Strategies to prevent and control hepatitis B and C virus infections: a global perspective

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of acu te and chronic liver disease worldwide. Chronic infection with these viruse s often leads to chronic liver disease, including cirrhosis or primary hepa tocellular carcinoma. Both HBV and HCV are bloodborne viruses; however, HBV is transmitted efficiently by both percutaneous and mucosal exposures, and HCV is transmitted predominantly by percutaneous exposures. Because the re lative importance of various modes of transmission of these viruses differs by country, the choice of specific prevention and control strategies depen ds primarily on the epidemiology of infection in a particular country. Comp rehensive hepatitis B prevention strategies should include (1) prevention o f perinatal HBV transmission, (2) hepatitis B vaccination at critical ages to interrupt transmission and (3) prevention of nosocomial HBV transmission . The prevention of hepatitis C is problematic because a vaccine to prevent HCV infection is not expected to be developed in the foreseeable future. F rom a global perspective, the greatest impact on the disease burden associa ted with HCV infection will most likely be achieved by focusing efforts on primary prevention strategies to reduce or eliminate the risk for transmiss ion from nosocomial exposures (e.g. blood transfusion, unsafe injection pra ctices) and high-risk practices (e.g, injecting drug use). Published by Els evier Science Ltd.