Approach Overlooks Hepatitis Threats

A new Institute of Medicine report calls for a major public-health push against hepatitis B and C, two liver diseases that together infect three to five times more Americans than HIV.

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Over the next decade, 150,000 people in the United States will die of either hepatitis B or C, according to the report. Though some patients fight them off, the viruses become chronic and incurable in 3.5 million to 5.3 million Americans, IOM estimates. Hepatitis B and C necessitate nearly half the liver transplants performed each year, and the infections disproportionately affect minorities, including blacks, Asians, and Pacific Islanders.

IOM's recommendations include:

>Boosting public awareness. People at greatest risk for hepatitis B include those born in parts of Asia and Africa where the disease in endemic, infants born to infected mothers, sexual partners of infected persons, and injecting drug users. Those at highest risk of hepatitis C include current and former IDUs as well as people who received a blood transfusion prior to 1992, when screening for the virus became available.

>Improving uptake of hepatitis B vaccine. Three states -- Alabama, Montana, and South Dakota -- do not require hepatitis B vaccination for children entering daycare or school. Vaccinating at-risk newborns against the virus in the delivery room, instead of the current practice of within 12 hours of birth, may give additional protection.

>Ramping up research into a vaccine against hepatitis C; currently, none exists. >Enhancing health services for hepatitis B and C patients and improving screening of those at risk, with special attention paid to stigma. Immigrants from countries where discrimination against infected persons is widespread -- China, for example -- may be especially reluctant to seek testing.