Activity

Prevention and Control of Viral Hepatitis Infections in the United States


Type: Consensus Study
Topics: Diseases, Public Health
Board: Board on Population Health and Public Health Practice

Activity Description

The Institute of Medicine has formed a committee to determine ways to reduce new hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and the morbidity and mortality related to chronic viral hepatitis. The committee is assessing current prevention and control activities and identifying priorities for research, policy, and action. The committee will highlight issues that warrant further investigations and opportunities for collaboration between private and public sectors. In conducting its work, the committee will consider:

1. Strategies for preventing new HBV and HCV infections:

  • Improving vaccine coverage among vulnerable populations to reach national transmission elimination goals. 
  • Increasing the proportion of persons aware of their chronic infection status.
  • Identifying barriers to the identification, counseling, and testing of persons at risk for chronic hepatitis, and ways they can be reduced and eliminated. 
  • Promoting prevention among adolescents and adults who engage in risky behaviors, particularity those known to have screened positive for HCV and HBV infection. 
  • Determining optimal ways to identify, develop, and implement prevention programs among at-risk populations.
  • Development of an effective HCV vaccine.  

2. Strategies for reducing morbidity and mortality from chronic HBV and HCV infections:

  • Providing appropriate medical referral, evaluation and management of chronically-infected persons.
  • Assessing health-care utilization and outcomes for persons with chronic infections, and opportunities for prevention and care to reduce health care-related costs. 
  • Reducing health disparities in morbidity and mortality from viral hepatitis. 
  • Improving clinical surveillance of markers of disease progression and stage of hepatocellular carcinoma associated with chronic viral hepatitis and associated cirrhosis. 

3. Assess the type and quality of data needed from state and local viral hepatitis surveillance systems to guide and evaluate prevention services:

  • Assess the role of acute disease surveillance in monitoring new infections, detecting outbreaks, identifying vaccine failures and documenting the elimination of HBV transmission.
  • Assess the role of state and local chronic disease surveillance in describing the burden of morbidity and mortality related to chronic hepatitis B and hepatitis C and related liver cirrhosis and cancer, the extent of ongoing risk behaviors, and the impact of HIV co-infection and other cofactors.
  • Assess the role of state and local disease registries in the delivery of prevention and care services for persons with chronic hepatitis B and persons with hepatitis C.
  • Assess the role of laboratory testing strategies for the identification of markers for acute HCV infection.
  • Assess laboratory testing strategies for identification of antiviral resistance for HBV and HCV.

Finally, the committee will pay attention to addressing the special needs of specific subpopulations at high risk, such as Asian Americans, African Americans, and persons born in HBV endemic countries.

 

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