HHS recognizes need for 'partnership' with hepatitis researchers

On National Viral Hepatitis Testing Day, the Department of Health and Human Services awarded 12 health care organizations for their continued work toward increasing awareness of hepatitis B and C virus infections among at-risk populations.

“We are excited by the work you are all doing on the front lines, working into communities who aren’t sure whether or not they trust you. … It is hard work and takes engagement recurrently with communities we need to make certain we are reaching,” Karen DeSalvo, MD, MPH, MSc, acting assistant secretary for health at the U.S. Department of Health and Human Services, said at the White House event. “I thank you for that effort and work, and I ask you to not let up on the gas. We have many more we need to reach.”

In this first-ever award ceremony, the organizations honored for their HBV and HCV programs include: The Charles B Wang Community Health Center from New York, Dallas-Fort Worth HBV Free Project and University of Texas Health Science Center at San Antonio from Texas, Holy Name Medical Center from New Jersey, Kalihi Palama Health Center and Hep Free Hawaii from Hawaii, Rhode Island Defeats Hepatitis, Asian Pacific Health Foundation from California, C A Difference from Pennsylvania, Cherokee Nation from Oklahoma, HBV Initiative of Washington D.C. and the Wyoming Department of Health Communicable Disease Unit.

“These represent the best of the best who are ensuring their communities are getting tested,” DeSalvo said. “These kinds of coordinated efforts are what we are seeing across the nation and we need to make sure these efforts keep going.”

DeSalvo addressed the increasing rates of HBV and HCV incidence and stated that one of the problems is that people do not know they have it, including those at high risk.

“We need to make sure we continue to carry forward the message of testing for HBV and HCV for a reminder for those born in Asia, Africa and their children, and that the baby boomers, like me, are getting tested,” DeSalvo said, noting that drug injection users and individuals who received previous blood transfusions are also at risk.

Amy Lansky, PhD, MPH, acting director of the Office of National AIDS Policy, spoke about the federal government’s Viral Hepatitis Action Plan and the relationship between viral hepatitis and other public health problems, including substance abuse and HIV.

“Viral hepatitis has a visible role in our HIV strategy because it influences HIV care as well,” Lansky said. “We know that one in four people living with HIV also have hepatitis C. … This contributes to why all HIV-infected people should be screened for hepatitis C infection and those susceptible to HBV should be vaccinated for HBV.”

People need to be aware of the risks for hepatitis, HIV and substance-use disorders and know they are related, she said.

“The solution demands we address not just the opioid epidemic and increases of HBV and HCV and HIV infection but that we address these issues in a coordinated way. We need to address HBV, HCV and HIV issues together to break down the stigma of each,” Lansky said.

According to HHS, an estimated 850,000 Americans have HBV and 3.5 million have HCV. Less than half of these infected individuals are aware of their status, which cripples their advantage of seeking life-saving treatments that are available for them. Because of this, these individuals remain at-risk for serious liver disease, including hepatocellular carcinoma and cirrhosis.

“The challenge is people still don't know they have it and they also don’t know they are at increased risk for these complications,” DeSalvo said, adding that strides have been made within the last decade.

“We have seen an 85% reduction in HBV since the vaccine came out in 1980s,” DeSalvo said.

However, she stated there was a 5% increase of HBV incidence from 2012 to 2013 and it is still increasing in certain areas.

Of the 61 reportable infectious diseases, the CDC’s recent report declared HCV as the No. 1 killer, DeSalvo noted.

“More than 19,000 deaths occurred from hepatitis C in 2014. Too many people are dying because they aren’t getting the treatment they need,” DeSalvo said.

Michael Botticelli, director of National Drug Control Policy, said at the event, “We know this is preventable. … There is a huge treatment gap, too few people who need treatment get it. The importance of rapid on-site testing for infections cannot be overstated.”

The Obama administration requested billions of dollars to help increase community prevention strategies and address the opioid crisis, according to DeSalvo, and she said the government is also working to update the viral hepatitis program through 2020.

“We are going to be trying to find ways to reduce death, morbidity and reduce disparities. However, all these federal efforts aren’t enough. We know for a fact we need to do this in partnership with all of you,” DeSalvo said. “It will take a diverse set of stakeholders to make sure we get the action we need on viral hepatitis.” – by Melinda Stevens