In keeping with the Biden administration’s multibillion-dollar initiative to eliminate viral hepatitis by 2030, Philadelphia’s Department of Public Health aims to eliminate hepatitis B and C in eight years.

Hepatitis B virus (HBV), for which there is a vaccine, is treatable, and hepatitis C virus (HCV) is curable.

Health officials are now tasked with accurately counting the thousands of people with the viruses, which often give rise to liver cancer and cirrhosis and kill about 325 Philadelphia residents each year.

“I don’t even have an educated guess ,” Danica Kuncio, the viral hepatitis program manager for the Department of Public Health, told The Philadelphia Inquirer.

Accurately tallying the number of people living with the viruses is difficult because about 40% of the 2.5 million Americans living with chronic HCV are unaware that they have the virus. Similarly, according to the Centers for Disease Control and Prevention, of the estimated 860,000 to 2 million individuals with HBV, about 66% don’t know they have it.

This is due largely to the fact that many people do not develop symptoms and don’t think they are at risk and doctors often don’t think to test their patients for the viruses. Stigma and lack of insurance pose further barriers to testing.

Catherine Freeland, associate director of public health research at the Pennsylvania-based Hepatitis B Foundation, thinks universal testing for hepatitis would be a “huge win” in the fight against hepatitis but admits that it’s unclear how such a policy might be implemented.

The city of Philadelphia, meanwhile, is hoping for more funding to help it do its part in eliminating viral hepatitis.