Board on Population Health and Public Health Practice, Institute of Medicine of the National Academies, Washington, DC, USA.
Hepatology. 2010 Mar;51(3):729-33. doi: 10.1002/hep.23561.
Despite federal, state, and local public health efforts to prevent and control hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, these diseases remain serious health problems in the United States. About 1%-2% of the U.S. population has chronic HBV or HCV infections, and each year about 15,000 people die from liver cancer or liver disease related to these preventable infections. The Institute of Medicine formed an expert committee to determine ways to reduce new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis and released its findings in a report. The major factor found to impede current efforts to prevent and control HBV and HCV is lack of knowledge and awareness about these diseases among healthcare and social-service providers, members of the public, and policy makers. Because the extent and seriousness of this public health problem is not appreciated, inadequate resources are being allocated to prevention, control, and surveillance programs. This situation has led to continued transmission of HBV and HCV and inadequate identification of and medical management for chronically infected people.
To address the situation, the Institute of Medicine report makes recommendations in four areas: improved surveillance for HBV and HCV; improved knowledge and awareness among healthcare and social-service providers and the public, especially at-risk people; improved HBV vaccine coverage; and improved viral hepatitis services and access to those services.
尽管联邦、州和地方公共卫生部门努力预防和控制乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染,但这些疾病仍是美国严重的健康问题。约有 1%-2%的美国人口患有慢性 HBV 或 HCV 感染,每年约有 15000 人死于肝癌或与这些可预防感染相关的肝病。医学研究所成立了一个专家委员会,以确定减少新的 HBV 和 HCV 感染以及与慢性病毒性肝炎相关的发病率和死亡率的方法,并在一份报告中发布了其调查结果。阻碍当前预防和控制 HBV 和 HCV 努力的主要因素是医疗保健和社会服务提供者、公众和政策制定者对这些疾病的知识和认识不足。由于对这一公共卫生问题的严重程度认识不足,预防、控制和监测计划的资源分配不足。这种情况导致了 HBV 和 HCV 的持续传播,以及对慢性感染者的识别和医疗管理不足。
为了解决这一问题,医学研究所的报告在四个方面提出了建议:加强 HBV 和 HCV 的监测;提高医疗保健和社会服务提供者以及公众的知识和认识,特别是高危人群;提高乙肝疫苗接种率;以及改善病毒性肝炎服务和获得这些服务的机会。