Viral hepatitis is a silent killer that must be stopped

There is a silent crisis affecting America. This crisis endangers 5.3 million people in the U.S. and is more common than HIV/AIDS, yet it remains unrecognized as a serious public health threat. The crisis: viral hepatitis. Most people who have it are unaware, that is until they develop cancer or liver disease years later. Given this national tragedy in the making, we must educate people on the pervasiveness of Hepatitis B and Hepatitis C, identify effective measures on viral hepatitis prevention, control and surveillance programs, and provide a mechanism to implement these measures.

It is not a misnomer to call this a silent crisis. Few people realize how highly infectious viral hepatitis is. Hepatitis B is 100 times more infectious than HIV. Few realize that, left untreated, it can cause liver disease, liver cancer and premature death decades after infection. Few realize that about 2 billion people worldwide have been infected with Hepatitis B; more than 170 million people are chronically infected with Hepatitis C. Tragically, two-thirds of those infected, on average, are unaware of their status, which increases the chance of spreading the disease.

We cannot afford to be silent anymore. Our countrymen and women are dying daily, needlessly, from a disease that is entirely preventable if detected early. Each year, about 15,000 people die from liver cancer or liver diseases related to Hepatitis B and Hepatitis C. That’s more than 40 Americans dying every day, with no state or district in our nation exempt from its deadly reach.

Beyond the tragic and preventable loss of human life, the costs to our country are explicitly economic as well. Without effective prevention and vaccination methods in place, chronic Hepatitis B and C are expected to cost our country at least $20 billion in treatments during the next 10 years. As a result, over the same time frame, commercial and Medicare costs will more than double. Projecting further out, over the next 20 years, total medical costs for patients with Hepatitis C infection are expected to increase more than 2.5 times from $30 billion to more than $85 billion.

Contrast the costs for early detection and intervention with the costs for treatment post-infection. Hepatitis B vaccinations are $60, whereas treatment can cost up to $16,000 per year. Screening for Hepatitis C is $8 compared to treatment that can cost up to $25,000 per year. Untreated, these infections will develop into liver disease that can cost up to $110,000 per hospital admission.

We must, therefore, change the way hepatitis is diagnosed and treated. The Institute of Medicine (IOM) report on “Hepatitis and Liver Cancer” corroborates this conclusion by calling for a national strategy in the prevention and control of Hepatitis B and C. The report concludes that the current approach to the prevention and control of chronic Hepatitis B and C is not working. As a remedy, the IOM recommends increased knowledge and awareness about chronic viral hepatitis among health care providers, social service providers, and the public; improved surveillance for Hepatitis B and Hepatitis C; and better integration of viral hepatitis services.

My call for a national strategy is not unlike IOM’s.  With bipartisan support, I introduced the Viral Hepatitis and Liver Cancer Control and Prevention Act, H.R. 3974, which provides almost $600 million over the next five years to treat hepatitis. The legislation mirrors many of the IOM’s recommendations and focuses federal efforts on a strategy that saves lives and makes our health system more efficient.

Specifically, H.R. 3974 increases interagency coordination between the Centers for Disease Control, National Institute for Health, National Cancer Institute, the Health Resource and Service Administration Agency for Healthcare Research and Quality and Veteran Affairs. It does so by implementing programs to increase awareness and enhance knowledge and understanding of Hepatitis B and C and requiring the CDC to integrate into existing programs immunization, prevention, and control programs and support counseling. The legislation expands current vaccination programs and establishes a national chronic and acute Hepatitis B and C surveillance program to identify incidence and prevalence in viral hepatitis and liver cancer.

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ass this bill and we bring together the common concerns of the diverse viral hepatitis community to fight chronic viral hepatitis by establishing, promoting and supporting a comprehensive prevention, research and medical management referral program. And we strengthen the ability of the CDC to support state health departments in the prevention, immunization and surveillance efforts.

Through this legislation, and with strategic investments in public health and prevention programs, billions of dollars can be saved, and so, too, the lives of tens of thousands of people in states and cities all over America. I urge all of you to join me in supporting activities that promote early detection and education. With your help, we can sound the alarm on this silent crisis.

Rep. Honda is the Chairman of the Congressional Asian Pacific American Caucus.

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