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.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON A NATIONAL STRATEGY FOR THE ELIMINATION OF HEPATITIS B AND C
• Reviewers
• Acknowledgments
• Preface
• Acronyms and Abbreviations
• Summary,
  • TARGETS FOR ELIMINATION
  • PUBLIC HEALTH INFORMATION
  • ESSENTIAL INTERVENTIONS
  • SERVICE DELIVERY
  • FINANCING ELIMINATION
  • RESEARCH
• 1. Introduction
  • THE CHARGE TO THE COMMITTEE
  • HEPATITIS AND LIVER CANCER
  • REFERENCES
• 2. Targets for Elimination
  • HEPATITIS B MODELS
  • HEPATITIS C MODELS
  • A CENTRAL COORDINATING OFFICE
  • REFERENCES
• 3. Public Health Information
  • DESCRIBING THE VIRAL HEPATITIS EPIDEMIC
  • REFERENCES
• 4. Essential Interventions
  • PREVENTION AND TESTING
  • CARE AND TREATMENT
  • REFERENCES
• 5. Service Delivery
  • ENCOURAGING COMPLIANCE AMONG PROVIDERS
  • REACHING PATIENTS
  • REFERENCES
• 6. Financing Elimination
  • AN INCREASED PATIENT BURDEN
  • A PURCHASING STRATEGY FOR MEDICINES
  • REFERENCES
• 7. Research
  • RESEARCH ACROSS THE CARE CONTINUUM
  • REFERENCES
• APPENDIXES
  • Appendix A. Population Health Impact and Cost-Effectiveness of Chronic Hepatitis B Diagnosis, Care, and Treatment in the United States
    Mehlika Toy.
  • Appendix B. Modeling the Elimination of Hepatitis C in the United States
    Homie Razavi.
  • Appendix C. Public Meeting Agenda
  • Appendix D. Committee Biographies

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2017. A national strategy for the elimination of hepatitis B and C: Phase two report. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24731.