Arun Sanyal, M.D., Professor of Medicine at Virginia Commonwealth

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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:
– B:
– C:
– D:
acute illness
both acute and chronic
chronic illness
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
THE CHOICE IS CLEAR
Status quo
• Detect disease late
•High cost of care
•Loss of workforce
•Disruption of family
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