House of Representatives Holds Hearing on the "Secret Epidemic" of Viral Hepatitis

		SUMMARY: One June 17 the U.S. House of Representative Oversight and Government Reform Committee held a hearing on viral hepatitis, a largely "silent epidemic" that has begun to receive more attention in the wake of the Institute of Medicine's report on liver cancer and hepatitis B and C. Assistant Secretary for Health Howard Koh and John Ward, director of the Centers for Disease Control and Prevention's Viral Hepatitis Program, participated in the meeting. The committee urged Congress to pass legislation introduced by Rep. Mike Honda and a bipartisan coalition of co-sponsors (H.R. 3974) that will increase funding for hepatitis B and C education, testing, and treatment.

Below is the text of a posting from the American Associations for the Study of Liver Diseases (AASLD) public policy web site describing the meeting.

Viral Hepatitis: The Secret Epidemic

Hearing by the Committee on Oversight and Government Reform, United States House of Representatives, June 17, 2010

Mike Honda

In response to the Institute of Medicine (IOM) report last January -- Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C -- and AASLD's collaboration with the Trust for America's Health to bring attention to the burden of liver disease created by viral hepatitis, the House Oversight and Government Reform Committee held a hearing on Thursday, June 17th entitled Viral Hepatitis: The Secret Epidemic. During the hearing, the Committee urged Congress to pass legislation to boost the diagnosis and treatment of viral hepatitis. Witnesses included Representatives Hank Johnson, Bill Cassidy and Mike Honda as well as Dr. Howard Koh, Assistant Secretary for Health at the Department of Health and Human Services, Mr. Randy Mayer, Chief of the Bureau of HIV, STD and Hepatitis at the Iowa Department of Public Health, Mr. Michael Ninburg, Executive Director of the Hepatitis Education Project, Dr. Jeffrey Levi, TFAH, and Mr. Rolf Benirschke, Spokesperson for Hepatitis C Awareness.

Representative Cassidy did an excellent job articulating the impact of viral hepatitis should it go unchecked. He raised the point that it costs $50 to vaccinate a child against HBV, but costs over $1 million to treat a HBV patient over their lifetime should they receive a liver transplant. He cited the effectiveness of the vaccines for children program authorized by Congress during the Clinton administration and urged Congress to act again to fight viral hepatitis. He stressed that the most important thing that can be done is to educate providers, patients, and their families. In his testimony, Representative Honda advocated for the support and passage of his bill, HR 3974.

Assistant Secretary Koh -- accompanied by Dr. John Ward -- said that the interagency report would be completed this fall. He cited the need for more research for a HCV vaccine, to improve awareness of infection, reduce the spread of hepatitis in health care settings, and raise awareness within and testing of high risk populations. When asked by Chairman Towns (D-NY) whether hepatitis could be eliminated, Koh responded that it could be with the right resources. Koh also touched on screening guidelines and cited the US Preventive Services Taskforce (USPSTF) as just one of the groups that releases screening guidelines. Representative Bilbray (R-CA) asked about the target population for screening, saying he believes that the population should be viewed multi-dimensionally. Koh and Ward responded that risk based screening models have created barriers to screening and given the segment of the population most likely to be developing symptoms, an age based strategy could be more effective.

While both Democrats and Republicans on the committee agreed that something must be done to prevent the spread of viral hepatitis, the main obstacle remains funding for the needed programs.