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Physician Letters for HCV Targeted Lookback

Letters for physicians who will be responsible for notifying their patients

 To physician whose patient received blood from a repeat donor who later tested RIBA positive for anti-HCV.  To physician whose patient received blood from a repeat donor who later tested repeatedly reactive for anti-HCV and was not tested by RIBA.  To physician whose patient received blood from a repeat donor who later tested RIBA 2.0 indeterminate for anti-HCV.  To physician whose patient received blood from a repeat donor who later seroconverted to anti-HCV (RIBA positive) and whose prior negative donation was based on multiantigen testing.  To physician whose patient received blood from a repeat donor who later tested repeatedly reactive for anti-HCV by EIA 1.0 with an S/CO >2.5. [Physician of prior transfusion recipient of donor who later tested anti-HCV RIBA positive]

[Date of Letter] HCV LB Case # [x]

Re: [Insert Patient's Name] Date of Transfusion: [xxx]

Dear Dr.

The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) require notification of persons who received blood or blood products that were potentially infectious for hepatitis C virus (HCV). Our records show that you are the physician of record for the patient listed above who received blood from a donor who later tested positive for antibody to HCV (anti-HCV).

At the time your patient received this blood, testing of blood donations for HCV either was not available or was performed with a less sensitive test than that used today. Serologic screening of blood donors for anti-HCV became available in May 1990, and improved screening tests were widely implemented by July 1992. The improved screening tests and the availability of confirmatory testing have made possible the more precise identification of donors who are infected with HCV. Because of these improvements in testing, some repeat blood donors, not tested or negative for anti-HCV on earlier donations, are found to be positive on a later donation.

The person who donated the blood that your patient received returned at a later time to donate again and tested positive for anti-HCV using the most precise tests available. This test result was confirmed with a supplemental assay. Because most persons who test positive for anti-HCV on both screening and supplemental assays are chronically infected with HCV, this donor may have been infected with HCV at the time your patient was transfused. However, the probability of this having occurred is unknown. If the donor was infected with HCV at the time your patient was transfused, the risk that HCV was transmitted to your patient is about 70%.

We are asking you to notify your patient of the receipt of blood possibly infectious for HCV, the importance of being tested for hepatitis C, and the need to be counseled regarding the test result. Testing for hepatitis C, if positive, will provide your patient the opportunity to be evaluated for chronic liver disease and possible treatment, counseled concerning avoidance of potential hepatotoxins such as alcohol that may increase the severity of HCV-related liver disease, and counseled about preventing HCV transmission to others.

Enclosed are materials on hepatitis C for you and your patient, a sample letter for you to use to notify your patient, which includes information on where your patient can obtain testing, and a list of sources from which additional information on hepatitis C can be obtained.

In order for us to provide documentation of this notification as requested by FDA and CMS, please complete the attached form and return by fax [or mail] within X weeks of the date of this letter. If you need additional information regarding the notification of your patient, please contact [xx].

Sincerely,

Enclosures [Physician of prior transfusion recipient of donor who later tested anti-HCV repeat reactive (RIBA not done)]

[Date of Letter] HCV LB Case # [x]

Re: [Insert Patient's Name] Date of Transfusion: [xxx]

Dear Dr.

The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) require notification of persons who received blood or blood products that were potentially infectious for hepatitis C virus (HCV). Our records show that you are the physician of record for the patient listed above who received blood from a donor who later tested positive for antibody to HCV (anti-HCV).

At the time your patient received this blood, testing of blood donations for HCV either was not available or was performed with a less sensitive test than that used today. Serologic screening of blood donors for anti-HCV became available in May 1990, and improved screening tests were widely implemented by July 1992. The improved screening tests and the availability of confirmatory testing have made possible the more precise identification of donors who are infected with HCV. Because of these improvements in testing, some repeat blood donors, not tested or negative for anti-HCV on earlier donations, are found to be positive on a later donation.

The person who donated the blood that your patient received returned at a later time to donate again and tested repeatedly reactive for anti-HCV using the improved screening test. However, we were unable to perform a supplemental assay on the donor’s blood to confirm the result. Based on the screening test result, the risk of this donor’s blood transmitting HCV is about 40%. Because most persons with HCV infection are chronically infected, this donor may have been infected with HCV at the time your patient was transfused. However, the probability of this having occurred is unknown.

We are asking you to notify your patient of the receipt of blood possibly infectious for HCV, the importance of being tested for hepatitis C, and the need to be counseled regarding the test result. Testing for hepatitis C, if positive, will provide your patient the opportunity to be evaluated for chronic liver disease and possible treatment, counseled concerning avoidance of potential hepatotoxins, such as alcohol, that may increase the severity of HCV-related liver disease, and counseled about preventing HCV transmission to others.

Enclosed are materials on hepatitis C for you and your patient, a sample letter for you to use to notify your patient, which includes information on where your patient can obtain testing, and a list of sources from which additional information on hepatitis C can be obtained.

In order for us to provide documentation of this notification as requested by FDA and CMS, please complete the attached form and return by fax [or mail] within X weeks of the date of this letter. If you need additional information regarding the notification of your patient, please contact [xx].

Sincerely,

Enclosures [Physician of prior transfusion recipient of donor who later tested anti-HCV RIBA 2.0 indeterminate]

[Date of Letter] HCV LB Case # [x]

Re: [Insert Patient's Name] Date of Transfusion: [xxx]

Dear Dr.

The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) require notification of persons who received blood or blood products that were potentially infectious for hepatitis C virus (HCV). Our records show that you are the physician of record for the patient listed above who received blood from a donor who later tested positive for antibody to HCV (anti-HCV).

At the time your patient received this blood, testing of blood donations for HCV either was not available or was performed with a less sensitive test than that used today. Serologic screening of blood donors for anti-HCV became available in May 1990, and improved screening tests were widely implemented by July 1992. The improved screening tests and the availability of confirmatory testing have made possible the more precise identification of donors who are infected with HCV. Because of these improvements in testing, some repeat blood donors, not tested or negative for anti-HCV on earlier donations, are found to be positive on a later donation.

The person who donated the blood that your patient received returned at a later time to donate again and tested repeatedly reactive for anti-HCV using one of these improved screening tests. However, when we performed a supplemental assay on the donor’s blood to confirm the result, the results were inconclusive. Based on these test results, the risk of this donor’s blood transmitting HCV is about 5%. Because most persons with HCV infection are chronically infected, this donor may have been infected with HCV at the time your patient was transfused. However, the probability of this having occurred is unknown.

We are asking you to notify your patient of the receipt of blood possibly infectious for HCV, the importance of being tested for hepatitis C, and the need to be counseled regarding the test result. Testing for hepatitis C, if positive, will provide your patient the opportunity to be evaluated for chronic liver disease and possible treatment, counseled concerning avoidance of potential hepatotoxins, such as alcohol, that may increase the severity of HCV-related liver disease, and counseled about preventing HCV transmission to others.

Enclosed are materials on hepatitis C for you and your patient, a sample letter for you to use to notify your patient, which includes information on where your patient can obtain testing, and a list of sources from which additional information on hepatitis C can be obtained.

In order for us to provide documentation of this notification as requested by FDA and CMS, please complete the attached form and return by fax [or mail] within X weeks of the date of this letter. If you need additional information regarding the notification of your patient, please contact [xx].

Sincerely,

Enclosures [Physician of prior transfusion recipient of donor who later seroconverted to anti-HCV RIBA positive]

[Date of Letter] HCV LB Case # [x]

Re: [Insert Patient's Name] Date of Transfusion: [xxx]

Dear Dr.

The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) require notification of persons who received blood or blood products that were potentially infectious for hepatitis C virus (HCV). Our records show that you are the physician of record for the patient listed above who received blood from a donor who later tested positive for antibody to HCV (anti-HCV).

Serologic screening of blood donors for anti-HCV became available in May 1990, and improved screening tests were widely implemented by July 1992. The person who donated the blood that your patient received was anti-HCV negative at the time of that donation using the most sensitive tests available and completed a satisfactory health history prior to the donation. This person returned at a later time to donate again and tested positive for anti-HCV, which was confirmed with a supplemental assay. Some donors negative for anti-HCV on an earlier donation may have been in a very early stage of HCV infection that was below the detectable range of the test. If the donor was in the early stages of HCV infection at the time your patient was transfused, the probability that this donor could have transmitted HCV is 10% to 30%.

We are asking you to notify your patient of the receipt of blood possibly infectious for HCV, the importance of being tested for hepatitis C, and the need to be counseled regarding the test result. Testing for hepatitis C, if positive, will provide your patient the opportunity to be evaluated for chronic liver disease and possible treatment, counseled concerning avoidance of potential hepatotoxins, such as alcohol, that may increase the severity of HCV-related liver disease, and counseled about preventing HCV transmission to others.

Enclosed are materials on hepatitis C for you and your patient, a sample letter for you to use to notify your patient, which includes information on where your patient can obtain testing, and a list of sources from which additional information on hepatitis C can be obtained.

In order for us to provide documentation of this notification as requested by FDA and CMS, please complete the attached form and return by fax [or mail] within X weeks of the date of this letter. If you need additional information regarding the notification of your patient, please contact [xx].

Sincerely,

Enclosures [Physician of prior transfusion recipient of donor who later tested anti-HCV pos. by EIA 1.0 with S/CO>2.5]

[Date of Letter] HCV LB Case # [x]

Re: [Insert Patient's Name] Date of Transfusion: [xxx]

Dear Dr.

The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) require notification of persons who received blood or blood products that were potentially infectious for hepatitis C virus (HCV). Our records show that you are the physician of record for the patient listed above who received blood from a donor who later tested positive for antibody to HCV (anti-HCV). At the time your patient received this blood, testing of blood donations for HCV was not available. Serologic screening of blood donors for anti-HCV became available in May 1990, and improved screening tests were widely implemented by July 1992. The improved screening tests and the availability of confirmatory testing have made possible the more precise identification of donors who are infected with HCV. Because of the availability of testing, some repeat blood donors, not tested on earlier donations, are found to be positive on a later donation.

The person who donated the blood that your patient received returned at a later time to donate again and tested reactive for anti-HCV using the first version of the screening test which was available during 1990- 1992. Although at that time there was no approved supplemental assay to confirm the result, the strength of the screening test result for this donor indicates that the risk of this donor’s blood transmitting HCV is about 50%. Because most persons with HCV infection are chronically infected and asymptomatic, this donor may have been infected with HCV at the time your patient was transfused.

We are asking you to notify your patient of the receipt of blood possibly infectious for HCV, the importance of being tested for hepatitis C, and the need to be counseled regarding the test result. Testing for hepatitis C, if positive, will provide your patient the opportunity to be evaluated for chronic liver disease and possible treatment, counseled concerning avoidance of potential hepatotoxins, especially alcohol that may increase the severity of HCV-related liver disease, and counseled about preventing HCV transmission to others.

Enclosed are materials on hepatitis C for you and your patient, a sample letter for you to use to notify your patient, which includes information on where your patient can obtain testing, and a list of sources from which additional information on hepatitis C can be obtained.

In order for us to provide documentation of this notification as requested by FDA and CMS, please complete the attached form and return by fax [or mail] within X weeks of the date of this letter. If you need additional information regarding the notification of your patient, please contact [xx].

Sincerely,

Enclosures

Physician Reply Form for Tracking Status of Notification Notification of Prior Transfusion Recipient of Receipt of Blood Possibly Infectious for HCV

[Pre-filled Out by Transfusion Service] Date: [Insert date of letter] Patient's Name: HCV LB Case# Date of Transfusion: WBN: Physician's Name: Component:

[Physician Completes] Please check the appropriate response(s) below: ____ I notified the patient named above by letter dated [insert date]. ____ I notified the patient named above by telephone on [insert date]. ____ The patient named above cannot be notified because (check one): ____ I cannot locate the patient. ____ Patient is deceased. ____ Patient is a minor. I have notified or attempted to notify the patient's relative or legal representative. ____ Patient is incompetent (I have notified or attempted to notify the patient's legal representative). ____ Other (specify) ______I am not notifying the patient because the patient has already been tested for HCV infection and is known to be anti-HCV: ____ Positive ____ Negative

Please return this form within X weeks to:

Resources for Physicians - Organizations for Information on Hepatitis American College of Gastroenterology (ACG) 4900 B South 31st Street Arlington, VA 22206 (703) 820-7400 fax: (703) 931-4520 http://www.acg.gi.org

Centers for Disease Control and Prevention (CDC) Hepatitis Branch; Mailstop G-37 1600 Clifton Road, N.E. Atlanta, GA 30333 Toll- free hot line 1 888 4 HEP CDC (443–7232) http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm

Digestive Health Initiative 7910 Woodmont Ave., Suite 700 Bethesda, MD. 20814 1-800-668-5237 http://www.gastro.org/adhf.html

Immunization Action Coalition (IAC) / Hepatitis B Coalition 1573 Selby Avenue, Suite 234 St. Paul, MN 55104 (612) 647-9009 http://www.immunize.org

National Digestive Diseases Information Clearinghouse (NDDIC) 2 Information Way Bethesda, MD 20892-3570 (301) 654-3810 http://www.niddk.nih.gov

SSA Death Master File The Death Master File (DMF) from the Social Security Administration (SSA) contains over 59.7 million records created from SSA payment records. The current update reflects data up through the end of June 1998. It contains the records of those for whom the lump sum death benefit was paid. That lump sum benefit could have been requested by a family member, an attorney, a mortuary, etc. [NOTE: If someone is missing from the list, it may be that the benefit was never requested, an error was made on the form requesting the benefit, or an error was made when entering the information into the SSDI.] Access to the Death Master File (DMF) may be obtained through the following Web site: www.ancestry.com/ssdi/advanced.htm

This file includes the following information on each decedent, if the data is available to the SSA:

Last name First name SS# (State issued) Birth date Death date Last residence/Lump sum payment

Transfusion Recipient Letters for HCV Targeted Lookback

 To prior recipient of repeat donor who later tested RIBA positive for anti-HCV.  To prior recipient of repeat donor who later tested repeatedly reactive for anti-HCV and was not tested by RIBA.  To prior recipient of repeat donor who later tested RIBA 2.0 indeterminate for anti-HCV.  To prior recipient of repeat donor who later seroconverted to anti-HCV (RIBA positive) and whose prior negative donation was based on multiantigen testing.  To prior recipient of repeat donor who later tested repeatedly reactive for anti-HCV by EIA 1.0 with an S/CO >2.5.

[Prior transfusion recipient of donor who later tested anti-HCV RIBA positive]

[Date of Letter] HCV LB Case # [x] [Name and Address]

Dear [Name of Recipient]:

A nationwide effort is now underway to identify people who may have been infected with the hepatitis C virus (HCV). One of the ways that HCV has been transmitted is through a blood transfusion. Our records show that you received blood that may have been infectious for HCV. This is NOT HIV, the virus that causes AIDS. HCV causes a liver disease called hepatitis C.

At the time you received this blood, screening tests to identify blood donors with hepatitis C either were not available or were less precise than they are now. The first screening test for hepatitis C became available in May 1990, and improved screening tests were put into use by July 1992. The person who donated the blood that you received came back to donate blood at a later time and tested positive for hepatitis C using these improved tests. Because most persons who test positive for hepatitis C have long-term HCV infection, this donor may have been infected with HCV at the time you were transfused. If the donor was infected with HCV at the time you were transfused, there are 7 chances out of 10 that this donor’s blood could have spread HCV to you.

You should get tested for hepatitis C. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not yet feel sick from the disease. Of every 100 persons infected with HCV, about 15 persons will develop cirrhosis (scarring) of the liver which can lead to liver failure. This can take many years to develop. It is important that you get tested for hepatitis C so you can be checked for liver disease and get treatment, if indicated, and so you can protect your liver by avoiding substances that can cause further harm, such as alcohol and certain medicines. If you have hepatitis C, it is also important that you learn what actions you can take to avoid spreading this disease to others. You are being contacted now because we have better tests to identify people with hepatitis C, better treatment for some people with hepatitis C, and better information about what people with hepatitis C can do to protect themselves and others. You can get tested for hepatitis C [at no charge by providing the case number at the top of this letter]. To arrange for this testing contact [insert contact and telephone number].

Enclosed is general information about hepatitis C and places you can contact to get more information. [I will be happy to answer any questions that you may have.]

Sincerely,

Enclosures

[Prior transfusion recipient of donor who later tested anti-HCV repeat reactive (RIBA not done)]

[Date of Letter] HCV LB Case # [x] [Name and Address]

Dear [Name of Recipient]:

A nationwide effort is now underway to identify people who may have been infected with the hepatitis C virus (HCV). One of the ways that HCV has been transmitted is through a blood transfusion. Our records show that you received blood that may have been infectious for HCV. This is NOT HIV, the virus that causes AIDS. HCV causes a liver disease called hepatitis C.

At the time you received this blood, screening tests to identify blood donors with hepatitis C either were not available or were less precise than they are now. The first screening test for hepatitis C became available in May 1990, and improved screening tests were put into use by July 1992. The person who donated the blood that you received came back to donate blood at a later time and tested positive for hepatitis C using one of these improved screening tests. Because most persons who test positive for hepatitis C have long-term HCV infection, this donor may have been infected with HCV at the time you were transfused. If the donor was infected with HCV at the time you were transfused, there are 4 chances out of 10 that this donor’s blood could have spread HCV to you.

You should get tested for hepatitis C. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not yet feel sick from the disease. Of every 100 persons infected with HCV, about 15 persons will develop cirrhosis (scarring) of the liver which can lead liver failure. This can take many years to develop. It is important that you get tested for hepatitis C so you can be checked for liver disease and get treatment, if indicated, and so you can protect your liver by avoiding substances that can cause further harm, such as alcohol and certain medicines. If you have hepatitis C, it is also important that you learn what actions you can take to avoid spreading this disease to others. You are being contacted now because we have better tests to identify people with hepatitis C, better treatment for some people with hepatitis C, and better information about what people with hepatitis C can do to protect themselves and others. You can get tested for hepatitis C [at no charge by providing the case number at the top of this letter]. To arrange for this testing contact [insert contact and telephone number].

Enclosed is general information about hepatitis C and places you can contact to get more information. [I will be happy to answer any questions that you may have.]

Sincerely,

Enclosures [Prior transfusion recipient of donor who later tested anti-HCV RIBA 2.0 indeterminate]

[Date of Letter] HCV LB Case # [x] [Name and Address]

Dear [Name of Recipient]:

A nationwide effort is now underway to identify people who may have been infected with the hepatitis C virus (HCV). One of the ways that HCV has been transmitted is through a blood transfusion. Our records show that you received blood that may have been infectious for HCV. This is NOT HIV, the virus that causes AIDS. HCV causes a liver disease called hepatitis C.

At the time you received this blood, screening tests to identify blood donors with hepatitis C either were not available or were less precise than they are now. The first screening test for hepatitis C became available in May 1990, and improved screening tests were put into use by July 1992. The person who donated the blood that you received came back to donate blood at a later time and tested positive for hepatitis C using one of these improved screening tests. In order to confirm this result, we retested the donor’s blood sample with another test but the results were inconclusive. On the basis of these test results, if the donor was infected with HCV at the time you were transfused, there are 5 chances out of 100 that this donor’s blood could have spread HCV to you.

You should get tested for hepatitis C. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not yet feel sick from the disease. Of every 100 persons infected with HCV, about 15 persons will develop cirrhosis (scarring) of the liver which can lead liver failure. This can take many years to develop. It is important that you get tested for hepatitis C so you can be checked for liver disease and get treatment, if indicated, and so you can protect your liver by avoiding substances that can cause further harm, such as alcohol and certain medicines. If you have hepatitis C, it is also important that you learn what actions you can take to avoid spreading this disease to others.

You are being contacted now because we have better tests to identify people with hepatitis C, better treatment for some people with hepatitis C, and better information about what people with hepatitis C can do to protect themselves and others. You can get tested for hepatitis C [at no charge by providing the case number at the top of this letter]. To arrange for this testing contact [insert contact and telephone number].

Enclosed is general information about hepatitis C and places you can contact to get more information. [I will be happy to answer any questions that you may have.]

Sincerely,

Enclosures [Prior transfusion recipient of donor who later seroconverted to anti-HCV RIBA positive]

[Date of Letter] HCV LB Case # [x] [Name and Address]

Dear [Name of Recipient]:

A nationwide effort is now underway to identify people who may have been infected with the hepatitis C virus (HCV). One of the ways that HCV has been transmitted is through a blood transfusion. Our records show that you received blood that may have been infectious for HCV. This is NOT HIV, the virus that causes AIDS. HCV causes a liver disease called hepatitis C.

The first screening test for hepatitis C became available in May 1990, and improved screening tests were put into use by July 1992. The person who donated the blood that you received was negative for hepatitis C at the time of that donation using these improved tests. This person returned at a later time to donate again and tested positive for hepatitis C which was confirmed with a supplemental assay. Some donors negative for hepatitis C on an earlier donation may have been in a very early stage of HCV infection that the test could not detect. If the donor was in an early stage of HCV infection at the time you were transfused, there are between 1 and 3 chances out of 10 that this donor’s blood could have spread HCV to you.

You should get tested for hepatitis C. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not yet feel sick from the disease. Of every 100 persons infected with HCV, about 15 persons will develop cirrhosis (scarring) of the liver which can lead to liver failure. This can take many years to develop. It is important that you get tested for hepatitis C so you can be checked for liver disease and get treatment, if indicated, and so you can protect your liver by avoiding substances that can cause further harm, such as alcohol and certain medicines. If you have hepatitis C, it is also important that you learn what actions you can take to avoid spreading this disease to others.

You are being contacted now because we have better tests to identify people with hepatitis C, better treatment for some people with hepatitis C, and better information about what people with hepatitis C can do to protect themselves and others. You can get tested for hepatitis C [at no charge by providing the case number at the top of this letter]. To arrange for this testing contact [insert contact and telephone number].

Enclosed is general information about hepatitis C and places you can contact to get more information. [I will be happy to answer any questions that you may have.]

Sincerely,

Enclosures [Prior transfusion recipient of donor who later tested anti-HCV repeat reactive by EIA 1.0 with S/CO >2.5]

[Date of Letter] HCV LB Case # [x]

[Name and Address] Dear [Name of Recipient]:

A nationwide effort is now underway to identify people who may have been infected with the hepatitis C virus (HCV). One of the ways that HCV has been transmitted is through a blood transfusion. Our records show that you received blood that may have been infectious for HCV. This is NOT HIV, the virus that causes AIDS. HCV causes a liver disease called hepatitis C.

At the time you received this blood, screening tests to identify blood donors with hepatitis C were not available. The first screening test for hepatitis C became available in May 1990, and improved screening tests were put into use by July 1992. The person who donated the blood that you received came back to donate blood at a later time and tested positive for hepatitis C using one of these screening tests. Because most persons who test positive for hepatitis C have long- term HCV infection, this donor may have been infected with HCV at the time you were transfused. If the donor had this test result at the time you were transfused, there are 5 chances out of 10 that this donor’s blood could have spread HCV to you.

You should get tested for hepatitis C. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not yet feel sick from the disease. Of every 100 persons infected with HCV, about 15 persons will develop cirrhosis (scarring) of the liver which can lead to liver failure. This can take many years to develop. It is important that you get tested for hepatitis C so you can be checked for liver disease and so you can protect your liver by avoiding substances that can cause further harm, especially alcohol and certain medicines. Your doctor may recommend that you get treated if your medical evaluation suggests you are likely to develop serious liver disease. If you have hepatitis C, it is also important that you learn what you can do to avoid spreading this disease to others.

You are being contacted now because we have better tests to identify people with hepatitis C, better treatment for some people with hepatitis C, and better information about what people with hepatitis C can do to protect themselves and others. You can get tested for hepatitis C [at no charge by providing the case number at the top of this letter]. To arrange for this testing contact [insert contact and telephone number].

Enclosed is general information about hepatitis C and places you can contact to get more information. [I will be happy to answer any questions that you may have.]

Sincerely,

Enclosures Resources for Patients -- Organizations for Information on Hepatitis

Centers for Disease Control and Prevention (CDC) Hepatitis Branch; Mailstop G-37 1600 Clifton Road, N.E. Atlanta, GA 30333 toll free 1-888-4 HEP-CDC (1-888-443-7232) Viral Hepatitis: http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm Frequently Asked Questions about Hepatitis C: http://www.cdc.gov/ncidod/diseases/hepatitis/c/faq.htm

American Liver Foundation (ALF) 1425 Pompton Ave. Cedar Grove, NJ 07009 1-800-Go Liver (1-800-465-4837) or 1-888 4 Hep ABC (1-888-443-7222) http://www.liverfoundation.org

Hepatitis Foundation International (HFI) 30 Sunrise Terrace Cedar Grove, NJ 07009-1423 1-800-891-0707 e-mail: [email protected] http://www.hepfi.org

Immunization Actionoalition/(IAC) Hepatitis B Coalition 1573 Selby Avenue, Suite 234 St. Paul, MN 55104 (612) 647-9009 http://www.immunize.org

National Digestive Diseases Information Clearinghouse (NDDIC) 2 Information Way Bethesda, MD 20892-3570 (301) 654-3810 http://www.niddk.nih.gov

American College of Gastroenterology (ACG) 4900 B South 31st Street Arlington, Virginia 22206 (703) 820-7400 fax: (703) 931-4520 http://www.acg.gi.org

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