Viral Hepatitis Can Be Eliminated If It Is a Top Priority

Viral Hepatitis Can Be Eliminated If It Is a Top Priority

Scientists' interim report cites cost and logistics as barriers to ending “silent killer” in U.S.

Viral hepatitis will only be eliminated in the U.S. if it is made a stronger priority, according to an interim report by the National Academies of Sciences, Engineering, and Medicine.

Approximately 20,000 people die in the U.S. each year from viral hepatitis, often referred to as a “silent killer” and given significantly less attention than other potentially fatal diseases.

Image of Brian Strom, RBHS chancellor
Brian L. Strom, chancellor, Rutgers Biomedical and Health Sciences, heads the National Academies of Sciences, Engineering, and Medicine committee studying how viral hepatitis can be eliminated.
Photo: Nick Romanenko/Rutgers University
“These deaths could be averted,” said Brian L. Strom, a renowned epidemiologist and the chancellor of Rutgers Biomedical and Health Sciences, who heads a committee of scientists selected by the Academies to study the issue. “The world has the tools to prevent hepatitis B and cure hepatitis C, which in turn could prevent most liver cancer.”

“But the barriers to elimination of hepatitis B and C are consequences of a more basic problem – that viral hepatitis is simply not a public priority in the U.S.,” Strom said.

That could change soon. In May, the World Health Assembly will consider a resolution setting broad global targets of 90 percent reduction in the incidence of viral hepatitis and 65 percent reduction in its mortality by 2030.

“The United States has both an opportunity and a responsibility to be part of the global action against viral hepatitis,” Strom said. The committee’s report is summarized today in the Annals of Internal Medicine.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) account for most of the world’s chronic viral hepatitis. HBV vaccine now results in 95 percent immunity, while new antiviral drugs can eliminate HCV infection in more than 90 percent of chronically infected patients, Strom explained. 

“Taken together, these advances have encouraged global momentum for action against viral hepatitis,” Strom said.

While the committee’s next report in the spring of 2017 will recommend actions to eliminate viral hepatitis as a major U.S. health threat, Strom noted that the current barriers to doing so relate to logistics and cost.

“The HBV vaccine makes it possible to interrupt horizontal transmission of the virus, but ending transmission would require immunization of every susceptible person in a population,” he said. “As for hepatitis C, the costs of curative drugs have made this strategy impractical.”

The report said, "Because most cases are imported, U.S. support of vaccination efforts in other countries would be a wise investment in reducing the future burden of hepatitis B in the United States."

Complicating the issue is the fact that most people chronically infected with viral hepatitis are unaware of their condition.

The report notes that though eliminating viral hepatitis as a major health threat is a challenging goal, the committee believes the goal is attainable.

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