Despite federal, state, and local public health efforts to prevent and control hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, these diseases remain serious health problems in the United States. About 1%-2% of the U.S. population has chronic HBV or HCV infections, and each year about 15,000 people die from liver cancer or liver disease related to these preventable infections. The Institute of Medicine formed an expert committee to determine ways to reduce new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis and released its findings in a report. The major factor found to impede current efforts to prevent and control HBV and HCV is lack of knowledge and awareness about these diseases among healthcare and social-service providers, members of the public, and policy makers. Because the extent and seriousness of this public health problem is not appreciated, inadequate resources are being allocated to prevention, control, and surveillance programs. This situation has led to continued transmission of HBV and HCV and inadequate identification of and medical management for chronically infected people. Conclusion: To address the situation, the Institute of Medicine report makes recommendations in four areas: improved surveillance for HBV and HCV; improved knowledge and awareness among healthcare and social-service providers and the public, especially at-risk people; improved HBV vaccine coverage; and improved viral hepatitis services and access to those services. (HEPATOLOGY 2010;51:729-733)
Up to 5.3 million people-2 percent of the U.S. population-are living with chronic hepatitis B or hepatitis C. These diseases are more common than HIV/ AIDS in the U.S. Yet, because of the asymptomatic nature of chronic hepatitis B and hepatitis C, most people who have them are unaware until they have symptoms of liver cancer or liver disease many years later. Each year about 15,000 people die from liver cancer or liver disease related to hepatitis B and hepatitis C. Hepatitis B and hepatitis C can be either acute or chronic. The acute form is a short-term illness that occurs within the first six months after a person is exposed to hepatitis B virus (HBV) or hepatitis C virus (HCV) which cause hepatitis B and hepatitis C, respectively. The diseases can become chronic, although this does not always happen and, particularly in the case of hepatitis B, the likelihood of this becoming a chronic disease depends on a person's age at the time of infection. Although the number of people with acute hepatitis B is declining in the U.S., mostly because of the availability of hepatitis B vaccines, about 43,000 people still develop acute hepatitis B each year. People at risk for hepatitis B include infants born to women with the disease and those who have sexual contact or share injection drug equipment with a person with the disease. People who received a blood transfusion before 1992 and past or current injection-drug users are at risk for chronic hepatitis C. In 2008, the Institute of Medicine convened a committee to assess current prevention and control activities for hepatitis B and hepatitis C and to determine ways to reduce new cases of HBV and HCV infections and illnesses and deaths from chronic viral hepatitis. The committee concludes that chronic. .. because of the asymptomatic nature of chronic hepatitis B and hepatitis C, most people who have them are unaware until they have symptoms of liver cancer or liver disease many years later. The Institute of Medicine serves as adviser to the nation to improve health. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policy makers, health professionals, the private sector, and the public.
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