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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.
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.
Saliva Protection and Transmissible Diseases provides a review of saliva protection, raising debate on micro-organisms potentially transmissible in saliva, and also considering the evidence on diseases that may be transmitted by kissing. Saliva is a complex body fluid essential to health, especially mastication, swallowing and speech, and hyposalivation can lead to dysfunction and even infection. More serious pathogens, such as herpes viruses and papillomaviruses can be conveyed by kissing, as can potentially lethal micro-organisms present in some saliva, such as meningococci, fungal organisms and Ebola viruses. - Stipulates the defensive roles of saliva, an important topic not previously reviewed in-depth in literature - Provides awareness that saliva also transmits infectious agents that can produce serious or even lethal diseases - Gives understanding that kissing may be an at-risk practice
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.
Essential Concepts in Molecular Pathology, Second Edition, offers an introduction to molecular genetics and the "molecular" aspects of human disease. The book illustrates how pathologists harness their understanding of these entities to develop new diagnostics and treatments for various human diseases. This new edition offers pathology, genetics residents, and molecular pathology fellows an advanced understanding of the molecular mechanisms of disease that goes beyond what they learned in medical and graduate school. By bridging molecular concepts of pathogenesis to the clinical expression of disease in cell, tissue and organ, this fully updated, introductory reference provides the background necessary for an understanding of today's advances in pathology and medicine. - Explains the practice of "molecular medicine" and the translational aspects of molecular pathology, including molecular diagnostics, molecular assessment and personalized medicine - Orients non-pathologists on what pathologists look for and how they interpret their observational findings based on histopathology - Provides the reader with what is missing from most targeted introductions to pathology—the cell biology behind pathophysiology
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 second of two, builds off the conclusions of the first report and outlines a strategy for hepatitis reduction over time and specific actions to achieve them.
Individuals who donate their blood provide a unique and precious gift in an act of human solidarity. In order to donate blood, prospective donors should be in good health and free from any infections that can be transmitted through transfusion. Most blood donors perceive themselves to be healthy, but some are unsuitable to donate blood due to the potential risk of compromising or worsening their own health or the risk of transmission of infections to patients. Blood transfusion services (BTS) have a duty of care towards blood donors as well as to the recipients of transfusion. This duty of care extends to prospective donors who are deferred from donation--whether on a temporary or permanent basis--as well as those who donate blood and are subsequently found to have unusual or abnormal test results. BTS have a responsibility to confirm test results and provide information, counseling and support to enable these individuals to understand and respond to unexpected information about their health or risk status. Counseling is part of the spectrum of care that a BTS should be able to provide to blood donors--including referral to medical practitioners or specialist clinical services. Pre-donation counseling was recognized as one element of the strategy to reduce and, if possible, prevent the donation of blood by individuals who might be at risk for HIV and other TTI including hepatitis B and C viruses as well as to inform the donor of the donation process and testing of blood for HIV. Post-donation counseling was acknowledged to be a necessary element of donor management as an adjunct to informing donors of unusual or abnormal test results. Blood donor counseling by trained specialist staff is now considered to be a key component of the blood system in most countries with a well-developed blood transfusion service. It may be required at a number of stages in the blood donation process or following blood screening and should be available at any point at which the BTS has an interface with donors. In many countries, however, blood donor counseling is not yet available in a structured way. Blood Donor Counselling: Implementation Guidelines has therefore been developed to provide guidance to blood transfusion services that have not yet established donor counseling programs.
Chronic hepatitis C is a major worldwide health problem affecting more than 170 million people. Chronic infections lead to cirrhosis and liver failure or hepatocellular cancer in many instances. This volume includes comprehensive reviews that cover much of the vast literature that has appeared since the identification of the hepatitis C virus RNA genome. It will be an invaluable collection for anyone wanting an up-to-date picture of HCV transmission, molecular virology, immune response, cellular/molecular pathogenesis, and possible avenues for developing effective new therapeutics and vaccines.
This volume is composed of chapters that review important fundamental aspects of HCV biology and disease pathogenesis including, for example, the discovery and identification of the HCV genome, early virus-cell interactions including identification of various cellular receptors, HCV gene expression studied using the HCV replicon system, identification and characterization of HCV structural- and non-structural HCV proteins, HCV replication in cultured cells, and host factors involved in viral replication. This volume also contains chapters dealing with immunity to HCV infection and pathogenesis. This is particularly important in understanding hepatitis C because HCV infection alone is not cell lytic. Mechanisms underlying the persistent nature of HCV infection are also discussed in these chapters. Many of the authors published articles that were listed among the “top 10 papers” published in the 24 years since HCV was discovered in 1989. Their citations are above 1,000 (Web of Science). The authors describe the background and significance of their contributions to the field in the context of findings from other research groups.