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Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
safety of the hepatitis B vaccine, and the findings are expected to be available in 2011.
The committee that wrote the present report met five times in the period December 2008–August 2009. During the meetings, the committee evaluated the evidence and deliberated on issues relevant to its charge. Types of evidence taken into consideration included international, federal, state, and community guidelines, programs, and other activities aimed at preventing new cases of HBV and HCV infection, identifying chronic cases of hepatitis B and hepatitis C, and managing those cases. It also explored federal and state surveillance mechanisms for identifying and tracking hepatitis B and hepatitis C cases. The committee began by identifying problems with and gaps in the current prevention and control systems. It also examined model programs for other infectious diseases, such as those covered under the Ryan White CARE Act (Health Resources and Services Administration, 2009). The committee developed evidence-based recommendations to address the problems with the current systems to reduce the numbers of new HBV and HCV infections, to manage the care of chronically infected people more effectively by reducing morbidity and mortality, and to improve surveillance of chronic hepatitis B and hepatitis C cases.
The committee focused on making recommendations that could be implemented with existing knowledge and available tools to advance prevention and control of chronic viral hepatitis in a timely manner. Although the committee recognizes the importance of basic research in this field, it believes that given the scope of the problem and the lack of available resources, its focus should be on improving prevention and control services. As a result, the committee did not address basic-research questions in the field extensively. Nor did it conduct cost–benefit analyses of its recommendations.
The committee’s general approach is presented in Figure 1-2. After defining the scope of the problem and reviewing the available evidence, the committee identified the primary underlying factors that impede current efforts to prevent and control hepatitis B and hepatitis C. The committee believes that a lack of awareness about viral hepatitis among both the general public and health-care and social-service providers is leading to continued high rates of morbidity and mortality from hepatitis B and hepatitis C. Consistent themes were found in all the materials reviewed by the committee; as a result, this report is organized according to four principal categories: