Index

A

Acute disseminated encephalomyelitis, 32

Acute infections

characteristics, 19

clinical outcomes, 117, 118, 136, 137

HBV, 1, 19, 23, 27, 34, 48, 50, 59, 70-71, 99, 117, 118, 119, 120, 121, 125, 161, 189

HCV, 19, 28, 29, 34, 47, 49, 51, 71, 136, 137, 163, 165

incarcerated people, 121

injection-drug use and, 120, 137, 189

outbreak detection and control, 48, 67, 70

prevalence and incidence, 1, 50, 70-71, 99, 118, 119, 120, 121, 125

screening and testing for, 47-51, 160, 161, 163, 165

surveillance, 29, 44, 47-51, 59, 64, 67, 71

Adolescents and young adults, 7, 11, 23, 25, 31, 44, 68, 71, 93, 98, 100, 110, 112, 127, 131, 134, 191

Adult Hepatitis B Vaccine Initiative, 129

Adult viral-hepatitis prevention coordinators (AVHPC), 42-43, 57, 59, 61, 64, 70, 152-153

Adults.

See also At-risk populations;

specific populations

asymptomatic infections, 47

HBV, 11, 27, 32, 47, 93, 110, 111, 113, 117-125, 127, 128, 129, 132, 134

HCV, 51

vaccination, 11, 32, 93, 110, 111, 113, 117-125, 127, 128, 129, 132, 134

Advisory Committee on Immunization Practices (ACIP), 4, 9-10, 11, 55, 83, 88, 93, 100, 110-111, 112-115, 116, 125, 127, 132, 133, 134, 181

African Americans/Blacks, 1, 2, 10, 27, 29, 30, 32, 93, 116, 124, 168, 169, 184

Agency for Healthcare Quality and Research, 149

Alabama, 27 n.1, 91, 116

Alanine aminotransferase (ALT), 48, 49, 50, 53, 93, 158, 167

Alaska, 120-121, 122-123.

See also American Indians and Alaska Natives

Alcohol consumption, 5, 14, 29, 30, 48, 84, 93, 148, 155, 168, 169, 181

Alternative-care providers, educational programs for, 86, 87, 89

American Academy of Pediatrics, 111

American Association for the Study of Liver Diseases (AASLD), 32, 155, 159, 166, 167, 168

American College of Obstetricians and Gynecologists, 84, 97



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Index A asymptomatic infections, 47 HBV, 11, 27, 32, 47, 93, 110, 111, 113, Acute disseminated encephalomyelitis, 32 117-125, 127, 128, 129, 132, 134 Acute infections HCV, 51 characteristics, 19 vaccination, 11, 32, 93, 110, 111, 113, clinical outcomes, 117, 118, 136, 137 117-125, 127, 128, 129, 132, 134 HBV, 1, 19, 23, 27, 34, 48, 50, 59, Advisory Committee on Immunization 70-71, 99, 117, 118, 119, 120, 121, Practices (ACIP), 4, 9-10, 11, 55, 83, 125, 161, 189 88, 93, 100, 110-111, 112-115, 116, HCV, 19, 28, 29, 34, 47, 49, 51, 71, 125, 127, 132, 133, 134, 181 136, 137, 163, 165 African Americans/Blacks, 1, 2, 10, 27, 29, incarcerated people, 121 30, 32, 93, 116, 124, 168, 169, 184 injection-drug use and, 120, 137, 189 Agency for Healthcare Quality and outbreak detection and control, 48, 67, Research, 149 70 Alabama, 27 n.1, 91, 116 prevalence and incidence, 1, 50, 70-71, Alanine aminotransferase (ALT), 48, 49, 50, 99, 118, 119, 120, 121, 125 53, 93, 158, 167 screening and testing for, 47-51, 160, Alaska, 120-121, 122-123. See also 161, 163, 165 American Indians and Alaska Natives surveillance, 29, 44, 47-51, 59, 64, 67, Alcohol consumption, 5, 14, 29, 30, 48, 84, 71 93, 148, 155, 168, 169, 181 Adolescents and young adults, 7, 11, 23, Alternative-care providers, educational 25, 31, 44, 68, 71, 93, 98, 100, 110, programs for, 86, 87, 89 112, 127, 131, 134, 191 American Academy of Pediatrics, 111 Adult Hepatitis B Vaccine Initiative, 129 American Association for the Study of Liver Adult viral-hepatitis prevention coordinators Diseases (AASLD), 32, 155, 159, (AVHPC), 42-43, 57, 59, 61, 64, 70, 166, 167, 168 152-153 American College of Obstetricians and Adults. See also At-risk populations; specific Gynecologists, 84, 97 populations 

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0 INDEX American College of Physicians, 159 services, 3, 5, 6, 13, 16-17, 56, 79, 149, American Indians and Alaska Natives, 29, 189-192 62, 81, 93, 129, 131, 168 surveillance, 2, 4, 6, 7, 61-62, 67, 68, Anti–tumor-necrosis factor therapy, 162 71-72 Asian American Hepatitis B Program, 92 Awareness. See Knowledge and awareness Asians and Pacific Islanders (APIs). See also of chronic hepatitis Foreign-born access to care, 56, 169 B educational programs for, 87, 92, 93, 153, 183 Baltimore, 28, 92, 122-123, 190 health-care providers, 82 Blacks. See African Americans/Blacks incidence and prevalence of HBV Blood transfusions, 2, 21, 24, 28, 50, 83, infection, 1-2, 23, 27, 29, 81-82, 83, 84, 151, 158 93, 117-118, 153-154, 161, 183, Brachial neuritis, 32 184-185 Brazil, 138 knowledge and awareness of HBV, 13, Breastfeeding, 84 82, 89-90, 173 Bureau of Primary Health Care, 151 liver cancer, 29, 153-154, 169 medical management of hepatitis, 183 risk of HBV, 90 C screening/testing, 161, 173 surveillance, 32, 62, 68 California, 58, 81, 83, 89, 99, 120, 121, treatment disparities, 169 122, 173, 174, 182, 183, 186 vaccination, 10, 90, 92, 116, 117-118, Cambodian Americans, 90, 92 161-162 Cancer chemotherapy, 162 Aspartate transaminase, 49, 167 Case definitions for hepatitis, 7, 48-49, 50, Asymptomatic infected individuals, 51, 52-53, 54, 55, 65, 68, 69 awareness of infection, 1, 3, 24, 26, Case management, 43, 45-46, 57-58, 62-63, 27, 50, 51, 90 65, 68, 70, 72 At-risk populations. See also Foreign- Centers for Disease Control and Prevention born populations; Illicit-drug users; (CDC), 2 Incarcerated populations; Men who Adult Hepatitis B Vaccine Initiative, 129 have sex with men; Pregnant women case definitions for hepatitis B and C, access to services, 3, 56, 79 48-49, 50, 52-53, 54, 55, 68 defined, 27, 86, 156 Division of Viral Hepatitis, 150-151 education programs, 4, 14, 85-86, 92- educational programs, 4, 8-9, 86, 87, 93, 95-96, 97, 98-100 97, 96 health service provider knowledge of, Emerging Infections Program, 43, 58, 59 80, 81-84, 89 Epidemiologic Surveillance Project, 60 immunization, 4, 9, 10-11, 27, 81, 93, estimates of hepatitis burden, 25, 26, 27, 113, 120-125 62, 120, 182, 189 knowledge and awareness of hepatitis, 3, National Immunization Program, 126 4, 8, 9, 34, 89-91, 93-96 NEDSS, 61 prevalence and incidence of hepatitis, NETSS, 60-61, 64 62, 81 partner services guidelines, 63 recommendations, 16-17 PHIN-compliant systems, 64, 70 screening and testing, 3, 4, 5, 6, 8, 9, prevention and control recommendations 11, 13-14, 16, 27, 71-72, 85, 86, 97, of, 30 124-125, 148, 153, 155, 156-159, resource allocation for services, 5-6, 14, 15, 161, 173 16-17, 26, 42, 54, 126-127, 148-150, 151, 152, 153, 175, 183, 186, 192

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 INDEX risk factors for hepatitis, 156, 157-158, Coinfection 159 HBV and HCV, 23, 29, 30, 32 screening and counseling HIV and hepatitis, 23, 29, 72, 81-82, recommendations of, 82-83, 84, 156- 190 157, 159, 183 Collaborative Injection Drug User Study state cooperative agreements with, 4, 7, Drug User Intervention Trial, 94, 95 42, 54, 57, 64-66, 67 Colorado, 58 surveillance initiatives, 4, 6, 7-8, 42-43, Committee task 44, 45, 50, 57, 58, 59-61, 63, 64, approach, 32-35 65-66, 67, 68, 69, 70-71 charge to committee, 30-32 vaccination recommendations and Community programs, 12, 110-111, 124-125, health centers, 16, 149, 186-189 126, 128-129, 134, 136, 153, 157 outreach, 9, 90, 91-92, 97, 98-99, 101 VFC program, 128-129, 130, 131, 134 screening and testing programs, 5, 13 Centers for Medicare and Medicaid Confidentiality safeguards, 43-44, 65 Services, 129, 149. See also Connecticut, 55, 58, 122 Medicaid; Medicare Contacts. See also Partner services Central nervous system demyelinating education of, 97, 98 disorders, 32 vaccination, 54, 57-58, 62, 93, 117, Chicago, 28, 116, 121 119-120 Childhood Immunization Initiative, 126 Correctional facilities. See also Incarcerated Children populations asymptomatic infections, 47 educational programs on viral hepatitis, HBV, 23, 25, 30, 47, 116-117, 128-132 88-89, 99-100 HCV, 51 recommendations, 16 information systems on, 127-128 viral hepatitis services, 6, 13, 14, 16, progression of infection in, 46, 117, 118 149, 184-186 vaccination, 4, 9, 10, 25, 30, 93, 97, 110, Counseling, 5, 14, 31, 62, 63, 84, 85, 87, 111, 112, 116-117, 128-132, 134 95, 124, 134, 148, 151, 152, 157, Children’s Health Insurance Program 160, 163, 168, 171, 172, 177, 179, (CHIP), 128, 129-132, 172 180, 181, 186, 189, 191 Chinese Americans, 68, 81, 82, 86, 89, 90, 92, 174 D Chronic infections. See also Hepatitis B; Hepatitis C; Knowledge and Deaths, preventable, by disease, 20 awareness of chronic hepatitis Denmark, 121 age at exposure and potential for, 19, 22, Department of Health and Human Services, 46, 51, 82-83, 113, 117, 118, 156 110 asymptomatic nature of, 3, 23, 24, 25, National Vaccine Program Office, 126 27, 28, 47, 50, 51, 52, 53, 55, 90, Office of Minority Health and Health 159, 162 Disparities, 2, 30, 149, 152 clinical outcomes, 23; see also Liver Department of Justice, 6, 16, 149, 186 cancer and liver cirrhosis Department of Veterans Affairs (VA), 2, 28, prevalence and incidence, 1, 34, 121 30, 94, 130, 171, 172 surveillance, 25, 44, 51-54, 59, 64, 67, Detroit, 121 71 Discrimination. See Stigmatization and Clinical outcomes. See also Liver cancer and discrimination liver cirrhosis Drug treatment programs and facilities. See age at exposure and, 19, 22, 46, 51, 82- also Illicit-drug users 83, 113, 117, 118, 156 educational programs on viral hepatitis, knowledge of, 80, 83, 89 8, 88-89, 95-96, 100, 176

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 INDEX funding, 176 Emerging Infections Program, 43, 58, 59 integrated approach, 14, 149, 179 Employee Retirement Security Act, 134 prevention of seroconversion, 177, 178 End-stage renal disease patients, 113, 131, screening and testing, 176 152 staff knowledge of hepatitis, 85, 88, 96 Epidemiologic Surveillance Project, 60 vaccination opportunities, 121, 124, 129 Epidemiology and Laboratory Capacity for Drug users. See Illicit-drug users Infectious Diseases program, 59 Exposure routes knowledge and awareness, 95 E sexual, 1, 23, 44, 72, 84, 119-120 unsafe vaccine injections, 24 Economic issues. See also Funding; Insurance coverage screening and testing, 27, 161-162, 163 F vaccination, 54, 57-58, 117-119, 124, 137-138 Federal Employees Health Benefits Program, Educational programs. See also Knowledge 5, 13, 130, 148, 172 and awareness of chronic hepatitis Florida Hepatitis Prevention Program, advocacy efforts, 153-154 186-187 for alternative-medicine professionals, Food and Drug Administration, 109 86, 87, 89 Foreign-born populations. See also Asians for at-risk populations, 4, 14, 85-86, 92- and Pacific Islanders; Hispanics 93, 95-96, 97, 98-100, 153-154 access to care, 56 CDC initiatives, 4, 8-9, 86, 87, 96, 97 culturally appropriate programs, 13, 56, contacts, 97, 98 173-174, 183-184 content, 86-87 educational outreach to, 9, 90, 91-92, continuing medical education, 87 97, 98-99, 101, 174-175 educational programs, 4, 8-9, 86, 87, exposure routes, 120 96, 97 geographic regions of endemicity, 81-82 evaluation of, 97 HBV, 1-2, 8, 13, 14, 23, 27, 81-82, 89- funding, 99, 152 90, 91-92 for general population, 4, 96, 97, 98, health disparity, 27 99, 153 incidence and prevalence of HBV, 8, 27, goals, 9, 97 79, 86, 93 for health-care and social service knowledge and awareness of risks to, 13, workers, 4, 8-9, 58, 82, 84-88 79, 81-82, 86, 87, 89-90, 173-174 integration into other programs, 9, 92, liver cancer and cirrhosis, 29 95-96, 98 recommendations, 14, 175 linguistically and culturally appropriate, screening and testing, 5, 13, 14, 90, 91, 9, 87, 90, 92, 93, 97, 98-99, 101, 148, 153-154, 155, 156, 161-162, 153, 183 173 outreach component, 96, 97, 98-99, 100 vaccination, 5, 10, 13, 14, 90, 91, 92- peer education, 95, 100 93, 116, 117-118, 120, 132, 148, in perinatal facilities, 99-101 157, 161-162 recommendations, 4, 8-9, 85-89, 96-101 viral hepatitis services for, 5, 13-14, 148, safety precautions and procedures, 88 173-175 on screening and testing, 9, 58, 98 Funding vaccination, 8, 9, 97, 101 education, 99, 152 Electronic medical records, 7, 50, 51, 60, surveillance, 3, 7, 42, 57, 58-59, 63, 65, 65, 68, 69, 70 66, 67, 71, 129 Egyptian immigrants, 24, 159 vaccination, 57, 118, 120, 129, 134

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 INDEX G chronic infection, 19, 22, 23, 34, 48, 51, 52, 59-60, 64 General population community knowledge and awareness, education program, 4, 96, 97, 98, 99 89-93 knowledge and awareness of chronic contact screening, 48, 82, 86 hepatitis, 3, 4, 9, 17, 33, 34, 79, 98 deaths, 20, 23, 26, 34, 83 recommendations, 13 economic issues, 25, 26, 128-135 screening and testing, 13 education programs, 83, 90, 92-93 viral hepatitis services, 13, 170-173 exposure routes, 1, 21, 23, 26, 44, 90 Guillain-Barré syndrome, 32 geographic differences, 27, 81 HBsAg determinant of infection, 10, 21, 22, 46, 48, 51, 52, 54, 55, 56, 69, H 82-83, 99, 100-101, 109, 110, 111, 112, 113, 114, 115, 124, 156, 157, Health Disparities Collaborative, 188 159, 160, 161, 162, 166, 174, 181, Health Resources and Services 182, 183 Administration (HRSA), 6, 16, 127, health-care provider knowledge, 81-83 148-149, 151-152, 187, 188-189, 192 health-care use trends, 30 Health-care providers and workers health-care workers, 91, 124 APIs, 82 HIV-infected people, 29, 124 educational programs, 4, 8-9, 58, 82, immunization, see Vaccines and 84-88 vaccination guidelines for, 80 incidence and prevalence, 1-2, 21, 23, immunization, 124 26-27, 29, 83, 118, 119 knowledge and awareness of hepatitis, 3, infants, 1, 25 4, 8, 17, 33, 34, 79, 80-89, 154-155, institutionalized developmentally 171, 182-183 disabled people, 124 outreach to, 97 insurance coverage, 5, 128-134 safety precautions and procedures, 88 knowledge and awareness of, 81-83, 89- vaccination, 88, 93, 113, 117, 118, 124, 93, 127-128 125 liver cancer and liver disease from, Healthcare Effectiveness Data and 29-30 Information Set (HEDIS), 126 medical management, 82, 90, 166-167 Healthcare Systems Bureau, 152 men who have sex with men, 91 Hemodialysis, 21, 22, 24, 44, 93, 113, 156, mistrust of vaccination, 127-128 158, 162 progression of infection and clinical Hepatitis A, 30, 48, 49, 50, 57, 58, 137, outcomes, 22, 23, 25, 29, 46; see 150-151, 189, 190 also Liver cancer and liver cirrhosis Hepatitis B. See also Vaccination for public vaccine programs and insurance, Hepatitis B; specific populations and 128-132 services racial/ethnic differences, 27, 29 acute infection, 1, 19, 23, 27, 34, 48, reactivation, 162 50, 59, 70-71, 99, 117, 118, 119, registries of immunization, 126-127 120, 121, 125, 161, 189 risk factors, 27 adults, 27, 47, 117-125, 132 screening and testing, 5, 8, 13, 14, 23, at-risk populations, 1-2, 21-22, 27, 81- 27, 47, 48-49, 51, 81, 82-83, 86, 90, 82, 120-125 91, 124-125, 152, 156-157, 160-162 case definition, 48, 50, 51, 52 stigma/discrimination, 23, 91-92 causative agent, 19, 21 surveillance, 44, 46, 47, 48, 50, 51, 52, children, 23, 25, 30, 47, 116-117, 59-60, 61, 64, 71 128-132

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 INDEX Hepatitis B immune globulin (HBIG), 4, 9- HIV/AIDS, 124 10, 55, 69, 110, 111, 112-113, 114, burden of disease, 25, 26 115, 182, 183-184 coinfection, 23, 29, 72, 81-82, 190 Hepatitis B Initiative, 92 funding for activities, 45, 150-151 Hepatitis C. See also specific populations HBV vaccination, 93, 113, 120, 124, 129 and services acute infection, 19, 28, 29, 34, 47, 49, mortality, 20, 45 51, 71, 136, 137, 163, 165 partner services, 63, 72 adults, 51 Prevention for Positives initiatives, 95 at-risk populations, 21-22, 28, 93-101, public awareness campaign, 98 158 screening and testing, 120, 156, 162 case definition, 49, 50, 53, 68 surveillance, 59, 61, 62, 63, 64, 66, 67, causative agent, 19, 21, 137 72 children, 51 HIV/AIDS Bureau, 152 chronic infection, 17, 22, 34, 51-52, 59, Homeless people, 56, 62, 71, 152, 154-155, 64, 136-138 187, 188, 191 economic issues, 25, 26, 137-138 education programs, 84-85, 95-96 I exposure routes, 2, 5, 21, 24, 26, 28, 44, 84 Illicit-drug users, injection drug users. See health-care provider knowledge, 83-85 also Drug treatment programs and in HIV-infected people, 30 facilities knowledge and awareness, 83-85, 93-96 access to health services, 2, 24, 29, 56, medical management, 167-169 85, 176 mortality, 20, 23, 26, 34, 45 acute infections, 120, 137, 189 prevalence and incidence, 21, 22-23, 24, contact notification, 63, 72, 86 26, 28-29, 137, 138 education programs, 95-96, 97, 154, prevention, 5, 24, 79, 136-138, 196-187 179 progression of infection and clinical gaps in services for, 175-181 outcomes, 22, 24, 29-30, 47, 84; see HBV, 1, 14, 23, 61-62, 82, 83, 120-121, also Liver cancer and liver cirrhosis 122-123, 176 racial/ethnic differences, 29-30, 168-169 HCV, 2, 5, 8, 14-15, 24, 28-29, 61, 62, risk factors, 29-30, 84 83, 84, 86, 93-94, 95-96, 136-137, screening and testing, 5, 8, 28, 51-52, 148, 158, 175-176 53-54, 62, 68, 84, 85, 86, 93-94, health-care use, 14, 176 152, 157-159, 162-165 high-risk period, 14-15 spontaneous resolution, 51, 136 knowledge and awareness of risks to, stigma/discrimination, 24, 85, 94-95 82, 83, 86, 94, 95-96 surveillance, 28, 44, 45, 47, 49, 51-52, needle-exchange/safe injection programs, 53-54, 59-60, 61, 62, 63, 64, 71 5, 9, 14, 28, 80, 88-89, 94, 97, 100, vaccine development, 2, 5, 24, 136-138 120-121, 148, 155, 166, 177, 180 Hepatitis C Continuity Program, 185-186 prevalence and incidence of infection, Hepatitis D, 30 14, 27, 61-62, 82, 96, 120, 176 Hepatitis E, 30 recommendations, 15, 179-181 Hepatocellular carcinoma. See Liver cancer referral for medical management, 148 and liver cirrhosis screening, testing, and counseling, 14, High-risk populations. See At-risk 62, 83, 85, 86, 94, 148, 156-157, populations 158, 162, 163, 179 Hispanics, 2, 10, 27, 30, 93, 116, 121, 159, stigmatization and discrimination, 24, 168-169, 184-185 85

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 INDEX surveillance, 2, 56, 61-62, 63 Infectious Diseases Society of America, 159 transmission of hepatitis, 1, 14, 24 Inflammatory bowel disease, 162 vaccination, 14, 93, 120-121, 122-123, Influenza, 20, 27, 110 124, 129, 157 Information systems, 5, 11, 72, 126-127 viral hepatitis services, 5, 14-15, 63, Initiative on Immunization Registries, 126 148-149, 175-181 Institute of Medicine, 127-128 Illicit-drug users, non-injection drug users, Institutionalized developmentally disabled 9, 14, 96, 97, 122-123, 175-176 people, 62, 93, 113, 124, 156-157 Immigrant services, 8. See also Foreign-born Insurance coverage populations gaps and barriers, 11, 134-135, 170 Immunization. See also Vaccines and private plans, 11, 12, 132-134 vaccination public plans, 11-12, 128-132, 172-173; HBIG adjuvant, 4, 9-10, 55, 69, 110, see also specific programs 111, 112-113, 114, 115, 182, 183-184 recommendations, 11-12, 172-173 Immunoglobulin M (IgM) antibody, 48, 49, screening and testing, 13, 148 50, 51, 52, 160, 161 vaccination, 5, 11-12, 128-132, 135 Immunosuppresive therapy, 162 International Symposium on Viral Hepatitis Incarcerated populations and Liver Disease, 82, 83 acute infections, 121 Injection-drug users. See Illicit-drug users education programs, 5, 8, 9, 99-100 Iowa, 95 HBV, 16, 27, 62, 83, 90-91, 121-124, Italy, 163 184 HCV, 8, 16, 28, 62, 83, 86, 100, 184 J knowledge and awareness of risks to, 83, 86, 90-91 Jade Ribbon Campaign, 92, 153-154 prevalence and incidence of infection, 121, 184 racial/ethnic differences, 184-185 K recommendations, 186 screening and testing, 16, 156-157, 185 Knowledge and awareness of chronic size of, 62, 99 hepatitis. See also Educational surveillance, 62 programs vaccination, 121-124, 157, 185 age and, 93 viral health services, 6, 16, 149, 184-186 asymptomatic infected individuals, 1, 3, Incidence of hepatitis. See Prevalence and 24, 26, 27, 50, 51, 90 incidence of hepatitis at-risk populations, 3, 4, 8, 9, 13, 34, Infants. See also Perinatal infections 82, 89-91, 93-96, 173 antiviral therapy, 183-184 of clinical outcomes, 80, 83, 89 followup, 56 community, 89-101 HBV case definition, 55 contact notification and screening, 9, 84 HBV infection, 4, 9-10, 25, 54-55, 75, correctional facilities, 88-89, 99-100 93, 100, 110, 111-116, 173, 182 and discrimination and stigma, 8, 9, 85, immunization, 4, 9-10, 25, 54-55, 75, 91-92, 94-95 93, 100, 110, 111-116, 173, 182 drug-treatment facilities and needle- incidence and prevalence of hepatitis, exchange programs, 5, 8, 9, 100 100, 111, 112, 182 exposure routes, 95 potential for and progression to chronic general public, 3, 4, 9, 17, 33, 34, 79, infection, 22, 46, 51, 82, 113, 156 98 preterm, 111, 112, 114, 115 HBV, 81-83, 89-93, 127-128 screening/testing, 54, 162 HCV, 83-85, 93-96 surveillance, 182

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 INDEX health-care and social-service providers, coinfections, 23 3, 4, 8, 17, 33, 34, 79, 88-89, 154- components of, 155 155, 171, 182-183 costs and cost-effectiveness, 163, mistrust of vaccination, 8, 127-128 169-170 perinatal facilities, 82-83, 100-101 disparities, 169 policy-makers, 3, 17, 98 education on, 86 of prevalence and incidence, 8, 79, 80, goals, 166 81, 83, 89, 153-154 guidelines, 30, 32, 80, 155, 166-168 of prevention approaches, 80, 89 insurance coverage, 130, 170 race/ethnicity and, 93 interferon-alpha-based treatment, 30, recommendations, 4, 8-9, 85-89, 96-101 170 or risk factors and high-risk population provider knowledge, 82, 86 characteristics, 80, 81-84, 89 racial/ethnic disparities, 168-169 of screening, testing, and management referral for, 5, 6, 14, 15, 31, 56, 62-63, methods, 5, 8, 9, 79, 80, 82-83, 84, 70, 72, 83, 120-121, 148, 149, 153, 90 166, 170, 171, 177, 181, 182, 183, surveillance and, 45 189 Korean Americans, 90 Medicare, 5, 13, 128, 130, 132, 134, 148, 152, 168, 172 Men who have sex with men, 21, 27, 44, L 71, 81, 82, 91, 97, 113, 156, 162, 191 Lamivudine prophylaxis, 162, 170, 183 Metabolic syndrome, 30 Lao People’s Democratic Republic, 115-116 Minnesota, 58, 172 Liver cancer and liver cirrhosis Mobile health units, 6, 13, 16-17, 120-121, age and, 79 122, 149, 189, 191-192 deaths, 1, 23, 24, 25, 29 Montana, 116 incidence and prevalence, 22-23, 79, 154 Multiple sclerosis, 32 prevention, 1, 19, 109 progression of infection to, 46-47 racial/ethnic differences, 29-30, 153-154, N 169 risk factors, 29-30, 169 National Alliance of State and Territorial surveillance, 67, 72 AIDS Directors (NASTAD), 42-43, survival rate, 23 58, 59, 60, 61, 63, 189 Liver transplants, 25, 67, 110, 169 National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis M Prevention, 26, 45, 150-151 National Center for Immunization and Maryland, 27 n.1, 116, 173 Respiratory Diseases, 15, 126, Massachusetts, 63, 69, 186 181-182 Measles, 20, 116 n.1, 136 National Electronic Disease Surveillance Medicaid, 13, 128-129, 132, 148, 152, 168, System (NEDSS), 61 172 National Electronic Telecommunications Early Periodic Screening, Diagnosis, and System for Surveillance (NETSS), Treatment, 11, 130-131, 134 60-61, 64 Medical management of hepatitis, 3, 5, National Health and Nutrition Examination 166-170 Survey, 62 access to, 56, 79, 130, 183 National HIV Behavioral Surveillance antiviral therapy, 6, 15, 24, 79, 86, 149, System, 62, 72 184

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 INDEX National Immunization Program, 126 prevention, 5-6, 15, 54, 183-184 National Immunization Surveys, 111-112, progression of, 46 126, 128 screening and testing, 54-56 National Institutes of Health, 6, 15, 30, surveillance, 54-56 149, 184 Peripartum antiviral therapy, 6, 15, 149, 184 National Vaccine Advisory Committee Policy-makers (NVAC), 126, 127 knowledge and awareness of chronic National Viral Hepatitis Roundtable, 2, 30 hepatitis, 3, 17, 98 Needle-stick injuries, 1, 21, 88, 158 Polio, 20, 110, 116 n.1 New Haven, 120, 122-123 Pregnant women. See also Perinatal New Jersey Academy of Family Physicians, infections 82, 83 antiviral therapy, 6, 15, 149, 184 New York City, 28, 58, 85, 90, 92, 120- case management, 70, 149, 182 121, 122, 173, 186, 190 education, 97, 100-101 New York state, 58, 185-186 educational programs on viral hepatitis, Nosocomial infections, 24, 67, 87, 88 9, 99-100 foreign-born women, 23, 182-183 HBV, 6, 15, 23, 25, 82-84, 90, 149, O 182-183 HCV, 83-84 Occupational Safety and Health household contacts and sexual partners, Administration, 88 54, 182 Office of Management and Budget, 129 knowledge and awareness of risks to, Omnibus Budget Reconciliation Act of 82-84 1993, 128-129 lamivudine prophylaxis, 162, 170, 183 Optic neuritis, 32 medical management, 6, 15, 149, Oregon, 58 182-183 Outbreak recommendations, 15-16, 184 detection and control, 48, 67, 70 screening and testing, 15, 25, 54-56, prevention, 88 69, 82-83, 84, 111, 120, 149, 162, 181-182 surveillance, 54, 69, 70, 182 P vaccination, 4, 10, 54, 111-116, 129, 131, 132, 182 Partner services viral hepatitis services, 15, 149, 181-184 CDC guidelines, 63 Prevalence and incidence of hepatitis contact notification, 9, 15, 63 accuracy of estimates, 50-51, 56, 57, 66, cost-effectiveness, 63 70-71 funding, 72 acute infections, 1, 50, 70-71, 99, 118, screening and testing, 48, 82, 86, 98, 119, 120, 121, 125 100, 154, 162 APIs, 1-2, 23, 27, 29, 81-82, 83, surveillance, 48, 62-63, 68, 72 93, 117-118, 153-154, 161, 183, vaccination, 54, 57-58, 62, 93, 113, 184-185 117, 119-120 at-risk populations, 62, 81 Perinatal hepatitis B coordinators, 15, 54, 152 CDC estimates, 25, 26, 27, 62, 120, Perinatal infections. See also Pregnant 182, 189 women chronic infections, 1, 34, 121 educational programs on, 99-101 definitions, 7 n.1 HBV, 46, 111-116, 152 immigration and, 2 immunization, 9, 54-55, 111-116 knowledge and awareness of, 8, 79, 80, knowledge and awareness, 82-83, 81, 83, 89, 153-154 100-101

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 INDEX monitoring and reporting, 71; see also Referral for additional services, 5, 6, 14, 15, Surveillance 31, 56, 62-63, 70, 72, 83, 120-121, U.S., 1, 2, 25-29, 86 148, 149, 153, 166, 170, 171, 177, worldwide, 22-24 181, 182, 183, 189 Prevention and control of hepatitis. See also Reporting systems and requirements, 59-61, Counseling; Educational programs; 68 Medical management of hepatitis; Resource allocation, 45 Screening and testing; Vaccines and barriers to, 3 vaccination; Viral hepatitis services CDC, 5-6, 14, 15, 16-17, 26, 42, 54, barriers to, 2-3 126-127, 148-150, 151, 152, 153, CDC recommendation, 30 175, 183, 186, 192 charge to committee, 31 Respiratory syncytial virus, 20 education on, 80, 87 Rheumatoid arthritis, 162 funding, 44, 54 Rhode Island, 90 harm reduction, 155, 166 Risk factors for hepatitis knowledge and awareness of methods, APIs, 90 84, 86 CDC, 156, 157-158, 159 needle-exchange/safe injection programs, knowledge and awareness of, 80, 81-84, 5, 9, 14, 28, 80, 88-89, 94, 97, 100, 89 120-121, 148, 155, 166, 180 screening for, 3, 5, 8, 11, 13, 16, 85, 86, perinatal transmission, 25, 183-184 124-125, 148, 153, 155, 156-159, research recommendations, 15 162 state plans, 152-153 Ryan White CARE Act and program, 33, strategies, 25, 31, 84, 177-179 152, 170 Prevention for Positives initiatives, 95 Public Health Information Network S (PHIN), 7, 61, 64, 65, 70 Safety precautions and procedures, 88 San Diego, 134, 170, 189-190 R San Francisco, 58, 81, 120, 121, 122-123, Race/ethnicity 173, 174, 182 and knowledge and awareness of Schistosomiasis-eradication campaign, 24 hepatitis, 93 Scotland, 122-123 vaccination disparities, 10, 116-117, 121 Screening and testing Racial and Ethnic Approaches to access to, 3 Community Health (REACH) 2010, acute infections, 47-51, 160, 161, 163, 93 165 Recommendations antigens and antibodies used for, 160, at-risk populations, 14, 15, 16-17, 175, 161 179-181, 184, 186 at-risk populations, 3, 4, 5, 6, 9, 11, committee approach, 32 13-14, 16, 27, 71-72, 91-92, 97, community health centers, 188-189 120, 124-125, 148, 152, 153-154, education programs, 4, 8-9, 85-89, 156-157, 158-159, 161-162, 173 96-101 barriers to, 124-125 insurance coverage, 11-12, 172-173 CDC recommendations, 82-83, 84, 156- integrated services, 192 157, 159, 183 outcomes of implementing, 17, 34 community-based programs, 5, 13 screening and testing, 4, 6, 13, 16, 148 confirmatory tests, 162-163 vaccination, 4-5, 9-12, 93, 114, 117, contacts/partners, 48, 82, 86, 98, 100, 125, 127, 135, 136, 138 154, 162

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 INDEX cost-effectiveness, 27, 161-162, 163 Sexually transmitted diseases (STDs) cultural aversion to, 91-92, 98 clinic services for hepatitis, 6, 13, 14, education on, 9, 58, 98 16-17, 54, 86, 87, 119-120, 124, electronic laboratory reporting, 7, 60, 125, 129, 134, 149, 151, 170, 171, 65, 68-69, 70 176, 189-190, 191, 192 enzyme immunoassay, 51, 53, 54, 162- disease intervention specialists, 63 163, 164-165 funding for services, 45, 151 followup/repeat, 48-49, 80 integrating services for STD and general population, 13 hepatitis, 189-190 goals, 154-155 partner notification, 63 guidelines, 80, 86 surveillance, 59, 61, 63 HBV, 5, 8, 13, 14, 23, 27, 48-49, 51, Shelter-based programs, 6, 13, 16-17, 149, 81, 82-83, 86, 90, 91, 124-125, 152, 189, 191, 192 156-157, 160-162 Social and peer support, 3, 95, 100, 155 HCV, 5, 8, 28, 51-52, 53-54, 62, 68, Social-service providers. See also Substance- 84, 85, 86, 93-94, 152, 157-159, abuse services and providers 162-165 educational programs, 88-89 importance, 23 knowledge and awareness of hepatitis, insurance coverage, 13, 148, 171 80-89 interpretation of results, 94, 160-161, Society of General Internal Medicine, 82 162, 164-165 South Dakota, 116 knowledge and awareness of methods, 5, Southeast Asian immigrants, 24, 79, 82, 183 8, 9, 79, 80, 82-83, 84, 90 Standardization of data, 69 laws, 83 State and territorial health departments nucleic acid testing, 49, 53-54, 68, 159, case followup, 55 163, 164-165 cooperative agreements with CDC, 4, 7, pregnant women, 15, 25, 54-56, 69, 82- 42, 54, 57, 64-66, 67 83, 84, 111, 120, 149, 162 funding, 152 recombinant immunoblot assay, 49, 53, surveillance role, 4, 6, 7 163, 164-165 STD/HIV clinics, 87, 189-190 recommendations, 4, 6, 13, 16, 148 Stigmatization and discrimination, 8, 9, 23, referral for medical management, 5, 6, 24, 56, 85, 87, 89, 91-92, 94-95, 97, 14, 15, 31, 56, 62-63, 70, 72, 83, 98, 170, 174 120-121, 148, 149, 153, 166, 170, Study to Reduce Intravenous Exposures 171, 177, 181, 182, 183, 189 (STRIVE), 95 reporting test results, 4, 6, 7, 41-56, 58, Sub-Saharan African immigrants, 23, 79, 59-61, 65, 66, 67, 68-69 82, 90 resource allocation, 3, 17, 45 Substance Abuse and Mental Health resources available for, 49, 54, 56, 57-58 Services Administration (SAMHSA), risk-factor, 3, 5, 8, 11, 13, 16, 85, 86, 149, 152 91, 124-125, 148, 153, 155, 156- Substance-abuse services and providers. 159, 162 See Drug treatment programs and serologic, 4, 5, 6, 7, 13, 47, 51, 53-54, facilities 120, 148, 156, 159-165 Surveillance VA program, 28, 158 acute infections, 29, 44, 47-51, 59, 64, Section 317 Immunization Grant program, 67, 71 11, 126, 129, 130, 132, 134, 135, analyzing, reporting, and disseminating 153 findings, 67, 70-71 Services. See Viral hepatitis services applications of data from, 41, 42, 43-46 Sexual exposure to hepatitis, 1, 23, 44, 72, at-risk populations, 2, 4, 6, 7, 32, 61-62, 84, 113, 119-120 67, 68, 71-72

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0 INDEX automated data collection, 7, 51, 56, 60, serologic testing, 4, 6, 7, 47, 51, 53-54, 65, 68-70 68, 71, 159-165 AVHPC surveys, 42-43, 54, 55, 57, 58, standardization issues, 6, 7, 41, 56, 61, 59, 61, 64, 70 64, 65, 66-67, 68, 69, 70 case definitions, 7, 48, 49, 50, 51, 52, state-CDC cooperative agreements, 4, 7, 53, 54, 55, 65, 68, 69 42, 54, 57, 64-66, 67 case management uses, 43, 45-46, 57- targeted, 43, 66, 71-72 58, 62-63, 65, 68, 70, 72 underreporting/misclassification of CDC initiatives, 4, 6, 7-8, 42-43, 44, 45, infections, 3, 27, 34, 47, 50, 60, 62, 50, 57, 58, 59-61, 63, 64, 65-66, 67, 70-71 68, 69, 70-71, 150 vaccinations, 59, 72, 111 challenges, 29, 47-54, 56, 60 chronic infections, 25, 44, 51-54, 59, 64, T 67, 71 committee charge and approach, 31-32, Tattooing and piercing, 99, 158-159 41-42 Transverse myelitis, 32 confidentiality safeguards, 43-44, 65 Travelers, 22, 93, 113, 117, 156 core activities, 4, 6, 7, 43, 66, 67, 68 Tuberculosis, 20, 26, 45, 61, 150, 151, 186 current system, 3, 25, 34, 41-42 design of programs, 6, 59 disease-specific issues, 46-56 u electronic medical records, 7, 50, 51, 60, 65, 68, 69, 70 United Kingdom, 162 enhanced projects, 58, 62, 71-72 US Preventive Services Task Force, 82-83, evaluation of systems, 63-64, 66, 69, 70 159, 181 funding, 3, 7, 42, 57, 58-59, 63, 65, 66, US Public Health Service, 132, 150, 159, 190 67, 71, 129 identifying infections, 4, 6, 41-56, 69 v infrastructure and process-specific issues, 57-66, 67, 70 Vaccines and vaccination, HBV jurisdictional issues, 56, 57, 60, 65-66 accessibility, 120-121, 124, 128, 129, and knowledge and awareness of 134, 135 heptatitis, 45 ACIP recommendations, 4, 9-10, 11, 55, liver cancer and cirrhosis, 67, 72 83, 88, 93, 100, 110-115, 116, 125, model programs, 43, 65, 66-72 127, 132, 133, 134, 181 outbreak detection and control uses, 44, adults, 11, 32, 93, 110, 111, 113, 116, 48, 67, 70 117-125, 126, 127, 128, 129, 132, partners of infected people, 48, 62-63, 134 68, 72 at-risk populations, 4, 9, 10-11, 27, 81, perinatal infections, 54-56 93, 113, 117-125 PHIN-compliant systems, 7, 61, 64, 65, barriers to, 8, 10, 11-12, 118, 120, 124- 70 125, 127-136 pregnant women, 54, 69, 70, 182 CDC recommendations and programs, programmatic design and evaluation 12, 110-111, 124-125, 126, 128-129, uses, 3, 41, 45, 57, 67 134, 136, 153, 157 quality of data, 50, 57, 64, 66, 67, 71, children and adolescents, 4, 9, 10, 25, 79, 94 30, 93, 97, 110, 111, 112, 116-117, recommendations, 4, 6-7, 43, 63-66 126, 127, 128-132, 134 reporting systems and requirements, 7, cost-effectiveness, 54, 57-58, 117-119, 48, 51, 58, 59-61, 65, 66, 67, 68-69 124, 137-138, 162 resource allocation uses, 3, 17, 45

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 INDEX coverage data, 111-112, 114-115, 116, supply of vaccines, 5, 12, 118, 127, 117, 118, 120, 121, 126, 132 135-136 education programs, 8, 9, 97, 101 surveillance, 59, 72, 111 efficacy, 110 travelers, 22, 93, 113, 117, 156 evaluation of programs, 45 WHO guidelines, 30, 114 foreign-born people, 5, 10, 13, 14, 90, Vaccines and vaccination, HCV 91, 92-93, 116, 117-118, 120, 132, development, 2, 24, 136-138, 166 148, 152, 161-162 feasibility, 136-137 formulations, 109-110, 136 need for, 137 funding for, 57, 118, 120, 129, 134, 152 recommendations, 5, 12, 138 geographic variability, 116 therapeutic, 136 HBIG adjunct, 110, 114 Vaccines for Children (VFC) program, 128- health-care and social-service workers, 129, 130, 131, 134 88, 93, 113, 117, 118, 124, 125 Veterans, 28, 94, 130-131, 158, 168, 171 HIV-infected people, 93, 113, 120, 124, Vietnamese Americans, 68, 90, 171 129 Viral hepatitis services. See also Counseling; identifying at-risk adults for, 124-125 Educational programs; Medical illicit-drug users, 14, 93, 120-121, 122- management of hepatitis; Screening 123, 124, 129 and testing; Vaccines and vaccination immunization-information systems, 5, access to, 2, 3, 34, 56, 79, 151, 169, 170 11, 72, 126-127 adult viral-hepatitis prevention incarcerated people, 11, 113, 121-124, coordinators, 42-43, 57, 59, 61, 64, 125 70, 152-153 incentives, 121 adults, 3, 5, 6, 13, 16-17, 56, 79, 149, infants, 4, 9-10, 25, 54-55, 75, 93, 97, 189-192 110, 111-116, 120, 173, 182 case management, 45-46, 57-58, 62-63, institutionalized developmentally 70, 72, 149, 170 disabled people, 93, 124 CDC allocations for, 5-6, 14, 15, 16-17, insurance coverage, 5, 11-12, 128-132, 26, 42, 54, 126-127, 148-150, 151, 135 152, 153, 175, 183, 186, 192 liver cancer prevention, 109 community-based approaches, 5, 6, 13, liver transplants and, 110 14, 16, 148, 149, 174-175, 186-188 mandatory, 116-117, 134, 153 core components, 5, 12, 13, 148, 153, mistrust of, 8, 127-128 154-157 partners and household members (ring current status, 148-154 vaccination), 54, 57-58, 62, 93, 117, design and evaluation of programs, 3, 119-120, 162 41, 45, 57, 67 payment for, 57, 128-135, 152, 153 foreign-born people, 5, 12, 13-14, 16, perinatal, 4, 10, 54, 111-116, 129, 131, 92, 148, 173-175 132 funding (public), 148-149, 150-152, public programs and insurance, 128-132 171, 172-173 racial and ethnic disparities, 10, 116- gaps in, 12-17, 170-192 117, 121 general population, 12, 13, 148, recommendations (committee), 4-5, 170-173 9-12, 93, 114, 117, 125, 127, 135, HBV, 5-6, 14, 15, 148, 149, 153, 136, 138 182-183 safety issues, 32-33, 127-128 HCV, 5, 14, 148-149, 153 schedules and completion of series, 11, identifying infected persons, see 25, 55, 91, 101, 110, 111, 114, Screening and testing 116 n.1, 120, 121, 125, 127, 157 illicit-drug users, 2, 5, 12, 14-15, 148- 149, 175-181

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 INDEX incarcerated populations, 6, 13, 16, 149, shelter-based programs, 6, 13, 16-17, 184-186 149, 189, 191, 192 integrated approach, 14, 16-17, 149, social support, 3 171-172, 179, 180-181, 189-192 at STD/HIV clinics, 6, 13, 14, 16-17, 54, knowledge and awareness of, 91 86, 87, 119-120, 124, 125, 129, 134, mobile health units, 6, 13, 16-17, 120- 149, 151, 170, 171, 176, 189-190, 121, 122, 149, 189, 191-192 191, 192 model programs, 33, 152, 157, 170, Viral Hepatitis Surveillance Emerging 171-172 Infections Program, 58 nongovernmental organizations, Vitamin K prophylaxis, 115 153-154 pregnant women, 5-6, 13, 15, 54, 70, W 149, 181-184 prevention, 3, 5, 12, 15, 166, 177-179, Washington State Basic Health Insurance 183-184; see also Vaccines and Plan, 171 vaccination Whites, 2, 10, 27, 30, 33, 81, 116, 168, program venues for high-risk groups, 13, 169, 184-185 176-177 World Health Organization, 23, 30, 115 recommendations, 5-6, 12-17, 148-149, Collaborating Center for Reference and 172-173, 179-181, 192 Research on Viral Hepatitis, 151