Improved prevention, screening and treatment could help eliminate hepatitis B and C as serious public health problems in the United States and save nearly 90,000 lives by 2030, according to a new report.
About 1.3 million people in the United States have chronic hepatitis B and about 2.7 million have chronic hepatitis C. These infections cause about 80 percent of liver cancer cases worldwide.
Liver cancer incidence in the United States rose 38 percent between 2003 and 2012. Liver cancer deaths increased 56 percent during that time, primarily due to viral hepatitis, according to the report from the National Academies of Sciences, Engineering, and Medicine.
“Viral hepatitis is simply not a sufficient priority in the United States,” said report committee chair Dr. Brian Strom, chancellor and professor at Rutgers University Biomedical and Health Sciences in Newark, N.J.
“Despite being the seventh leading cause of death in the world — and killing more people every year than HIV, road traffic accidents or diabetes — viral hepatitis accounts for less than 1 percent of the [U.S.] National Institutes of Health research budget,” Strom said in an academies news release.
Hepatitis B is spread through body fluids, such as through sexual contact or sharing IV drug equipment. It could also be passed from an infected woman to her baby at birth.
Hepatitis C is also spread by blood contact, and most people are infected by sharing needles and other types of drug equipment, according to the U.S. Centers for Disease Control and Prevention.
There is a vaccine for hepatitis B, and hepatitis C can be cured with short courses of medicines, the report said.
The number of U.S. deaths from hepatitis B could be halved by 2030 if:
- 90 percent of chronic hepatitis B patients were diagnosed,
- 90 percent of diagnosed patients received care,
- 80 percent of patients who needed treatment got it.
These measures would prevent more than 60,000 deaths and also reduce liver cancer and cirrhosis from hepatitis B infection by about 45 percent, the report said.
Treating all U.S patients with chronic hepatitis C would lead to:
- A 90 percent decrease in new infections by 2030,
- A 65 percent reduction in hepatitis C deaths,
- 28,000 fewer deaths by 2030.
However, eliminating hepatitis B and C as serious public health threats in the United States by 2030 requires aggressive testing, diagnosis, treatment and prevention methods, such as needle exchange, the report said.
The report authors said a coordinated federal effort is needed. They recommended the expansion of syringe exchange for injection drug users, free access to the hepatitis B vaccine in pharmacies and other easily accessible places, and unrestricted treatment for everyone with hepatitis C.
Medicines to cure chronic hepatitis C are expensive — about $90,000 for a full course per patient. One way to make them more affordable is to create voluntary licensing agreements between the federal government and patent-holding drug makers, the report said.
The report committee also recommended testing and vaccinating for hepatitis B in prisons. The authors also said prisoners should be tested and treated for hepatitis C infections. They noted that the burden of hepatitis infections is high in prisons.
The U.S. Centers for Disease Control and Prevention has more on viral hepatitis.