Chronic viral hepatitis has a reputation for being a silent killer. The infection often goes undetected until the symptoms of advanced liver cancer appear. By that point, a patient has a five-year survival rate, according to the American Cancer Society.
The National Academy of Sciences estimates that 3.5 to 5.3 million people in the United States are living with HBV or HCV, as the two infections are known, and while drug therapies can treat both, there is no cure for Hepatitis B, and no vaccine for Hepatitis C. Hepatitis C can be cured, but treatment is very expensive.
Brian Strom, a renowned epidemiologist and the chancellor of Rutgers Biomedical and Health Sciences, is heading a team of scientists who are trying to change the outlook for hepatitis patients. Last month Strom was appointed to chair a committee selected by the National Academy of Sciences' Institute of Medicine to determine whether eliminating HBV and HCV is feasible, and if so, to develop an action plan within the next few years.
"Hepatitis is an important health issue affecting 1 to 2 percent of the U.S. population," said Strom, a member of the Institute of Medicine (IOM) who has led several institute projects, including the smallpox vaccination program implementation in 2002-2003 and the committee on dietary salt intake in 2012-2013. "The challenges are significant: To determine if elimination is doable and, if so, how would you design a program to get rid of it in the United States."
HBV is most commonly transmitted through contact with infectious blood, semen and other bodily fluids, through birth to an infected mother, sexual contact with an infected individual and sharing of needles, syringes and other drug paraphernalia. The most common route of HCV transmission is through the sharing of contaminated injection-drug equipment.
According to Gillian Buckley, director of the feasibility study, the committee is conducting its analysis under an accelerated schedule so that its conclusions and recommendations can be reviewed by the Centers for Disease Control and Prevention prior to its participation in the 69th World Health Assembly in May 2016. There, a five-year global strategy for fighting viral hepatitis will be examined.
"There may be different goals internationally for greatly reducing and eliminating hepatitis transmission," Buckely said. "As the momentum builds, we want our findings to be considered as the global strategy is being developed."
Buckley said the committee consists of researchers selected because of their widely diverse training and research perspectives. In addition to Strom, the committee members are:
Jon Andrus, Sabin Vaccine Institute executive vice president and director of the vaccine advocacy and education program
Daniel R. Church, viral hepatitis prevention coordinator and an epidemiologist in the Bureau of Infectious Disease at the Massachusetts Department of Health
Alison A. Evans, an assistant professor in the Department of Epidemiology and Biostatistics at Drexel University School of Public Health
Paul Kuehnert, former deputy state health officer in Maine and currently a nurse and public health expert for Robert Wood Johnson Foundation
Vincent Lo Re, assistant professor in the Division of Infectious Diseases and Assistant Professor of Epidemiology in the Department of Biostatistics and Epidemiology at the University of Pennsylvania
Kathleen Maurer, Connecticut Department of Correction's director of health and addiction services and medical director
Randall R. Mayer, chief of the bureau of HIV, STD, and hepatitis at the Iowa Department of Public Health
Shruti Mehta, professor in the Johns Hopkins Bloomberg School of Public Health
Stuart Ray, director of the virology laboratory and a clinical investigator in the Center for Viral Hepatitis Research in the Division of Infectious Diseases at Johns Hopkins Bloomberg School of Public Health
Arthur Reingold, the Edward Penhoet Distinguished Professor of Global Health and Infectious Diseases at the School of Public Health, University of California, Berkeley
Samuel So, a professor of surgery and director of the Asian Liver Center and director of the Multidisciplinary Liver Cancer Program at Stanford University
Neeraj Sood, vice dean for research at the University of Southern California Price School of Public Policy
Grace Wang, the chief medical officer for international community health services in Seattle.