Hepatitis B, C Threat Can Be Eliminated in the US by 2030, Physicians Say

Hepatitis B and C can be eliminated as serious public health problems in the United States by 2030 with aggressive testing, treatment, and prevention methods, according to the National Academies of Sciences, Engineering and Medicine. Such efforts, along with creative financing for hepatitis drugs, would prevent almost 90,000 deaths in the country by that year, the nonprofit institutions found.

“Viral hepatitis is simply not a sufficient priority in the United States,” said Brian Strom, MD, MPH, (photo) chancellor of Rutgers Biomedical and Health Sciences at Rutgers University in Newark, New Jersey. Strom, who chaired the committee that conducted the study, says viral hepatitis accounts for less than 1% of the research budget at the National Institutes of Health (NIH), the agency responsible for studying health-related issues.

About 2.7 million people in the US have chronic hepatitis C, according to the report. If everyone in the country with the liver-attacking virus were treated, new infections would tumble by 90% by 2030. Deaths would fall by 65% during the same time, the committee said.

New direct-acting antiviral (DAA) drugs have made curing the virus possible with shorter therapy times and fewer side-effects. However, these medicines are expensive, making it difficult to treat everyone affected. The earliest the drugs will come off patent is 2029, according to the report.

To make DAAs more affordable for underserved patients, the committee suggested that the federal government pursue a voluntary licensing agreement with a patent-holding pharmaceutical company. A patent license should cost about $2 billion, the committee said. States and the federal government would pay about $140 million to produce drugs needed to treat about 700,000 neglected patients. In contrast, it would cost about $10 billion over the next 12 years to reach only 240,000 of the same patients in the current environment.

Preventing hepatitis C in the first place will happen mostly by limiting exposure to the virus. Because people who inject drugs account for 75% of the roughly 30,500 new hepatitis C infections in the US, safer injections and treatment for the underlying addiction are the best strategies, the committee said. It recommended expanding access to syringe exchange programs and opioid agonist therapies.

Covering everyone with chronic hepatitis C, regardless of disease stage, would avert cirrhosis, liver cancer, and death. It also would pay off by reducing new infections. Delaying mass treatment until generic medicines are available would result in tens of thousands of deaths and billions of dollars in wasted medical costs, the researchers said.

Hepatitis B, which affects 1.3 million people in the US, is preventable with vaccination. Because the virus can easily pass from mother to baby, the committee said that children born to women with chronic hepatitis B require immunization within 12 hours of birth. Other children should receive the vaccine within a day of birth.

The study was sponsored by the US Centers for Disease Control and Prevention, the US Department of Health and Human Services; the American Association for the Study of Liver Diseases, the Infectious Diseases Society of America, and the National Viral Hepatitis Roundtable.

The news release was provided by the National Academies of Sciences, Engineering, and Medicine.

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