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Division of Viral Hepatitis (DVH) strategic plan, 2016–2020 : bringing together science and public-health practices for the elimination of viral hepatitis
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2/26/16
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Description:Viral hepatitis takes a tremendous toll on the lives of many persons in the United States and globally, particularly hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. In the United States, as many as 5.7 million persons are living with HBV or HCV infection, which together are major causes of chronic liver disease and liver cancer. At least half of the persons living with hepatitis B or hepatitis C do not know they are infected. Only through testing and knowledge of infection status can these persons receive the care and treatment that can vastly improve health outcomes. Of particular concern is the annual number of HCV-associated deaths. In 2013, the number of HCV-associated deaths exceeded the number of deaths from all other nationally notifiable diseases combined. This increased mortality is occurring at a time when all-oral curative therapies for HCV are available. Licensed therapies are capable of curing more than 90% of HCV-infected persons who complete treatment, yet without treatment, one in three persons currently living with hepatitis C would die of HCV-related complications. Also concerning is the more than 150% increase in the number of new HCV infections reported from 2010–2013, mostly among adolescents and young adults. In 2013 and for the first time since 1990, the number of new cases of HBV infections rose as a result of increased transmission among persons who inject drugs (PWID) and those with other HBV-related risks. Despite recommendations for routine screening of pregnant women for HBV and hepatitis B vaccination of infants beginning at birth, cases of mother-to-child transmission of HBV continue to occur. Of infants infected at the time of birth, 90% develop chronic HBV infection. Left undiagnosed and untreated, nearly one in four of these infants will develop serious liver problems, including liver cancer. Similar to other infections, certain U.S. populations with chronic viral hepatitis are affected disproportionately. For example, two of three Asian Americans are unaware they are living with hepatitis B, and while Asian Americans represent less than 5% of U.S. population, they are estimated to account for more than one half of all cases of chronic HBV infection. With respect to hepatitis C, at least 50% of persons born 1945-1965 do not know they are living with HCV infection; African Americans comprise less than 11% of the population born 1945-1965, but 25% are estimated to be infected with HCV. Of particular concern are recent data that show certain groups are disproportionately dying with viral hepatitis, including Asians/Pacific Islanders and persons aged 55-64 years with hepatitis B, and American Indians/Alaska Natives and persons aged 55-64 years with hepatitis C. Persons born during 1945-1965, most of whom were infected before HCV was discovered in 1989, account for more than 70% of all HCV-associated deaths.
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dvh-strategicplan2016-2020-draft.pdf
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