Hepatitis B in the Greater San Francisco Bay Area: an integrated programme to respond to a diverse local epidemic

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01382.x/abstract

Hepatitis B in the Greater San Francisco Bay Area: an integrated programme to

respond to a diverse local epidemic

R.G. Gish1, S.L. 2,3,4,5

Article first published online: 8 DEC 2010

DOI: 10.1111/j.1365-2893.2010.01382.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 4, pages e40–e51, April 2011

Summary.  Although chronic hepatitis B (CHB) affects approximately 2 million

United States residents, there is no systematic screening of at-risk

individuals, and most remain unaware of their hepatitis B virus (HBV) infection.

Unmonitored and untreated, CHB results in a 25–30% risk of death from liver

cancer and/or cirrhosis, inflicting an increasing healthcare burden in

high-prevalence regions. Despite high prevalence in immigrant Asians and Pacific

Islanders, among whom CHB is a leading cause of death, community and healthcare

provider awareness remains low. Because safe and effective vaccines and

effective antiviral treatments exist, there is an urgent need for integrated

programmes that identify, follow and treat people with existing CHB, while

vaccinating the susceptible. We describe an extant San Francisco programme that

integrates culturally targeted, population-based, HBV screening, vaccination or

reassurance, management and research. After screening over 3000 at-risk

individuals, we here review our operational and practical experience and

describe a simple, rationally designed model that could be successfully used to

greatly improve the current approach to hepatitis B while ultimately reducing

the related healthcare costs, especially in the high-risk populations, which are

currently underserved.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01382.x/abstract

Hepatitis B in the Greater San Francisco Bay Area: an integrated programme to

respond to a diverse local epidemic

R.G. Gish1, S.L. 2,3,4,5

Article first published online: 8 DEC 2010

DOI: 10.1111/j.1365-2893.2010.01382.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 4, pages e40–e51, April 2011

Summary.  Although chronic hepatitis B (CHB) affects approximately 2 million

United States residents, there is no systematic screening of at-risk

individuals, and most remain unaware of their hepatitis B virus (HBV) infection.

Unmonitored and untreated, CHB results in a 25–30% risk of death from liver

cancer and/or cirrhosis, inflicting an increasing healthcare burden in

high-prevalence regions. Despite high prevalence in immigrant Asians and Pacific

Islanders, among whom CHB is a leading cause of death, community and healthcare

provider awareness remains low. Because safe and effective vaccines and

effective antiviral treatments exist, there is an urgent need for integrated

programmes that identify, follow and treat people with existing CHB, while

vaccinating the susceptible. We describe an extant San Francisco programme that

integrates culturally targeted, population-based, HBV screening, vaccination or

reassurance, management and research. After screening over 3000 at-risk

individuals, we here review our operational and practical experience and

describe a simple, rationally designed model that could be successfully used to

greatly improve the current approach to hepatitis B while ultimately reducing

the related healthcare costs, especially in the high-risk populations, which are

currently underserved.