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Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
CDC should revise and standardize definitions and methods. Revised case definitions should reflect active and resolved hepatitis C infection (for example, a case should not be confirmed if only antibody test results are available). Recommended testing for hepatitis C should include, where possible, HCV RNA tests to determine whether a person is actively infected. The case definition for acute HBV and HCV infection should be revised to remove the need for symptoms for classification as a confirmed case. Classification as a suspected case of acute HCV infection should be used to encourage active followup of likely recent infections (for example, in adolescents and young adults) (CDC, 2008f).
The case-reporting form should be standardized, and core components of it should be required of all jurisdictions to permit better capture of information on cases of acute and chronic HCV and HBV infection. The required elements should be such that they could reasonably be found in a patient’s medical record. For example, the current CDC form requests the number of sexual partners in a given period. That information is not typically found in a medical record or known by a medical provider. Additional, more comprehensive epidemiologic studies could be funded to provide for patient interviews and a detailed assessment of risk factors (see Recommendation 2-3). Furthermore, the case-reporting form should collect more detailed demographic data on racial and ethnic populations to identify and address disparities among populations. For example, the case-reporting form should include categories for different ethnicities and should disaggregate Asians and Pacific Islanders (for example, Chinese, Vietnamese, Japanese, and Marshallese).
Automated Data-Collection Systems
Automated or passive methods of accessing and processing test results should be supported and improved. Enhancing and expanding automated methods of collecting data (for example, Web-based disease-reporting systems, electronic laboratory reporting, and electronic medical records) reduce staff time, increase timeliness and completeness, and minimize data-entry errors (Klevens et al., 2009; Klompas et al., 2008; Lazarus et al., 2001; Panackal et al., 2002; Vogt et al., 2006; Wurtz and Cameron, 2005). Given the volume of viral-hepatitis data, automated systems clearly are indicated (Hopkins, 2005). However, it has been noted that although electronic laboratory reporting can greatly increase the timeliness and accuracy of