Steve Bingham, Co-Owner of the Internet Hepatitis B Information and Support List (HBList.org)

A newcomer to our HB-List wrote, "Thanks Steve and everyone for all the information and advice this past week. I don't mean to sound ungrateful, but every time I ask a question, I end up more confused. When I tried to explain hepatitis B to my girlfriend, she got really scared and won't return my calls. Now I think I might have depression. Best regards, Al."

Our Al has found a new appreciation for the axiom, "Ignorance is bliss." Try explaining HBV testing, transmission, treatment, or prognosis in 500 words or less. Toss in the complication of HBV genotypes and mutations. If Al miraculously understands all that information, then try telling him how he's supposed to break the news of his infection to his girlfriend.

Unfortunately there are no easy, black and white answers to the most basic hepatitis B questions. Take just the one topic of "treatment". What we learned at the recent B Informed patient conference in July from Dr. Raj Reddy is that there are five different practice guidelines for treating chronic hepatitis B to choose from. The U.S. guidelines include, U.S. Algorithm (Dr. Keeffe, 2004), AASLD (2001/updated 2004), and NIH (2000/updated 2001). In Europe and Asia, EASL and APASL guidelines respectively, were both approved in 2003.

You can find four of the treatment guidelines on the HBF's website, www.hepb.org/professionals/who_should_be_treated.htm.

To help patients looking for answers, Sheree Martin and I maintain a free HBV research listserv, and you can subscribe by sending a message to HBV_Research-on@mail-list.com or visit our website at http://archive.mail-list.com/hbv_research.

Unfortunately, as Greek researcher Dr. John Ioannidis concluded in a recent publication, most medical research exists in the gray. He examined the major clinical research studies published over the past 13 years in three of the world's most prestigious medical journals, and found that a third of them were eventually contradicted (J. of American Medical Association, July 13, 2005).

But not to worry, Al. Dr. Ioannidis was reassuring in an interview with Newsweek (July 25, 2005). "The general public should not panic [about studies published, then contradicted]. We all need to start thinking more critically," he said.

"How to Think Critically" would be a good subject for a future column here, but right now, Al just wants to know if he'll ever be able to get another date!

Best Wishes,
Steve

To join the only online support group for those living with chronic hepatitis B, visit the Hepatitis B Information and Support List at www.HBList.org.

BInformed, Fall 2005.