Today, the National Academies of Sciences, Engineering, and Medicine released the second phase of a report on eliminating viral hepatitis in the United States. The report, Eliminating the Public Health Problem of Hepatitis B and C in the United States, provides a U.S. strategy for eliminating hepatitis B and hepatitis C virus infection and the disease and mortality caused by these agents as public health threats by 2030. The report sets out elimination goals for the nation and a practical set of recommendations to scale up current prevention activities and focuses on five areas: (1) public health information; (2) essential interventions; (3) service delivery; (4) financing elimination; and (5) research.
Results from phase-one, released in April 2016, examined the feasibility of ending the transmission of hepatitis B and C in the U.S. and preventing further sickness and deaths from the diseases. The phase-one report concluded that eliminating hepatitis B and C in the United States is feasible, but it will take considerable will and resources. In the short term, it is feasible to control hepatitis B and C by reducing their incidence and prevalence.
The phase-two report outlines some key targets for the larger goal of eliminating the public health problem of hepatitis B and hepatitis C in the U.S. by 2030:
- A 50% reduction in mortality from hepatitis B (compared to 2015) is possible in the U.S. by 2030.
- Meeting this goal will require diagnosing 90% of chronic hepatitis B cases, bringing 90% of those to care, and treating 80% of those for whom treatment is indicated.
- A 90% reduction in incidence of hepatitis C is possible in the U.S. by 2030.
- Meeting this goal will require treatment without restrictions and a consistent ability to diagnose new cases.
- A 65% reduction in mortality from hepatitis C (compared to 2015) is possible by 2030.
Millions of Americans are living with viral hepatitis, and more than half don’t know they have the virus. Thus, they are at risk for life-threatening liver disease and cancer and unknowingly transmitting the virus to others. It is estimated that 3.5 million people are living with hepatitis C in the United States and 850,000 people are living with hepatitis B.
Viral hepatitis is especially a concern for racial and ethnic minority populations. According to the U.S. Department of Health and Human Services National Viral Hepatitis Action Plan 2017 – 2020:
- Asian Americans and Pacific Islanders (AAPI) are the racial/ethnic group that is most heavily affected by hepatitis B virus; they comprise about 5% of the U.S. population but comprise about half of all persons living with hepatitis B.
- An estimated one in 12 AAPIs is living with hepatitis B infection. However, as many as two of three hepatitis B-infected AAPIs do not know they are infected because they have not been tested.
- Africans Americans comprise approximately 11% of the U.S. population, but comprise 25% of people in the U.S. with chronic hepatitis C infections.
- African Americans have higher rates of infection and hepatitis C-related death compared with the overall population.
- African Americans aged 60 and older are 10 times more likely to be chronically infected with hepatitis C compared to other races.
- American Indian and Alaska Native (AI/AN) people are the racial/ethnic group with both the highest rates of acute hepatitis C infection as well as hepatitis C-related deaths. The AI/AN HCV-related death rate is more than double the national rate. Hepatitis C-related hospitalizations among AI/AN people more than tripled from 1995 to 2007.
The U.S. Department of Health and Human Services (HHS) Office of Minority Health thanks the National Academies for this vital report, which was sponsored by CDC’s Division of Viral Hepatitis and Division of Cancer Prevention and Control, HHS Office of Minority Health, American Association for the Study of Liver Diseases, Infectious Diseases Society of America, and National Viral Hepatitis Roundtable.
To view the full report, click here:
org/hmd/reports/2017/national- strategy-for-the-elimination- of-hepatitis-b-and-c.aspx