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Goal

• Reduce the risk of chronic hepatitis B virus (HBV) infection and its long-term complications

Objectives

• Prevent new HBV infections by promoting screening, immunization and education
• Promote early detection, appropriate follow-up and clinical management of persons with chronic HBV infection
• Increase awareness and support of HBV and liver cancer research among national and state policy makers

Strategy #1: Improve HBV-related Public Health Prevention Infrastructure

1. Emphasize the importance of HBV surveillance systems to document and monitor the burden of chronic HBV infection and its associated liver disease, including hepatocellular carcinoma (HCC)
2. Promotion of comprehensive case registries and prevention, care and treatment networks at state and local levels.
3. Support infrastructure development for vaccination, screening, and prevention services.
4. Enhance health system data management, intentional reporting and communication so that HBV disease surveillance occurs in a way that facilitates public health action and follow-up.

Strategy #2: Increase HBV-related Health Education and Awareness

1. Develop a national education and awareness campaign targeting the general public and at-risk communities by concurrently engaging, mobilizing, and facilitating a grassroots movement among community stakeholders including, but not limited to, health care providers, employers, mainstream and ethnic media, community groups, community-based organizations, and students
2. Raise hepatitis B birth dose vaccination coverage to 100 percent.
3. Provide culturally competent education and training about HBV for health care providers.
4. Ensure that every health care professional is educated about whom to vaccinate and whom to screen, the appropriate use and interpretation of hepatitis B serology screening tests, and the need to evaluate all persons who are HBsAg+ with additional tests (e.g., HBV viral load) to identify the stage of infection and the risk of liver cancer
5. Develop a national advocacy plan in order to educate national and state policy makers about HBV.
6. Promote the establishment of support networks for patients with chronic HBV and HCC on national, regional and local levels.

Strategy #3: Increase Screenings for Chronic HBV Infection

1. Promote programs that properly screen, provide links to those that require vaccination or follow-up care, and collect de-identified data for persons at risk for chronic hepatitis B (based on CDC recommendations).
2. Promote the use of HBsAg testing as a tool for liver cancer screening.
3. Support adherence to CDC recommendations to screen for HBV using HBsAg, anti-HBc, and anti-HBs prior to immunosuppressive therapies.

Strategy #4: Improve Access to Care and Treatment for Chronic HBV

1. Improve access to and maintenance of care for insured, uninsured, underinsured and low-income persons who have chronic HBV infection.
2. Provide access to culturally and linguistically appropriate treatment to all.
3. Improve access to and maintenance of care by increasing patient education and compliance.

Strategy #5: Increase Research for HBV and Liver Cancer

1. Advocate and support HBV and primary liver cancer research at NIH and CDC that will lead to better prevention, management and treatment of chronic HBV infection and earlier detection and improved treatment of HCC:
   1. Epidemiologic research - to better understand the burden of disease and groups most at risk of infection
   2. Behavioral research - to prevent behaviors that lead to the spread of new infections and foster behaviors that lead to better adherence to care and treatment
   3. Basic and translational research – to improve our understanding of the host and virus interactions during infection and develop new treatments and better treatment regimens
   4. Clinical research – to understand better the spectrum of HBV disease and identify risk factors for disease progression
   5. Diagnostic research - to develop point-of-care diagnostic assays and better biomarkers for the early detection of liver cancer
   6. Prevention research - to understand how best to implement interventions within the healthcare system or in other settings that are feasible, effective, and culturally appropriate.
2. Promote conduct of clinical trials to improve early detection, prevention and treatment of chronic HBV infection and HCC that includes minority populations and incorporates the principles of community-based participatory research.