[Hepatitis B and C: in view of the treatment options, priority should be given to reaching the groups at risk]

Abstract

There are now effective treatments for both hepatitis B and C. For hepatitis B, a highly effective vaccine is available that is in common use in the Netherlands for the prevention of infection in the children of HBsAg-positive mothers. In the Dutch policy regarding viral hepatitis, a key role is given to contact with the groups at risk. The problem with this is that an individual must first acknowledge, on the basis of the information that is available and known to him or her, that he or she is at risk before becoming eligible for the next step, such as vaccination or a screening study. Immigration, sexual transmission and trips to endemic areas are important factors in the dissemination of hepatitis B in the Netherlands. For a vaccination policy that is based on the approach to groups at risk, the challenge is to achieve at least 80% coverage of the relevant groups, such as travellers and homosexual men. The situation is comparable for hepatitis C: a hepatitis that progresses slowly in the course of 20-30 years but is still asymptomatic at the beginning can be completely cured, provided that drug treatment is started on time. The challenge here is again to reach the highly varied groups at risk. Specifically for hepatitis C, a major campaign, supported by the Dutch Health Council, was started in 2007.