1. Hepatitis B and C: A silent but
deadly epidemic
Arun J Sanyal M.D.
Charles Caravati Professor of Medicine
Virginia Commonwealth University
Richmond, Virginia

2. Hepatitis B and C: Basic
information
• Virus infections of the liver:
– A: acute illness
– B: both acute and chronic
– C: chronic illness
– D: dual infection- B and D have to co-exist
• Hepatitis B and C affect 5.3 million
Americans

3. Hepatitis B and C is everyone’s
problem
• Who has it?
– Seen in all segments of
society
– Some segments more at
risk: Immigrants, Asians,
African-Americans
• How do you get it?
– Exposure of contaminated
blood
– Sexual exposure
– ? Unknown

4. What happens if you don’t
diagnose hepatitis B or C in time?
• Progression to
cirrhosis:
– liver failure
– internal bleeding
– brain malfunction
– kidney failure
– cancer
• Other medical problems:
– diabetes
– kidney disease

5. Why the status quo is
unacceptable
• Disease diagnosed late in its course
• Treatment options are more limited
• Treatment not tolerated as well
• Greater impact on family
• More days of work loss
• Greater cost of care
• Strains the ability of small businesses to afford
health care for its employees and their families

6. Why is the situation particularly tragic ?
• Risk factors for viral hepatitis are well known
• A highly effective vaccine for hepatitis B exists
• Tests to diagnose the disease are available and
are being improved upon- and should allow point
of care testing
• Highly effective treatments for both hepatitis B
and C are available and getting better

7. Impediments to reducing the burden of viral
hepatitis
• Lack of knowledge and awareness
• Lack of adequate screening, surveillance and
reporting of viral hepatitis
• Lack of effective immunization strategies
• Lack of health services related to viral hepatitis
in general-especially detection and treatment

8. The choice before us today
Healthy people
• immunize
• educate
• screen
• identify and treat
• surveillance
Status quo
• Detect disease late
•High cost of care
•Loss of workforce
•Disruption of family
THE CHOICE IS CLEAR