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Hepatitis B

Hepatitis B is an infectious liver disease caused by the hepatitis B virus (HBV) (A.D.A.M Editorial Board 2010; Merck 2007; Mayo Clinic 2011b). While most adults infected with HBV recover, a portion can develop chronic hepatitis B, risking serious illness or death from cirrhosis, hepatocellular carcinoma (liver cancer), or liver failure (El-Serag 2012; Nebbia 2012; WHO 2009; Lee 2008).

According to 2009 World Health Organization estimates, greater than 2 billion people have been exposed to the hepatitis B virus and 360 million are chronically infected worldwide (WHO 2009). It has been estimated that 12 million people In the U.S. have been exposed to HBV, with roughly 700,000 being chronically infected (Ioannou 2011).

Chronic HBV infection often does not cause symptoms in its early stages, so only about 33% of adults with chronic hepatitis are aware they are infected. Of those eligible for treatment for chronic HBV, only about 12.5% are receiving it (Scaglione 2012).

While the availability of HBV vaccination has decreased the incidence of HBV infection in the U.S., about 43,000 cases of acute hepatitis B still occur each year (Mitchell 2010). Rates of vaccination are relatively low among high-risk populations (eg, illicit IV drug users, individuals with HIV, and hemophiliacs); according to a 2007 CDC survey, over 51% of high risk adults remained unvaccinated in the U.S. (Ladak 2012).

Standard therapies for chronic HBV infection and hepatitis are limited, and are not effective in all cases (Scaglione 2012; Mutimer 2012). Additionally, the unique lifecycle of the HBV allows it to evolve and develop resistance to antiviral drugs (Billioud 2011).

Overlooked is an abundance of published research documenting potent anti-viral and liver-protecting properties of easy-to- obtain nutrients.

Fortunately, minimization of risk factors for HBV can reduce transmission of the virus, while new diagnostics and emerging treatments continue to advance the ability to combat this disease. This protocol will review these conventional treatments, as well as discuss nutritional approaches for addressing HBV infection and chronic liver disease progression.