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The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care. Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood. Hepatitis and Liver Cancer identifies missed opportunities related to the prevention and control of HBV and HCV infections. The book presents ways to reduce the numbers of new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis. It identifies priorities for research, policy, and action geared toward federal, state, and local public health officials, stakeholder, and advocacy groups and professional organizations.
Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide. The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report.
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to receive the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviors and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination. These are the first WHO guidelines on testing for chronic HBV and HCV infection and complement published guidance by WHO on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. These guidelines outline the public health approach to strengthening and expanding current testing practices for HBV and HCV, and are intended for use across age groups and populations.
Chronic viral hepatitis has emerged as one of the most common causes of disease and death worldwide. Because of their unique modes of replication and intimate association with the host immune system, hepatitis B virus (HBV) and hepatitis C virus (HCV) pose challenging problems to scientists in basic and applied research as well as to clinicians engaged in disease management. Although approved antiviral therapy is available for chronic HBV, the emergence of viral resistance provides a rationale for the development of novel chemotherapeutic agents. The lack of a robust cell culture system for HCV replication and a readily accessible small-animal model of HCV infection have hampered the development of antiviral agents for HCV. Neverthe-less, new antiviral agents targeting HCV are now in preclinical and clinical development. This monograph, providing an up-to-date overview of the field of Hepatitis Prevention and Treatment, includes contributions from internationally recognized experts in the field of viral hepatitis, and covers the current state of knowledge and practice regarding the molecular biology, immunology, biochemistry, pharmacology and clinical aspects of chronic HBV and HCV infection. The volume includes salient topics such as: the history and epidemiology of HBV and HCV; recent insights into the molecular mechanisms of viral replication; the host immune response to infection and a discussion of the use (HBV) or potential development (HCV) of vaccines; the current standard of care for chronically-infected patients; and emerging therapies and issues associated with current antiviral treatments. The latest information to researchers and clinicians actively engaged in viral hepatitis research is provided, but also sufficient background and discussion of the literature to benefit the newcomer to the field.
THE ESSENTIAL WORK IN TRAVEL MEDICINE -- NOW COMPLETELY UPDATED FOR 2018 As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, practical information about the health challenges posed by travel has never been greater. For both international travelers and the health professionals who care for them, the CDC Yellow Book 2018: Health Information for International Travel is the definitive guide to staying safe and healthy anywhere in the world. The fully revised and updated 2018 edition codifies the U.S. government's most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts. The 2018 Yellow Book also addresses the needs of specific types of travelers, with dedicated sections on: · Precautions for pregnant travelers, immunocompromised travelers, and travelers with disabilities · Special considerations for newly arrived adoptees, immigrants, and refugees · Practical tips for last-minute or resource-limited travelers · Advice for air crews, humanitarian workers, missionaries, and others who provide care and support overseas Authored by a team of the world's most esteemed travel medicine experts, the Yellow Book is an essential resource for travelers -- and the clinicians overseeing their care -- at home and abroad.
Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.
This book provides a comprehensive, state-of-the art review of HBV infection and liver disease. It discusses new data on basic and translational medicine, including the viral life cycle, the immunopathogenesis of virus-induced chronic hepatitis, viral and host genetic factors affecting disease progression, and the mechanism of virus-induced hepatocarcinogenesis, as well as their potential applications in daily clinical practice. The clinical aspects of chronic HBV infection are examined in chapters on the global epidemiology, efficacy of HBV vaccination, natural history, co-infections with HCV, HDV or HIV, and management of special populations including children, pregnant women and patients undergoing immunosuppressive therapy. Further, it describes the advances and perspectives in the development of novel antiviral treatments as possible cures for HBV infection. The book is a valuable resource for medical students, physicians, and researchers who are interested in managem ent of patients with chronic HBV infection and investigation of HBV infection.
This book presents a comprehensive collection of classic cases and problem scenarios encountered as bedside case discussions during ward rounds. It facilitates the practical management of hepatic disorders. The unique aspect of hepatology involves the blend of the basic tenet of clinical medicine applied to liver disease and a multitude of interventional modalities in the management of liver, biliary, and pancreatic diseases. This book takes the reader through the process of ruling in and ruling out possibilities based on clinical data (history and examination) and then traces the logical trajectory of each case from recommended investigations to the analysis of test results and finally to making a syndromic diagnosis. By adopting an evidence-based approach, the book emphasizes analytical and need-based studies to exclude any mimics. This book helps practice hepatologists and gastroenterologists for a systematic approach towards the most common cases.
This book assembles recent achievements in both basic research and clinical management in the field of hepatology, virology and immunology. It provides up-to-date information for clinicians who can apply the relevant knowledge to their daily clinical practice and for researchers who are interested in clinically orientated studies. The updated and detailed technology, state-of–the-art treatment strategies provided in this book serve as references for clinicians and resident physicians in the daily management of ACLF. The rationality and strategies for basic research as well as patient management in this book can also be a valuable reference for other fatal and end stage liver diseases than HBV induced ACLF. This Volume 2 has 6 chapters and focuses on its diagnosis and management.
In early 2013, WHO convened an expert group of scientists from 14 collaborating research institutions to update the assessment of the burden of diarrhoeal disease from inadequate water, sanitation and hygiene (WASH) and to reassess the effectiveness of WASH interventions. This group considered evolving and alternative methods for assessing the burden of disease and agreed on a rigorous new approach using meta-regression. In deriving the new figures, the experts incorporated the latest data on use of improved water and sanitation with minor adjustments, and drew upon the results from two new global reviews on microbial water quality and of handwashing practices specially prepared as part of this effort. This document outlines the latest research on the burden of diarrhoea related to inadequate water, sanitation and hygiene (WASH). It is based on a series of articles published in the scientific literature. In bringing together current evidence on exposure to unsafe drinking-water, inadequate sanitation and hygiene, alongside the most up-to-date analysis on the health impacts of interventions, this document contributes to informed policymaking and targeting of resources. It underscores how further progress can be achieved in this unfinished global water and sanitation and health agenda.