IOM Urges Hepatitis Screening, Prevention

The Institute of Medicine is calling for increased awareness of hepatitis B and C among health care providers, social service providers, and at-risk communities as well as better surveillance and more stringent vaccination requirements nationwide in its newly released report on hepatitis and liver cancer.

“The committee believes that these recommendations will prevent further infections, improve the lives and health of infected individuals, and reduce the long-term burden of liver disease and liver cancer,” Dr. R. Palmer Beasley said during a teleconference sponsored by the National Academies of Science. Dr. Beasley chaired the IOM committee that wrote the report “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C” (available at www.iom.edu/viralhepatitis

“Although hepatitis B and C are preventable, the rates of infection have not declined over the past several years, underscoring the conclusion that we have allowed gaps in screening, prevention, and treatment to go unchecked,” Dr. Beasley said in a statement.

“This report outlines the additional resources and actions needed to reduce the unacceptably high burden of liver disease and cancer associated with these viruses,” said Dr. Beasley, who is a professor of epidemiology and disease control at the University of Texas in Houston.

It's estimated that 800,000 to 1.4 million Americans have chronic hepatitis B, and between 2.7 million and 3.9 million have chronic hepatitis C. Most are unaware that they are infected until they develop symptoms of liver cancer or liver disease.

The committee identified three major factors that impede current efforts to prevent and control hepatitis B and C:

▸ Lack of knowledge and awareness about chronic viral hepatitis on the part of health care and social service providers.

▸ Inadequate knowledge and awareness about chronic viral hepatitis among at-risk populations, members of the public, and policy makers.

▸ Insufficient understanding about the extent and seriousness of this public health problem that has led to the inadequate allocation of resources for prevention, control, and surveillance programs.

Perhaps the greatest difficulty in diagnosing and treating patients with hepatitis B and C is that these diseases are often asymptomatic.

In addition, minority groups—Asians, Pacific Islanders, and blacks—are at greatest risk. Those most at risk for hepatitis B include people born in East and Southeast Asia or sub-Saharan Africa, infants born to women infected with the disease, and people who have sexual contact or share injection-drug equipment with an infected person. Those at greatest risk for hepatitis C include people who received a blood transfusion before 1992 (before implementation of blood screening for hepatitis C) and past or current injection drug users.

The committee noted that health care and social service providers generally have limited knowledge about the two conditions. Many of these providers fail to follow guidelines for screening patients and providing prevention, treatment, and follow-up services.

The committee made recommendations for improving surveillance, knowledge and awareness, immunization, and services for viral hepatitis. Highlights of these recommendations include:

▸ A complete evaluation by the Centers for Disease Control and Prevention of the national hepatitis B and C public health surveillance system.

▸ Coordination between CDC and key stakeholders to develop hepatitis B and C education programs for health care and social service personnel.

▸ Coordination between CDC and key stakeholders to develop innovative and effective programs to target at-risk populations and to increase awareness of hepatitis B and C among the general public.

▸ Vaccination of all neonates weighing at least 2,000 g and born to hepatitis B–positive women.

▸ Mandatory vaccination for hepatitis B as a requirement for school attendance.

▸ Studies to develop a vaccine for hepatitis C.

▸ Resources for the expansion of community-based programs that provide hepatitis B screening, testing, and vaccination services that target at-risk populations.

▸ A public awareness initiative, similar to the successful effort to increase recognition, prevention, and treatment of HIV/AIDS.

The report was developed in partnership with the Centers for Disease Control and Prevention Foundation, the Office of Minority Health, the Department of Veterans Affairs, and the National Viral Hepatitis Roundtable.

The Institute of Medicine is calling for increased awareness of hepatitis B and C among health care providers, social service providers, and at-risk communities as well as better surveillance and more stringent vaccination requirements nationwide in its newly released report on hepatitis and liver cancer.

“The committee believes that these recommendations will prevent further infections, improve the lives and health of infected individuals, and reduce the long-term burden of liver disease and liver cancer,” Dr. R. Palmer Beasley said during a teleconference sponsored by the National Academies of Science. Dr. Beasley chaired the IOM committee that wrote the report “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C” (available at www.iom.edu/viralhepatitis

“Although hepatitis B and C are preventable, the rates of infection have not declined over the past several years, underscoring the conclusion that we have allowed gaps in screening, prevention, and treatment to go unchecked,” Dr. Beasley said in a statement.

“This report outlines the additional resources and actions needed to reduce the unacceptably high burden of liver disease and cancer associated with these viruses,” said Dr. Beasley, who is a professor of epidemiology and disease control at the University of Texas in Houston.

It's estimated that 800,000 to 1.4 million Americans have chronic hepatitis B, and between 2.7 million and 3.9 million have chronic hepatitis C. Most are unaware that they are infected until they develop symptoms of liver cancer or liver disease.

The committee identified three major factors that impede current efforts to prevent and control hepatitis B and C:

▸ Lack of knowledge and awareness about chronic viral hepatitis on the part of health care and social service providers.

▸ Inadequate knowledge and awareness about chronic viral hepatitis among at-risk populations, members of the public, and policy makers.

▸ Insufficient understanding about the extent and seriousness of this public health problem that has led to the inadequate allocation of resources for prevention, control, and surveillance programs.

Perhaps the greatest difficulty in diagnosing and treating patients with hepatitis B and C is that these diseases are often asymptomatic.

In addition, minority groups—Asians, Pacific Islanders, and blacks—are at greatest risk. Those most at risk for hepatitis B include people born in East and Southeast Asia or sub-Saharan Africa, infants born to women infected with the disease, and people who have sexual contact or share injection-drug equipment with an infected person. Those at greatest risk for hepatitis C include people who received a blood transfusion before 1992 (before implementation of blood screening for hepatitis C) and past or current injection drug users.

The committee noted that health care and social service providers generally have limited knowledge about the two conditions. Many of these providers fail to follow guidelines for screening patients and providing prevention, treatment, and follow-up services.

The committee made recommendations for improving surveillance, knowledge and awareness, immunization, and services for viral hepatitis. Highlights of these recommendations include:

▸ A complete evaluation by the Centers for Disease Control and Prevention of the national hepatitis B and C public health surveillance system.

▸ Coordination between CDC and key stakeholders to develop hepatitis B and C education programs for health care and social service personnel.

▸ Coordination between CDC and key stakeholders to develop innovative and effective programs to target at-risk populations and to increase awareness of hepatitis B and C among the general public.

▸ Vaccination of all neonates weighing at least 2,000 g and born to hepatitis B–positive women.

▸ Mandatory vaccination for hepatitis B as a requirement for school attendance.

▸ Studies to develop a vaccine for hepatitis C.

▸ Resources for the expansion of community-based programs that provide hepatitis B screening, testing, and vaccination services that target at-risk populations.

▸ A public awareness initiative, similar to the successful effort to increase recognition, prevention, and treatment of HIV/AIDS.

The report was developed in partnership with the Centers for Disease Control and Prevention Foundation, the Office of Minority Health, the Department of Veterans Affairs, and the National Viral Hepatitis Roundtable.

The Institute of Medicine is calling for increased awareness of hepatitis B and C among health care providers, social service providers, and at-risk communities as well as better surveillance and more stringent vaccination requirements nationwide in its newly released report on hepatitis and liver cancer.

“The committee believes that these recommendations will prevent further infections, improve the lives and health of infected individuals, and reduce the long-term burden of liver disease and liver cancer,” Dr. R. Palmer Beasley said during a teleconference sponsored by the National Academies of Science. Dr. Beasley chaired the IOM committee that wrote the report “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C” (available at www.iom.edu/viralhepatitis

“Although hepatitis B and C are preventable, the rates of infection have not declined over the past several years, underscoring the conclusion that we have allowed gaps in screening, prevention, and treatment to go unchecked,” Dr. Beasley said in a statement.

“This report outlines the additional resources and actions needed to reduce the unacceptably high burden of liver disease and cancer associated with these viruses,” said Dr. Beasley, who is a professor of epidemiology and disease control at the University of Texas in Houston.

It's estimated that 800,000 to 1.4 million Americans have chronic hepatitis B, and between 2.7 million and 3.9 million have chronic hepatitis C. Most are unaware that they are infected until they develop symptoms of liver cancer or liver disease.

The committee identified three major factors that impede current efforts to prevent and control hepatitis B and C:

▸ Lack of knowledge and awareness about chronic viral hepatitis on the part of health care and social service providers.

▸ Inadequate knowledge and awareness about chronic viral hepatitis among at-risk populations, members of the public, and policy makers.

▸ Insufficient understanding about the extent and seriousness of this public health problem that has led to the inadequate allocation of resources for prevention, control, and surveillance programs.

Perhaps the greatest difficulty in diagnosing and treating patients with hepatitis B and C is that these diseases are often asymptomatic.

In addition, minority groups—Asians, Pacific Islanders, and blacks—are at greatest risk. Those most at risk for hepatitis B include people born in East and Southeast Asia or sub-Saharan Africa, infants born to women infected with the disease, and people who have sexual contact or share injection-drug equipment with an infected person. Those at greatest risk for hepatitis C include people who received a blood transfusion before 1992 (before implementation of blood screening for hepatitis C) and past or current injection drug users.

The committee noted that health care and social service providers generally have limited knowledge about the two conditions. Many of these providers fail to follow guidelines for screening patients and providing prevention, treatment, and follow-up services.

The committee made recommendations for improving surveillance, knowledge and awareness, immunization, and services for viral hepatitis. Highlights of these recommendations include:

▸ A complete evaluation by the Centers for Disease Control and Prevention of the national hepatitis B and C public health surveillance system.

▸ Coordination between CDC and key stakeholders to develop hepatitis B and C education programs for health care and social service personnel.

▸ Coordination between CDC and key stakeholders to develop innovative and effective programs to target at-risk populations and to increase awareness of hepatitis B and C among the general public.

▸ Vaccination of all neonates weighing at least 2,000 g and born to hepatitis B–positive women.

▸ Mandatory vaccination for hepatitis B as a requirement for school attendance.

▸ Studies to develop a vaccine for hepatitis C.

▸ Resources for the expansion of community-based programs that provide hepatitis B screening, testing, and vaccination services that target at-risk populations.

▸ A public awareness initiative, similar to the successful effort to increase recognition, prevention, and treatment of HIV/AIDS.

The report was developed in partnership with the Centers for Disease Control and Prevention Foundation, the Office of Minority Health, the Department of Veterans Affairs, and the National Viral Hepatitis Roundtable.