I 
114TH CONGRESS 
1ST SESSION H. R. 1101 
To amend the Public Health Service Act to revise and extend the program 
for viral hepatitis surveillance, education, and testing in order to prevent 
deaths from chronic liver disease and liver cancer, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 26, 2015 
Mr. GUTHRIE (for himself, Mr. HONDA, Mr. DENT, and Mr. JOHNSON of 
Georgia) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Veterans’ Affairs, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act to revise and extend 
the program for viral hepatitis surveillance, education, 
and testing in order to prevent deaths from chronic 
liver disease and liver cancer, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Viral Hepatitis Testing 
Act of 2015’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Approximately 5,300,000 Americans are 
chronically infected with the hepatitis B virus (re-
ferred to in this section as ‘‘HBV’’), the hepatitis C 
virus (referred to in this section as ‘‘HCV’’), or 
both. 
(2) In the United States, chronic HBV and 
HCV are among the most common causes of liver 
cancer, one of the most lethal and fastest growing 
cancers in the United States. Chronic HBV and 
HCV are among the most common causes of chronic 
liver disease, liver cirrhosis, and the most common 
indication for liver transplantation. More than 
15,000 deaths per year in the United States can be 
attributed to chronic HBV and HCV. Current infor-
mation indicates these represent a fraction of deaths 
attributable in whole or in part to chronic hepatitis 
C. From 2007 through 2011, mortality rates of per-
sons with hepatitis C increased 39 percent among 
persons aged 55–64 years to a rate of 21.9 deaths 
per 100,000 population in 2011. In 2011, the high-
est mortality rates of persons with hepatitis C by 
race/ethnicity and sex were observed among Amer-
ican Indians and Alaska Natives (10.6 deaths per 
100,000 population) and males (7.1 deaths per 
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100,000 population) respectively. Mortality data 
from 2011, the latest year for which these data were 
available, reveal the serious health consequences as-
sociated with viral hepatitis: chronic liver disease, in-
cluding cirrhosis, was the 12th leading cause of 
death in the United States in 2011. Chronic HCV 
is also a leading cause of death in Americans living 
with HIV/AIDS. Many of those living with HIV/ 
AIDS are coinfected with chronic HBV, HCV, or 
both. 
(3) According to the Centers for Disease Con-
trol and Prevention (referred to in this section as 
the ‘‘CDC’’), approximately 2 percent of the popu-
lation of the United States is living with chronic 
HBV, HCV, or both. The CDC has recognized HCV 
as the Nation’s most common chronic bloodborne 
virus infection. 
(4) HBV is easily transmitted and is 100 times 
more infectious than HIV. According to the CDC, 
HBV is transmitted through contact with infectious 
blood, semen, or other body fluids. HCV is trans-
mitted by contact with infectious blood, particularly 
through percutaneous exposures (i.e. puncture 
through the skin). 
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(5) The CDC conservatively estimates that in 
2011 approximately 16,500 Americans were newly 
infected with HCV and more than 18,800 Americans 
were newly infected with HBV. These estimates 
could be much higher due to many reasons, includ-
ing lack of screening education and awareness, and 
perceived marginalization of the populations at risk. 
According to the CDC, from 2010 to 2011 there was 
a 45 percent increase in the number of reported 
acute hepatitis C cases (from 850 to 1,229 cases) 
and another 45 percent increase from 2011 to 2012 
(from 1,229 to 1,778 cases), representing a 75 per-
cent increase from 2010–2012. In 2012, the rate of 
acute hepatitis C increased in every age group when 
compared with 2010 and 2011, with the largest in-
creases among persons aged 0–19 years (from 0.05 
to 0.11 cases per 100,000 population) and 20–29 
years (from 0.75 to 1.73 cases per 100,000 popu-
lation). 
(6) In 2012, CDC released new guidelines rec-
ommending every person born from 1945 through 
1965 receive a one-time HCV test. Among the esti-
mated 102 million (1.6 million chronically HCV-in-
fected) eligible for screening, birth-cohort screening 
leads to 74,000 fewer cases of decompensated cir-
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rhosis, 46,000 fewer cases of hepatocellular car-
cinoma, 15,000 fewer liver transplants and 120,000 
fewer HCV-related deaths versus risk-based screen-
ing. 
(7) In 2013, the United States Preventative 
Services Task Force (USPSTF) issued a Grade B 
rating for screening for hepatitis C virus (HCV) in-
fection in persons at high risk for infection and 
adults born between 1945 and 1965. In 2009, the 
USPSTF issued a Grade A for screening pregnant 
women for the hepatitis B virus (HBV) during their 
first prenatal visit. In 2014, the USPSTF issued a 
Grade B for screening for HBV in individuals at 
high risk. 
(8) There were 35 outbreaks (19 of HBV, 16 
of HCV) reported to CDC for investigation from 
2008–2012 related to health care acquired infection 
of HBV and HCV, 33 of which occurred in nonhos-
pital settings. There were more than 99,975 patients 
potentially exposed to one of the viruses. 
(9) Chronic HBV and chronic HCV usually do 
not cause symptoms early in the course of the dis-
ease, but after many years of a clinically ‘‘silent’’ 
phase, CDC estimates show more than 33 percent of 
infected individuals will develop cirrhosis, end-stage 
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