Category Archives: HBV Awareness

HBV Journal Review – June 2014

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ChrisKHBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
 latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:

  • Belatedly, National Panel Recommends Screening At-Risk Patients for Hepatitis B
  • Genotypes and Mutations Define the Course of Hepatitis B Infection
  • Older Patients Who Lose HBeAg After Treatment May Relapse
  • Tenofovir Proves Ineffective in Patient with Multiple Drug Resistance
  • Nearly All HBeAg-Negative Patients Relapse After Antiviral Treatment Stops
  • Studies Find Hepatitis Infection Does Not Increase Pancreatic Cancer Risk
  • Screening Pregnant Women for High Viral Loads Is Cost Effective
  • Hepatitis B Appears to Impede Fertility
  • Despite Low Viral Load, Infected People Can Still Infect Family Members
  • Good News: HBV Infection Rates Lower Than Expected Among Korean-Americans
  • Green Tea May Be an Effective Antiviral

HBV Journal Review

June 1, 2014
Volume 11, Issue 6
by Christine M. Kukka

Belatedly, National Panel Recommends Screening At-Risk Patients for Hepatitis B

Ten years after it recommended against screening the “general population” for hepatitis B, an independent national task force that creates prevention guidelines for primary care providers has finally recognized that certain high risk groups in the U.S. should be screened for hepatitis B.

Their recommendations, recently published in the Annals of Internal Medicine, come after numerous studies faulted primary care providers for failing to screen patients for hepatitis B and missing opportunities to treat patients for liver disease and immunize family members against hepatitis B virus (HBV) infections.

Other health care organizations, including the U.S. Centers for Disease Control and Prevention (CDC), the Institute of Medicine, and the American Association for the Study of Liver Disease, have been recommending for years that primary care doctors screen high-risk patients for hepatitis B, which has infected up to 2.2 million Americans.

The U.S. Preventive Services Task Force (USPSTF) recently issued clinical guidelines recommending that doctors screen the following patients for hepatitis B:

  • People from countries that have hepatitis B rates exceeding 2% (which includes Asia, Africa, Central Europe and parts of Central and South America).
  • U.S.-born people whose parents immigrated from countries with high rates of HBV infection.
  • HIV-positive people, injecting drug users, men who have sex with men, and
  • Household contacts of people infected with HBV.

The task force’s guidelines suggest that because an effective vaccine to protect against the infection and effective treatments for hepatitis B are now available, they decided to issue these recommendations. However, both the vaccine and effective treatments have been available for more than a decade.

“In the 2004 recommendation, the USPSTF focused only on the general population,” the authors wrote in the recommendations. “In the current recommendation, the USPSTF focused on high-risk populations as it considered new evidence on the benefits and harms of antiviral treatment, the benefits of education or behavior change counseling, and the association between improvements in intermediate and clinical outcomes after antiviral treatment.” The task force noted that it, “…found inadequate evidence that education or behavior change counseling reduces disease transmission.”

Source: www.uspreventiveservicestaskforce.org/uspstf/
uspshepb.htm

Genotypes and Mutations Define the Course of Hepatitis B Infection
Researchers are increasingly finding that HBV genotypes or strains—and the mutations that they generate—can determine the severity of a patient’s infection.

Each of the world’s 10 genotypes and their mutations have different characteristics that can increase risk of cirrhosis and liver cancer, determine whether an infection becomes chronic, and basically determine a patient’s destiny, according to a recent study, published in the May issue of the World Journal of Hepatology …

Continue reading the HBV Journal Review… 

New USPSTF Recommendation on Hepatitis B Screening for People at High-Risk

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Unknown-1Truly historic news! Those living with chronic hepatitis B will be identified sooner and learn more about their HBV infection. They can live full lives by improving their health through regular monitoring, treatment when necessary, and adopting healthy lifestyles that benefit the liver. Symptoms may not occur for decades so many are completely unaware of their infection. If you believe you are at risk, please talk to your doctor about being screened for hepatitis B.

By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

On Monday, May 26th, the U.S. Preventive Services Task Force (Task Force) published its final recommendation statement on screening for hepatitis B virus (HBV) infection in individuals at high risk. This recommendation includes adults and adolescents who are not pregnant and who have not been vaccinated, as well as other individuals at high risk for infection.

Click here to better Understand the details of the Task Force Recommendations.

After reviewing the evidence, the Task Force recommends screening people who have the following risk factors for HBV infection:

  • People born in countries and regions with a high prevalence of HBV infection, such as Africa, Southeast Asia, Pacific Islands, China, Middle East, Eastern Europe, and the northern countries in South America;
  • U.S.-born persons not vaccinated as infants whose parents were born in countries or regions with a high prevalence of HBV infection;
  • HIV-positive people, injection drug users, men who have sex with men, and those living with or having sex with someone with HBV infection; or
  • Patients with weakened immune systems or undergoing treatment for kidney failure (hemodialysis).

There are still as many as 2.2 million people in the United States chronically infected with hepatitis B and 15 to 25 percent of those individuals die from liver disease including liver cancer. “Screening can identify people who have chronic HBV infection, and the good news is that treatment can help prevent liver cancer in these people,” says Task Force member Dr. Douglas K. Owens of Stanford University.

The Task Force’s final recommendation statement has been published online in Annals of Internal Medicine , as well as on the Task Force Web site . A fact sheet  [PDF 151KB] explains the recommendation statement in plain language.

“The Task Force’s new Grade B recommendation in favor of HBV screening for persons at high risk for infection – people who are more likely to get infected or to pass on the infection – provides us with another important tool to use as we pursue the goals of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis,” observed Ms. Corinna Dan, Viral Hepatitis Policy Advisor at the HHS Office of HIV/AIDS and Infectious Disease Policy. “In the weeks and months ahead, federal and nonfederal stakeholders alike will incorporate this recommendation into efforts detailed in the Action Plan to improve viral hepatitis testing, care and treatment to prevent liver disease and cancer.”

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Do You Know Your Hepatitis Facts from Fiction?

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Hepatitis-Awareness-Month(2)

May is Hepatitis Awareness Month!

In recognition of May as Hepatitis Awareness Month, Liver Cancer Connect reviews some important facts and dangerous fiction about chronic hepatitis B and C- the world’s leading causes of liver cancer.  Continue reading

Viral Hepatitis Action Alert!

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red-phoneRepresentatives Mike Honda, Hank Johnson, and Judy Chu are asking all House Representatives to sign an important letter supporting increased funding for viral hepatitis programs in the Fiscal Year 2015 appropriations bill (see text of letter below)

Please take a few minutes before March 25th to call your House Representative’s office in Washington, DC and ask/him to sign this letter.

You can reach your Representative through the Congressional Switchboard at (202) 224-3121. Ask to be connected to your Representative. Once you are connected to the office, ask to speak to the staff person who handles health care issues. Whether you speak to that person live or leave a voicemail, tell them (1) your name, (2) where you live and that you are a constituent, (3) that you would like the Representative to sign the “Dear Colleague” letter from Representatives Honda, Johnson, and Chu supporting increased funding for viral hepatitis and (4) a brief message why this issue is important to you. Tell them they can sign the letter by contacting Kelly Honda in Representative Honda’s office, Scott Goldstein in Representative Johnson’s office, or Linda Shim in Representative Chu’s office. The deadline for Representatives to sign is March 25th.

Text of “Dear Colleague” letter from Representatives Honda, Johnson, and Chu:

Support Funding for Viral Hepatitis

March XX, 2014

The Honorable Jack Kingston
Chairman
Subcommittee on Labor, Health and Human Services
United States House
Washington, D.C., 20515

The Honorable Rosa DeLauro
Ranking Member
Subcommittee on Labor, Health and Human Services
United States House
Washington, D.C., 20515

Dear Chairman Kingston and Ranking Member DeLauro:

As you begin deliberations on the Fiscal Year 2015 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill, we would like to respectfully request that you allocate $47.8 million for the Division of Viral Hepatitis (DVH) at the Centers for Disease Control and Prevention (CDC), an increase of $16.4 million over the FY2014 level.

The CDC’s 2010 professional judgment (PJ) budget recommended $90.8 million each year from FY2011-FY2013, $170.3 million annually from FY2014-FY2017, and $306.3 million annually from FY2018-FY2020 for DVH in order to comprehensively address the viral hepatitis epidemic. While past increases have been helpful, these have only been small steps toward building a more comprehensive response to viral hepatitis. Our recommendation of $47.8 million is in line with the needs determined by the PJ and the goals of the Viral Hepatitis Action Plan, but pales in comparison to the CDC’s PJ.

The need to enhance and expand these prevention efforts is growing more urgent. Viral hepatitis is the leading cause of liver cancer – one of the most lethal, expensive and fastest growing cancers in America. More than 5.3 million people in the U.S. are living with hepatitis B (HBV) and/or hepatitis C (HCV) and 65-75% of them are undiagnosed. Without an adequate, comprehensive surveillance system, these estimates are only the tip of the iceberg. Viral hepatitis kills 15,000 people each year and is the leading non-AIDS cause of death in people living with HIV – nearly 25 percent of HIV-positive persons are also infected with HCV and nearly 10 percent with HBV.

The epidemic is particularly alarming because of the rising rates of new infections and high rates of chronic infection among disproportionately impacted racial and ethnic populations, and presents a dramatic public health inequity. For example, HCV is twice as prevalent among African Americans as among Caucasians. Asian Americans comprise more than half of the known hepatitis B population in the United States and, consequently, maintain the highest rate of liver cancer among all ethnic groups. Additionally, African American and Latino patients are less likely to be tested for HCV in the presence of a known risk factor, less likely to be referred to treatment for subspecialty care and treatment, and less likely to receive antiviral treatment. Recent alarming epidemiologic reports indicate a rise in HCV infection among young people throughout the country. Some jurisdictions have noted that the number of people ages 15 to 29 being diagnosed with HCV infection now exceeds the number of people diagnosed in all other age groups combined.

Further, the baby boomer population (those born 1945-1965) currently accounts for two out of every three cases of chronic HCV. As these Americans continue to age, they are likely to develop complications from HCV and require costly medical interventions that can be avoided if they are tested earlier and provided with treatment options. It is estimated that this epidemic will increase costs to private insurers and public systems of health such as Medicare and Medicaid from $30 billion in 2009 to over $85 billion in 2024, and also account for additional billions lost due to decreased productivity from the millions of workers suffering from chronic HBV and HCV.Over the last two years, CDC and the U.S. Preventive Services Task Force (USPSTF) have begun to align their recommendations for hepatitis screening, recommending one-time testing of baby boomers and screening vulnerable groups for HCV.

We appreciate the Committee’s support for viral hepatitis prevention, in particular the increased support to prioritize the identification of HBV and HCV-positive individuals who are unaware of their status. We strongly encourage you to sustain your commitment this year. We have the tools to prevent the major causes of viral hepatitis and liver cancer – a hepatitis B vaccine and effective treatments that reduce disease progression, new diagnostics for HCV and treatments that increase cure rates over 90%, and even more medical advances in the research pipeline. Making this relatively modest investment in the prevention and detection of viral hepatitis represents a key component in addressing a vital public health inequity and will get more Americans into care, strengthen our public health infrastructure and combat the devastating and expensive complications caused by viral hepatitis.

Sincerely,

XXX

Re-energized in Our Mission … A Message from Joan Block of HBF

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Historic ruling now officially recognizes HBV infection as a protected disability under the Americans with Disabilities Act.

What a difference two years make. In 2011 the Hepatitis B Foundation celebrated its 20th anniversary and we were ready to rest awhile on our laurels after working so hard. But instead, we rallied for new challenges and now we have a lot to celebrate in 2013! Continue reading