Experts say there’s real hope in someday ridding the United States of the “public health problem” of hepatitis B and C infection.
The two viral strains cause serious, often fatal, liver disease for tens of thousands of Americans each year.
The comprehensive new report is from a panel of experts at the U.S. National Academies of Sciences, Engineering, and Medicine. They believe that the advent of a powerful new vaccine and medicines could help drastically lower hepatitis B and C rates across the country.
Still, to reach that goal will take time and considerable resources, the report said.
“Ending illness and deaths from hepatitis C depends on both stopping the disease’s progression in its early stages and reversing the course of advanced disease,” the committee said in a news release.
According to the report, between 700,000 and 1.4 million Americans have chronic hepatitis B, and between 2.5 million and 4.7 million have chronic hepatitis C. Between them, the two viruses kill about 20,000 people a year in the United States.
Eliminating hepatitis B and C as a public health problem is not the same as completely eliminating them from the country, the panel stressed. Instead, it means stopping their transmission in the United States and preventing signs and symptoms of the disease in people who are still infected.
Hepatitis B can be transmitted from an infected mother to child, through contact with infected blood and through unprotected sex with an infected person.
Transmission in the United States can be halted with universal immunization of children and adults, according to the report. The three-dose vaccine provides long-lasting, 95 percent immunity. And while current treatments do not cure hepatitis B infection, they do prevent disease progression and deaths from cirrhosis and liver cancer.
Hepatitis C is transmitted through contact with infected blood (for example, through needle-sharing) and less often through unprotected sex or from an infected mother to child. There is no vaccine for hepatitis C, so preventing transmission is vital, the experts said.
People born between 1945 and 1965 account for the majority of Americans with chronic hepatitis C, but most new infections are occurring among injection drug users. Hepatitis C can be cured, however, and curing infected injection drug users could reduce transmission and lower disease rates between 20 and 80 percent.
However, outreach and intervention involving injection drug users is challenging, the report acknowledged.
Some research suggests that programs such as needle exchanges might help reduce hepatitis C transmission among injection drug users. Efforts to curb drug addiction rates could also lower hepatitis C rates, the report said.
The report is the first of two. The second, scheduled for release in early 2017, will outline ways to achieve the goals listed in this report, which also outlined a number of barriers to eliminating this public health problem.
One barrier is that most state and local health offices can’t identify hepatitis B and C infections, the report’s authors said. Another barrier is that about two-thirds of Americans with chronic hepatitis B and half of those with chronic hepatitis C do not know they are infected because both diseases do not cause symptoms until the later stages.
Stigma about the hepatitis-linked diseases can also prevent people from getting testing and receiving care. Also, the report notes that most new cases of chronic hepatitis B in the United States occur in foreign-born people, who may face language or social problems in seeking care.