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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.
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.
Clinical information about Hepatitis C is quickly outdated, so Dr. Poordad has assembled expert authors to provide state-of-the-art clinjcal reviews for hepatologists. This issue is uniquely organized to present articles based on therapeutic regimens for certain types of patients: Regimens for the Treatment-Naïve Patient; Regimens for Treatment of the Interferon-Failure Patient; Regimens for DAA Failure Patients; Regimens for the Cirrhotic Patient; Regimens for the Peri-Transplant Patient; Regimens for the HIV-Co-Infected Patient; and Next-generation Regimens: The Future of HCV Therapy. This presentation will be very clinically relevant for the practicing hepatologist.
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.
Gastroenterology and Hepatology encompass a vast anatomic assortment of organs with diverse structure and function and the potential for affliction from a multiplicity of diseases. Completely covering these complex and interrelated systems, Mayo Clinic Gastroenterology and Hepatology Board Review provides an in-depth examination of essential knowledge in gastroenterology, hepatology, and the integral related areas of pathology, endoscopy, nutrition, and radiology. With contributions from experts at Mayo Clinic who are currently in clinical practice and have a strong commitment to teaching, the book assists physicians-in-training to prepare for the gastroenterology board examination.
Sixth edition of the hugely successful, internationally recognised textbook on global public health and epidemiology, with 3 volumes comprehensively covering the scope, methods, and practice of the discipline
This volume provides the reader with a detailed overview of the current state-of-the art approach of Hepatitis C management. It reviews the course of action in handling of chronic Hepatitis C patients with various HCV genotypes and treats special cases such as acute hepatitis, transplant and renal patients as well as people who inject drugs. The two volume work on Hepatitis C introduces to the topic by reviewing virology, diagnosis, epidemiology, prevention, management and elimination of HCV. The book provides a valuable source at full length for researchers and clinicians working on Hepatitis C.
There are over 180 million people with chronic HCV infection worldwide with between 2.7 and 3.9 million in the United States. Hepatitis C most significantly affects Asia and Africa, with rates up to 15% in countries such as Egypt and up to 30% in certain regions such as Punjab, Pakistan. Hepatitis C places a significant burden on the public health infrastructure, as it remains the leading cause of chronic liver disease, accounting for 50-75% of primary liver cancers and is responsible for 30% of all liver transplantations. It is estimated to have cost the United States $5.5 billion in 1997, comparable to the national cost of asthma, $5.8 billion in 1994.This number is only expected to grow as the current HCV population ages, increasing overall rates of compensated cirrhosis/end-stage liver disease. The evolution of directly acting anti-virals has ushered in a new era for chronic hepatitis C. Ongoing drug development strategy has involved targeting several replication steps of the virus and the hope is to see all oral therapies by late 2014 or early 2015. Thus we are at an exciting cross roads with regard to new information and challenges with HCV: rising disease burden with associated high costs, the challenges globally and in multiple patient populations, and the impending availability of effective and well tolerated treatments. Therefore there is a need to commission an exclusive issue of GCNA for HCV.
Alcohol abuse remains a significant problem world-wide. The most commonly affected organ remains the liver with a risk of alcoholic liver disease (ALD) which can range from asymptomatic to alcoholic hepatitis to alcoholic cirrhosis. In 2010, alcohol-attributable cirrhosis was responsible for 0.9% of all global deaths. Given the sheer magnitude of alcohol abuse and alcoholic liver disease, an update on this topic is pertinent and relevant. This issue will focus on a variety of topics including alcoholism, the pathogenesis of ALD, the spectrum of ALD, the pathology of ALD, and the long-term management of patients with ALD. Alcoholic hepatitis is a particular type of ALD with a high mortality. This issue will explore the syndrome of alcoholic hepatitis, its prognostic markers, and the available therapies. Because alcohol intake can influence so many other conditions of the liver (especially hepatitis C), articles in this issue will also explore the impact of alcohol abuse on other liver conditions. In addition, several other topics such as nutritional therapy for ALD, ALD and liver cancer, and ALD and infection risk will be explored. Also, even though it is quite controversial, we will also explore liver transplant as a therapy for alcoholic liver disease including alcoholic hepatitis.