Current EPI and a Focus on Therapy of Hepatitis B Planning for 2015 and beyond.
AASLD Talk
Robert [email protected] Diego, CA
USA
Medical Director Hepatitis B Foundation
Professor Consultant, Stanford University
Senior Medical Director St Josephs Medical Center, Phoenix
Arizona
Current EPI and a Focus on Therapy of Hepatitis BPlanning for
2015 and beyond
SOTA 2015 1DisclosuresRelevant Disclosures to HBVConsulting :
Gilead, Genentech, Arrowhead, ISIS, Contravir, Enyo, MedImmuneStock
or stock options: Arrowhead#HBV: Phase I TestsHBsAg =
infectionAnti-HBs = immunity if anti-HBc is negativeAnti-HBc =
exposureWhat has the USPHSTF changed and recommended?Foreign Born:
from endemic regionsChildren of parents who are from regions where
HBV has over 2% prevalenceMSMIVDUHigh risk behavior
2014Yet Are Rarely ScreeningSource: Pri-Med CME Outcome
Data2012How often do you screen Asian/Asian American patients for
chronic HBV? RarelySometimes Often Always78% rarely or sometimes
screen; only 10% always screen1029%348%11%11%10050425Lack of
Knowledge Re: Isolated Hepatitis B Core Antibody
Source: Pri-Med CME Outcome Data20122/3 of PCPs do not know how
to interpret HBV lab findingsHepatitis B: The FactsHepatitis B is
the worlds most common serious liver infection1 and is a widespread
global health issueHBV is not curable but controllable and
suppressibleHBsAg clearance is a functional cureHBV is 100 times
more infectious than HIV (human immunodeficiency virus)2 10 times
more infectious than hepatitis C3The virus is transmitted via the
blood and bodily fluids1Hepatitis B progresses slowly over time
Complications generally involve vague symptoms or none at all, and
are often undetected for many years1. Hepatitis Australia.
Available at
http://www.hepatitisaustralia.com/about_hepatitis/hep_b.html.
Accessed April 2009; 2. World Health Organization. Hepatitis B Fact
Sheet. Available at
http://www.who.int/mediacentre/factsheets/fs204/en/. Accessed April
2009; 3. Ulmer T, et al.(2007) European orientation towards the
Better Management of Hepatitis B in Europe .
Hepatitis has 3x the death rate of HIV in the AP region: yet no
significant funding !
Prevalence of HBV:Global Estimates: note China < 8%; Vaccines
work!HBsAg PrevalenceHigh (>8%)Intermediate (2%-7%)Low (8% of
the population is HBsAgpositive); 43% in areas with a moderate
prevalence (2% to 7% of the population is HBsAgpositive); and 12%
in areas with a low prevalence (
