Hepatitis B and C: A silent but deadly epidemic

Arun J Sanyal M.D.

Charles Caravati Professor of Medicine

Virginia Commonwealth University

Richmond, Virginia

Hepatitis B and C: Basic information

• Virus infections of the liver:– A: acute illness– B: both acute and chronic– C: chronic illness– D: dual infection- B and D have to co-exist

• Hepatitis B and C affect 5.3 million Americans

Hepatitis B and C is everyone’s problem

• Who has it?– Seen in all segments of

society– Some segments more at

risk: Immigrants, Asians, African-Americans

• How do you get it?– Exposure of contaminated

blood– Sexual exposure– ? Unknown

What happens if you don’t diagnose hepatitis B or C in time?

• Progression to cirrhosis:– liver failure– internal bleeding– brain malfunction– kidney failure

– cancer• Other medical problems:

– diabetes– kidney disease

Why the status quo is unacceptable

• Disease diagnosed late in its course• Treatment options are more limited• Treatment not tolerated as well• Greater impact on family• More days of work loss• Greater cost of care• Strains the ability of small businesses to afford

health care for its employees and their families

Why is the situation particularly tragic ?

• Risk factors for viral hepatitis are well known

• A highly effective vaccine for hepatitis B exists

• Tests to diagnose the disease are available and are being improved upon- and should allow point of care testing

• Highly effective treatments for both hepatitis B and C are available and getting better

Impediments to reducing the burden of viral hepatitis

• Lack of knowledge and awareness• Lack of adequate screening, surveillance and

reporting of viral hepatitis• Lack of effective immunization strategies• Lack of health services related to viral hepatitis

in general-especially detection and treatment

The choice before us today

Healthy people• immunize• educate• screen• identify and treat• surveillance

Status quo• Detect disease late•High cost of care•Loss of workforce•Disruption of family

THE CHOICE IS CLEAR