OTHER HEPATITIS B INFORMATION

CO-INFECTION WITH OTHER VIRUSES

THE HEPATITIS D VIRUS

The Hepatitis D Virus (HDV) is a unique, defective RNA virus that can only infect an individual in the presence of Hepatitis B. It occurs either as a co-infection with acute Hepatitis B or as a superinfection in people with chronic Hepatitis B. HDV is mostly found among IV drug users, but transmission by other routes is possible. Infection with HDV can make the acute phase of Hepatitis B unusually severe. It can cause an acute "exacerbation" in chronic Hepatitis B carriers (superinfection), or cause a relatively aggressive course of chronic Hepatitis B.

Some recent research as shown that Hepatitis D can exist without Hepatitis B being present. But the presence of Hepatitis B is required for the initial infection to take place.(?)

THE HEPATITIS C VIRUS

Studies indicate that coinfection with Hepatitis C can suppress Hepatitis B and Hepatitis C is the dominant illness. However sometimes the combination can lead to very aggressive hepatitis and also the risk of liver cancer (HCC) is increased.

There is still much research to be done in this field.

HIV

In general coinfection with HIV leads to a milder form of hepatitis although this may get much worse in patients with AIDS. Current research indicates that coinfection with HIV is should not be a factor in deciding weather to take interferon treatment as response rates are only slightly lower, however the risk of viral reactivation after a successful response is increased.

NON "E" ANTIGEN HEPATITIS B

There are strains of hepatitis that do not produce the "e" antigen. This strain normally shows up in cases of mild chronic infection or occasionally in very aggressive disease. Research has shown that the response rate to interferon in this strain of Hepatitis B is lower than normal. However where a long term response is achieved success rates are comparable.

RELAPSE.

After a chronic Hepatitis B infection people do not, to my knowledge, produce the surface antibody that would provide protection. Even after a pesponse to interferon (I.e. loss of the surface antigen) there have been rare cases of viral reactivation if the immune system becomes suppressed or it may just happen.. It is therefore advised that your Hep B antigen status if examined periodically to be on the safe side.

LIVER CANCER (HEPATOCELLULAR CARCINOMA OR HCC).

Chronic infection with Hepatitis B can lead to an increased incidence of HCC (5%). It is believed that after several years of chronic Hep B infection the Hep B viral DNA becomes integrated with human DNA. In most cases this poses no problems and the result generally causes the liver cell(s) where integration has occurred to produce surface proteins (HBsAg) but not complete viral particles. However when the DNA integration occurs sometime mistakes may be made during integration or it may be inserted into the human gnome at a place that "turns on" the instruction to replicate uncontrollably. The error may also occur as when liver cells naturally reproduce. Anyone expressing the HBsAg generally has increased risk of HCC. Treatment of HCC is a large subject in itself and when I have the time & information and I hope to expand on this information.

LIVING WITH HEPATITIS B

Note: I cannot locate the the source of this article. If you recognise it please let me know so I can credit the authors

You Can Lead a Normal, Healthy Life as a Hepatitis B Carrier:

FACTS FOR THE HEPATITIS B CARRIER

Most Hepatitis B carriers do not feel or look sick and will never suffer from any health problems associated with Hepatitis B. However, some carriers have an increased risk of becoming sick with liver disease. Carriers need to have the regular care of a doctor.

People who are not exposed to your or body fluids are not at risk for catching Hepatitis B from you. Therefore, you do not need to mention your infection to your employers, co workers or people you are in casual contact with. It is okay to share meals with family and friends.

WHAT YOU CAN DO TO TAKE CARE OF YOURSELF:

• Avoid alcohol because it can damage your liver.
• Tell your doctor that you are a Hepatitis B carrier. Discuss with your doctor any recommended treatment or tests and the need to avoid certain medications.
• If you inject (shoot) drugs, you could catch a more severe form of hepatitis. Get help from a drug treatment centre to get off drugs.

WHAT YOU CAN DO TO PROTECT OTHERS:

Remember, carriers may feel healthy but can still spread the Hepatitis B infection to other people.

People who may be exposed to your blood or certain body fluids are at risk of becoming infected with Hepatitis B. To protect others you should:

• Make sure your sexual partner(s) and all household members see a doctor for testing and immunisation (protective shots) against Hepatitis B.
• Tell your sex partner that you have Hepatitis B and use a latex condom every time you have sex until that person can be tested and immunised against Hepatitis B.
• If you are pregnant, it is important to tell your doctor that you are a carrier so that your new baby is started on Hepatitis B immunisations immediately at birth. It is okay to breastfeed if your baby has started the Hepatitis B immunisations.
• Never share syringes and needles.
• Never donate blood, plasma, body organs, tissue or sperm.
• As with many types of infections, good hygiene offers the best protection to others. You should:-
• Never share cigarettes, toothbrushes, razors, scissors, nail files or clippers, needles (for ear piercing or shooting drugs), or anything that may have come in contact with your blood.
• Cover all cuts, blisters, and open sores with a bandage.
• Wash hands well after touching your blood.
• Clean up blood spills. Then re-clean the area with a diluted household bleach solution (one part bleach mixed with 9 parts of water).

OBTAINING HERBS AND AMINO ACIDS VIA NHS PRESCRIPTION.

UK SPECIFIC
A GP can prescribe you ANYTHING they believe my be of benefit to your health unless it is specifically banned or restricted by the NHS or Health authority. If you can convince/prove to your doctor that the above will be of benefit to you he can write you a prescription although in some cases in you pay a prescription charge it can be cheaper to obtain them yourself.

However before doing this your GP understandably needs evidence that these may be of benefit to you. Provided your GP with photocopies from medical journals, printouts of information from the Internet etc. If you can, and I advise it, arrange (probably via your specialist at your local hospital) to monitor your blood work for any adverse reaction and inform him of this he may write you a prescription. It may also help to inform him of the low cost of many of these compounds.

Once you have obtained your prescription you should take this to your chemist (note, this is much easier at a small local chemist than a large chain such as Boots or Superdrug) and hand the prescription to the pharmacist. For hard to find items you will need to give them the all the necessary information on where to obtain things, eg address, telephone number etc. You may wish to specify a brand name for some items. The pharmacist will then order the items on the prescription and they should be available for collection normally within a week.

Due to the delay in obtaining non standard items it is advised that you obtain and hand to your pharmacist repeat prescriptions for any items you may require 2 weeks before you need them to avoid running out.