World Hepatitis Day: The History of the Hepatitis B Vaccine

Hepatitis B particles are made of a protein shell with viral DNA inside. Image: CDC

In the early 1970s, Ted Slavin, a hemophiliac, learned his blood was special. Over a lifetime of transfusions, he had slowly amassed a huge collection of antibodies, which are proteins produced by the immune system that attach to invaders, such as viruses and bacteria. When he started receiving transfusions in the 1950s, blood wasn’t screened for diseases, which meant that he’d been repeatedly exposed to some pathogens. His immune system manufactured large amounts of protective antibodies to battle these constant invaders, one of which was hepatitis B virus (HBV) — resulting in blood with extremely high concentrations of hepatitis B antibodies.


After sunshine and smoking, hepatitis B is the most common cause of cancer.


His physician relayed this discovery to Slavin — most doctors wouldn’t have bothered, and in fact might have surreptitiously sold his blood to researchers. Back then, scientists were at work on a hepatitis B vaccine, and hepatitis B antibodies were a hot commodity. Likewise, Slavin needed money — his medical condition precluded regular work, and treatments were costly. He contracted with labs and pharmaceutical companies to sell his antibodies directly, for as much as $10 per milliliter and up to 500 milliliters per order.

When someone has a chronic HBV infection, the virus has “hijacked” some of his or her cells, “tricking” them into manufacturing copies of the virus. A virus consists of an outer protein shell housing genetic information — the blueprint that cells follow when they produce virus copies. When hepatitis B viruses are manufactured in cells, an excess of surface proteins is produced — these waste products litter the bloodstream, and testing for their presence allows people to be diagnosed with HBV infections. These surface proteins are called antigens — and as luck (or evolution) would have it, the antibodies our immune systems produce can attach to viral antigens, helping us to keep pathogens at bay. Continue reading

STD Awareness: Viral Hepatitis

Hepatitis A virus particles are pictured in this electron micrograph. Image: Betty Partin, CDC

Hepatitis isn’t commonly thought of as a sexually transmitted disease (STD) — for most people, hepatitis conjures images of contaminated food or unsanitary restaurants. But hepatitis should be on the radar of anyone who is sexually active. There are several different viruses that cause hepatitis, and some can be sexually transmitted, including hepatitis A (HAV), hepatitis B (HBV), and, to a lesser extent, hepatitis C (HCV).

While HBV is most efficiently transmitted through blood, it can also easily hitch rides from person to person via sexual fluids. However, we covered HBV in depth last year in observance of World Hepatitis Day. As May is Hepatitis Awareness Month, we’ll turn the spotlight on HAV and HCV for this month’s installment of our STD Awareness series.

Hepatitis A (HAV)

HAV spreads through fecal-oral contact and is more widespread in parts of the world with poor sanitation. It is relatively rare in the United States, although in 2003 there was a hepatitis A outbreak outside of Pittsburgh — the largest in the United States — that was traced to improperly washed raw scallions. All told, there were 650 confirmed illnesses and four deaths. HAV is very resilient and can survive outside a host for long periods of time — other foodstuffs it can contaminate include filter-feeding shellfish, which can concentrate HAV from contaminated seawater in their tissues. When these shellfish are undercooked, they can pack quite a punch as billions of virus particles are released into the unsuspecting diner’s body.


Vaccination against hepatitis A confers lifelong immunity while sparing you from illness caused by a natural infection.


Unfortunately, no matter how well you clean your fresh produce or how long you cook shellfish, certain sexual activities can increase your risk of acquiring HAV. As with intestinal parasites, which can be present in minuscule amounts of fecal matter, so too can virus particles be present in microscopic bits of feces. Oral contact with the anus (“rimming” or anilingus) is the riskiest activity in terms of HAV transmission — oral-genital contact can also do the trick, as can manual contact between the anus and the mouth. While hepatitis A outbreaks have been reported among MSM — men who have sex with men — populations, oral-anal contact is associated with increased risk for HAV infection regardless of sexual orientation. To reduce your risk of sexual HAV transmission, use latex condoms or dental dams during oral activities. HAV can also be transmitted via blood, and hepatitis A outbreaks have been reported among IV drug users. Continue reading