያለበት እና ቫይረሱን ወደሌሎች ማስተላለፍ የሚችል እንደሆነ እንዲሁም በዶክተር ክትትል ሊደረግለት እንደሚገባ ለማመላከት ነው፡፡   ለሄፓታይተስ ቢ ህክምና አለው? አንዳንድ ጎልማሶች ያለምንም መድሀኒት በመጀመሪያ ደረጃ ካለ የቫይረሱ መያዝ ራሳቸውን ያድናሉ፡፡ ስር በሰደደ ሄፓታይተስ ቢ ለተያዙ ጎልማሶች፣ ህፃናት እና ጨቅላ ህፃናት ምንም አይነት መድሀኒት የለም፡፡ ነገር ግን መልካም የሚባለው ዜና በፀና በታመመው ህመምተኛ ሰውነት ውስጥ ያለውን ቫይረሱን በማዳከም የከፋ ደረጃ ላይ ሊደርስ የሚችለውን የጉበት ህመም መቀነስ የሚያስችል ህክምና አለ፡፡ የሚራቡት የሄፓታይተስ ቢ ቫይረሶች ቁጥር በቀነሰ ጊዜ በጉበት ላይ የሚደርሰው ጉዳትም ይቀንሳል፡፡ ያሉት ተስፋ ሰጪ ምርምሮች ሲታዩ፣ ወደፊት ስር የሰደደውን ሄፓታይተስ ቢ ለማከም የመረዱ መድሀኒቶች እንደሚገኙ ታላቅ ተስፋ አለ፡፡ የእኛንይጎብኙ መድሀኒት ተመልከት በመሞከር ላይ ያሉ የመድሀኒት ዝርዝሮችን ለማየት፡፡ የእኔን ሄፓታይተስ ቢ ን ለማከም ምን አማራጮች አሉ? በመጀመሪያ ደረጃ ላለ የቫይረሱ መያዝ እረፍት ከማድረግና ማንኛውንም የበሽታውን ምልክቶች ከመቆጣጠር የዘለለ ምንም አይነት ህክምና የለም፡፡  ስር ለሰደደ ሄፓታይተስ ቢ የተለያዩ ህክምናዎች አሉ፡፡ በሄፓታይተስ ቢ በፅኑ የታመመ ሰው ሁሉ ህክምና እንደማያስፈልገው መረዳት ያስፈልጋል፡፡ ህክምና እንደሚስፈልግህ አሊያም ሁኔታውን አየተከታተልክ ለመጠበቅ እንድትወስን ዶክተርህ ያግዝሀል፡፡ የተለያዩ የአንቲቫይራል ህክምናዎች የሄፓታይተስ ቢ ን ቫይረስ ከመባዛት ይገታሉ አሊያም ይቀንሳሉ፤ ይህም በጉበት ላይ የሚደርሰውን የማቃጠል ስሜት እና መሰል ጉዳትን ለመቀነስ ይረዳል፡፡ እነዚህ አንቲቫይራሎች በፒል መልክ በቀን አንድ ጊዜ ቢያንስ ለ 1 ዓመትና ከዚያም በላይ በፒል መልክ ይወሰዳሉ፡፡ በአሜሪካ 6 በኤፍ.ዲ.ኤ እውቅና የተሰጣቸው አንቲቫይራሎች አሉ፤ ነገር ግን ሶስቱ “በመጀመሪያው መስመር ያሉ”የሚባሉት አንቲቫይራሎች ይመከራሉ፦ቴኒፎቪር ዲሶፕሮክሲል (ቪሬድ/ቲ.ዲ.ኤፍ)፣ ቴኖፎቪር አላፍናማይድ (ቬምሊዲ/ቲ.ኤ.ኤፍ) እና ኢንትካቪር (ባራክሉድ)፡፡ መጀመሪያው መስመር ላይ ያሉት አንቲቫይራሎች አስተማማኝና በጣም ውጤታማ በመሆናቸው ይመከራሉ፡፡ በመጀመሪያ ደረጃ ያሉት የሚባሉት አንቲቫይራል ህክምናዎች ውጤት ካላመጡ ወይም አንሱን የማግነት እድል ከሌላቸው ሌሎች አማራጮች አሉ፦ telbuvidine (Tyzeka፣ Sebivo)፣ adefovir dipivoxil (Hepsera)፣ እና lamivudine (Epivir-HBV፣ Zeffix፣ Heptodin)፡፡ ምንም እንኳን ኤፍ.ዲ.ኤ እነዚህን አንቲቫይራሎች ጥቅም ላይ እንዲውሉ ቢመክርም ስር የሰደደውን ሄፓታይተስ ቢ ን ሙሉ በሙሉ ማከም አይችሉም፡፡ ነገር ግን በጉበት ላይ ሊደርስ የሚችለውን ጉዳት እና የጉበት ካንሰርን ለመቀነስ ይችላሉ፡፡ አንቲቫይራሎች ዝም ተብለው የሚወሰዱ እና የሚቆሙ ባለመሆናቸው ለሄፓታይተስ ቢ ተብሎ የሚደረገውን ህክምና ከመጀመር በፊት እውቀቱ ያለው ዶክተር ጥልቅ ምርመራ ማድረግ አለበት፡፡ ኢሚዩኖሞዱሌተር መድሀኒቶች የሄፓታይተስ ቢ ቫይረስን በመቆጣጠር የሰውነት የመከላል ብቃትን ከፍ ያደርጋል፡፡ ከ 6 ወር እስከ 1 ዓመት ባለው ጊዜ ውስጥ በመርፌ የሚሰጡ ናቸው፡፡ በብዛት የታዘዘው ኢንተርፌሮን አልፋ-2b (Intron A) እናፔጊሌትድ ኢንተርፌሮን (Pegasys) ናቸው፡፡ እርስዎና ዶክተርዎ ካሉት የህክምና አማራጮች መካከል ለእርስዎ የተሻለውን ለመምረጥ እንዲቻል መነጋገር አለባችሁ፡፡ ለአብዛኞቹሰዎች መድሀኒቶቹ የሄፓታይተስ ቢ ቫይረስን ወይ ይቀንሳሉ አሊያም ያስቆማሉ፡፡ በጥቂት ወራት ውስጥ ህመምተኛው የተሻለ ስሜት ይሰማዋል፤ ምክንያቱም ጉበቱ ላይ በቫይረሱ እየደረሰበት የነበረው ጉዳት እየቀነሰ ይመጣል፤ አሊያም ለረዥም ጊዜ ሲወሰድ ድጋሚ ሊያገረሽም ይችላል፡፡ በኤፍ.ዲ.ኤ ለተረጋገጠ የተሟላ የመድሀኒት ዝርዝር እና በሄፓታይተስ ቢ ዙሪያ እየተሰሩ ላሉ ተስፋ ሰጪ መድሀኒቶች፣ ይጎብኙ መድሀኒት ተመልከት፡፡     General Information What is hepatitis B?Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B. How many people are affected by hepatitis B?Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world?Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B?Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous?Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected. What is acute hepatitis B?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. 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 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. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your 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 with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms 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 an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. 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. What is chronic hepatitis B?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. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected. The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with 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. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase 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 risk. 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. 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. 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. What does it mean to be a “chronic carrier”?When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B?Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. But the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. What options are there to treat my hepatitis B?For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three “first-line” antivirals are recommended: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic hepatitis B. There are also immunomodulator drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.

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