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