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