titis C, to identify patients who may be at risk for these infections, and to test for chronic HBV and HCV infection in patients and their sexual, family, and household contacts in the case of hepatitis B and in drug-use networks in the case of hepatitis C. To address that issue, the committee offers the following recommendation:

Recommendation 3-1. The Centers for Disease Control and Prevention should work with key stakeholders (other federal agencies, state and local governments, professional organizations, health-care organizations, and educational institutions) to develop hepatitis B and hepatitis C educational programs for health-care and social-service providers.

Educational programs and materials for health-care and social-service providers should focus on improving provider awareness and adherence to practice guidelines for hepatitis B and hepatitis C. The educational programs should be targeted to primary care providers, appropriate social-service providers (such as staff of drug-treatment facilities and immigrant-services centers), and licensed and unlicensed alternative-medicine professionals (such as acupuncturists and traditional Chinese medicine practitioners) that serve at-risk populations. At-risk populations include foreign-born people from HBV- or HCV-endemic countries, clients of sexually-transmitted-disease (STD) clinics and HIV clinics, IDUs, others at risk because of a history of percutaneous exposures, and close contacts of people who have chronic hepatitis B and chronic hepatitis C.

The educational programs should include at least the following components:

  • Information about the prevalence and incidence of acute and chronic hepatitis B and hepatitis C both in the general US population and in at-risk populations, particularly foreign-born populations in the case of hepatitis B, and IDUs and incarcerated populations in the case of hepatitis C.

  • Guidance on screening for risk factors associated with hepatitis B and hepatitis C.

  • Information about hepatitis B and hepatitis C prevention, hepatitis B immunization, and medical monitoring of chronically infected patients, specifically,

    • Information about methods of testing and interpretation of results.

    • Information about medical management and long-term care:

      • How to select candidates for antiviral therapy.

      • Importance of liver-cancer screening.

      • When to refer patients to a specialist.

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