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Even medical professionals lack awareness of hepatitis threat, new report finds

January 11, 2010 |  8:00 am
Hepatitis B and C remain serious threats to public health, but many healthcare providers fail to screen at-risk patients and don’t know how to treat those infected with the viral diseases that can cause liver failure and cancer, according to a report released today by the National Academy of Sciences.

The long-awaited assessment calls for a campaign to educate the public, doctors and lawmakers about the diseases, an approach similar to HIV/AIDS outreach that has made that issue prominent in people’s minds. Researchers found that even though chronic viral hepatitis infections are three to five times more frequent than HIV in the United States, many doctors and nurses do not understand the extent and seriousness of the problem.

Most of the estimated 3 million to 5 million people with chronic hepatitis B and C don’t know they have the diseases. Infected people can show no signs of illness for years, and by the time they start to show symptoms, they may have already developed scarring of the liver or liver cancer and can be close to death.

“The challenge we have with hepatitis B and C is similar to our HIV stories. ... We really don’t know they are infected until they end up sick and in the hospital,” said Dr. Gail Bolan, chief of the sexually transmitted diseases control branch of the California Department of Public Health. “It’s been a silent epidemic.”

The 176-page report requested by federal health officials was released by the Institute of Medicine, the health arm of the National Academy of Sciences. Although an estimated 1% to 2% of the U.S. population has chronic hepatitis B and C, researchers found that awareness of the diseases remains low.

Each year lack of awareness contributes to about 1,000 infants contracting Hepatitis B from their mothers during childbirth. Although preventative steps can significantly reduce the likelihood of chronic infection in  babies, the number of new infections has not declined in a decade.

“Although hepatitis B and C are preventable, the rates of infection have not declined over the past several years,” R. Palmer Beasley, an epidemiologist at the University of Texas School of Public Health in Houston said in a statement. “We have allowed gaps in screening, prevention and treatment to go unchecked.”

The report calls for those most at risk to be screened. Black adults have the highest rate of acute hepatitis B infection in the United States. And although Asian Americans make up less than 5% of the U.S. population, they account for more than half of chronic hepatitis B cases nationwide, the institute said. California health officials said 10% of Asian Americans have hepatitis B.

Those at greatest risk for hepatitis B include those born in East and Southeast Asia, sub-Saharan Africa, babies born to infected mothers and those who have had sex with or shared needles or syringes with an infected person.

Hepatitis C is usually spread through blood contact, and those at risk are injection drug users and anyone who received a blood transfusion or organ transplant before 1992. There is a vaccine for hepatitis B, but none for hepatitis C.

Bolan, whose department today released a separate report on hepatitis in California, cautioned that baby boomers are at higher risk for hepatitis C if they injected a drug even one time. As that demographic ages, she said, symptoms of the disease, which include fatigue, jaundice, vomiting and abdominal pain, may begin to appear.

According to the U.S. Centers for Disease Control and Prevention, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplants. California health officials said that hospitalizations related to hepatitis B and C in California cost $2 billion in 2007.

-- Rong-Gong Lin II