World Hepatitis Day

 Did you know?  

• Approximately 500 million people around the world are currently infected with chronic hepatitis b or c
• 1 in every 3 individuals will be exposed to hepatitis b or c in their lifetime

Due to the lack of routine screening programs, most hepatitis infected individuals will not receive testing until symptoms of liver disease develop. World Hepatitis Day is an opportunity to raise awareness about this frequently overlooked set of diseases.

 

According to a recent report from the Institute of Medicine (IOM), “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and Hepatitis C” up to 5.3 million people, or 2% of the US population, are infected with hepatitis B or C. The IOM report attributes the lack of viral hepatitis awareness in the United States to inadequate education and inadequate funding. For example, in 2008 the CDC’s National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention had a budget of almost $1 billion and only 2% of it was allocated to viral hepatitis initiatives. The recommendations put forward in the report frequently site increasing the amount of laboratory testing conducted as a vital step in increasing the awareness of infection status and decreasing transmission rates.

 

In the event that the recommendations from the IOM report are implemented, it is likely that public health laboratories will play a key role in those initiatives. In 2009 APHL surveyed 51 public health laboratories to determine their viral hepatitis testing capabilities and capacities. The survey found that 88% of state public health laboratories (SPHLs) in the US perform or refer some level of hepatitis testing, indicating that SPHLs continue to play an important role in the diagnosis and surveillance of viral hepatitis infection in the United States. However, 58% of responding laboratories reported that the funding they currently receive is not enough to meet hepatitis testing needs in their state.

 

APHL is releasing the full survey report in observance of World Hepatitis Day and would like to recognize our members, colleagues and partners in the public health laboratory system who are working to reduce the burden of viral hepatitis around the world.

 

Approaches to Combating HIV/AIDS

At a recent amFAR (The Foundation for AIDS Research) sponsored Congressional briefing* on AIDS research at NIH, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease (NIAID), described what he viewed as the three essential approaches in combating HIV/AIDS: 

• controlling disease progression
• preventing new infections; and
• curing existing infections.

Antiretroviral therapy (ARV) is one of the most potent interventions available in medicine today and can significantly prolong a patient’s life. Continued expansion of ARV therapy, especially in the developing world, is essential to controlling disease progression and improving patient outcomes.

 

For a sustainable response to the pandemic, however, preventing new infections will be crucial. A significant focus of NIH funding supports vaccine development and treatment research (Pre-Exposure Prophylaxis, test & treat programs, and microbicides). Dr. Fauci cited the positive results of a vaccine trial last year as a significant first step towards developing an effective vaccine.

 

In the coming years, NIAID plans to continue investing in vaccine research to build on this preliminary success. The ability to cure existing infections would be an incredible breakthrough, but as Dr. Fauci mentioned, HIV is capable of hiding in the body making a true sterilizing cure very difficult to develop. Research is continuing, though, especially on so-called “functional cures” that wouldn’t completely eliminate the virus from the body but would prevent its proliferation and pathogenesis without the need for additional treatments.

 

While it is clear that a great deal of research funding is directed toward HIV vaccines and cures, NIH is also committed to researching new approaches in testing and treatment. It is estimated that 21% of HIV-infected individuals are unaware of their status. In efforts to expand testing, public health laboratories will continue to play an important role in the public health response to this pandemic.

 

*The briefing was held in collaboration with the offices of Congresswoman Rosa DeLauro (D-CT), Congresswoman Barbara Lee (D-CA), and Congressman Eliot Engel (D-NY). Thank you to those offices for their support.