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Abstract
Hepatitis B and C infection is a severe health problem in the United States that persists even with the available clinical interventions, diagnostic tests, and therapeutics that exist such as a highly effective vaccine for hepatitis B and better-tolerated treatment for hepatitis C. Only acute hepatitis B and C infection can lead to chronic infection, and these two types of hepatitis have many similarities regarding the need for improved testing to diagnose infection and linkage to care. This study focuses on acute hepatitis B virus and hepatitis C virus infection in the United States and assesses state-level readiness to achieve national viral hepatitis elimination goals. The main objective of this study is to 1) assess the relationship between acute hepatitis B and C infection at the state level and the socioeconomic factors associated with high infection rates, and 2) compare and assess state-level readiness to eliminate viral hepatitis. Acute hepatitis B and hepatitis C infection rates at the state level were significantly associated with substance use, opioid-related variables, and socioeconomic factors like the rate of homelessness in the state. Efforts to eliminate hepatitis at the state level are multidimensional. Common strengths of hepatitis elimination efforts were identified among selected states to include robust harm reduction programs, accessible wrap-around services, and improved access to testing and treatment services. Similarly, weaknesses of hepatitis elimination efforts included having no harm reduction programs in place or having programs that do not go far enough in preventing disease transmission, persistent barriers in access to testing and treatment services, and a lack of wrap-around services, particularly among at-risk populations. More remains to be done at the state and national levels to accelerate progress toward achieving national viral hepatitis elimination goals in the United States.