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1 Introduction
Pages 15-28

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From page 15...
... There is an effective vaccine to prevent hepatitis B, advances in treatment can prevent most deaths in those chronically infected with HBV, and hepatitis C is now curable with a short course of easily tolerated treatment (Afdhal et al., 2014; Feld et al., 2014)
From page 16...
... . As of July 2016, a government referendum guaranteed free HCV treatment for uninsured patients (Daily News Egypt, 2016b)
From page 17...
... . Like a previous Institute of Medicine committee that commented on woefully underfunded surveillance systems and inadequate public spending on viral hepatitis prevention and treatment, this committee's previous report discussed limitations with, among other things, surveillance, case detection, and access to care, as well as gaps in the current understanding of the viruses (IOM, 2010; NASEM, 2016)
From page 18...
... to determine whether HBV and HCV elimination goals for the United States are feasible and to identify possible critical success factors. A brief report containing the committee's conclusion regarding the feasibility of setting elimination goals and possible critical success factors shall be prepared.
From page 19...
... Members of the public submitted written testimony to the committee (available from the National Academies of Sciences, Engineering, and Medicine's Public Access Records Office, PARO@nas.edu)
From page 20...
... • Undiagnosed, asymptomatic • Much of the burden for chronic infections a reservoir managing chronic hepatitis B for infection falls on overworked primary Reducing morbidity and Slowing Feasible • Need for physicians trained care providers. mortality attributable to progression to in the management of chronic • There is a need to better ongoing infection cirrhosis HBV infection understand the virus and the • The threat of reactivation in management of chronic HBV Reducing deaths infection.
From page 21...
... treatment adherence • The high cost of direct Reducing morbidity and Slowing Feasible • Problems assessing and staging acting antiviral drugs makes mortality attributable to progression to fibrosis universal treatment unfeasible. ongoing infection cirrhosis • Obesity, HIV, alcohol use can • Hepatitis C is not a public aggravate disease progression priority.
From page 22...
... A separate chapter presents the results of commissioned models informing the committee's goals on suitable targets, interim indicators, and a timeline for elimination in the United States. HEPATITIS AND LIVER CANCER The 2016 Annual Report to the Nation on the Status of Cancer celebrated continued declines in cancer deaths in the United States, attributing much of this progress to public health (Ryerson et al., 2016)
From page 23...
... The incidence of hepatocellular carcinoma, the most common form of primary liver cancer, increased 38 percent between 2003 and 2012, the most recent years for which data are available (Ryerson et al., 2016)
From page 24...
... Almost every family in Mongolia is affected by hepatitis or liver cancer. Mongolia's first national strategy on viral hepatitis covered years 2010 to 2015, and emphasized hepatitis B immunization to decrease HBsAg prevalence to less than 2 percent among children under 5.
From page 25...
... Box 1-4 describes Mongolia's hepatitis elimination program in response to the country's high rate of liver cancer mortality. Much as public health measures have lessened the burden of lung, breast, colorectal, and prostate cancers over time, so can public health programs reverse troubling trends in liver cancer.
From page 26...
... 2010. Hepatitis and liver cancer: A national strategy for preven tion and control of hepatitis B and C
From page 27...
... 2011. Smoking, hepatitis B virus infection, and development of hepatocellular carcinoma.
From page 28...
... 2016. The global burden of viral hepatitis: Better estimates to guide hepatitis elimination efforts.


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