Joan M. Block, RN, BSN
Co-Founder, Hepatitis B Foundation
How low must we go? Experts at the April NIH meeting on hepatitis B wrestled with this question since viral loads are increasingly becoming the standard by which treatment decisions are made and evaluated (page 3). The three approved oral drugs for hepatitis B have similar mechanisms of action, but differ in how fast and how low they can reduce a patient’s viral levels.

Conversely, the HBF asks, how high will we go in the search for a more accurate count of the number of individuals with chronic hepatitis B in this country? For the past decade, the figure has remained constant at 1.2 million, despite the millions of immigrants who have emigrated to the U.S. from countries where hepatitis B is highly prevalent.

Preliminary research by the HBF suggests that there could be as many as one million people overlooked by hepatitis B surveillance surveys. We speculate the true number of chronically infected Americans could exceed two million!

These are numbers that matter, and can have a significant impact on health care policy and budgets. Calculating viral loads and the true incidence of chronic hepatitis B in the U.S. will make May Hepatitis Awareness Month add up to something important all year round.

BInformed, Summer 2006.