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6 recent reports on hepatitis risks, elimination progress

Recently, the nation of Georgia and the Cherokee Nation in Oklahoma have reported excellent progress toward elimination of hepatitis C among their populations. Additionally, the Alaska Native Tribal Health Consortium announced the elimination of acute hepatitis B and early-onset of hepatocellular carcinoma as a public health threat among its pediatric population.

The elimination of HBV and HCV in the U.S. and around the globe depends on prevention as much as it does treatment. Hepatitis-related health risks are a topic of concern among researchers. Healio.com/Hepatology presents recent news on hepatitis elimination and the behavior risk factors involved in transmission.

Vaccine program in Alaskan Natives eliminates acute HBV, early HCC

The Liver Disease and Hepatitis Program, which includes universal newborn hepatitis B vaccination and mass screening and immunization, has eliminated acute HBV and early-onset hepatocellular carcinoma as a public health threat among Alaska Native children, according to a study presented at the World Indigenous Peoples’ Conference on Viral Hepatitis.

“The elements of this program that we introduced — which include screening and interventions to reduce perinatal transmission and universal vaccination — are recommended as the standard of care for all U.S. populations, including Indigenous populations,” Brian J. McMahon, MD, from the Alaska Native Tribal Health Consortium, said in a press release. “Elimination in other populations, however, depends on how effectively those interventions are applied, which might not be as comprehensive as took place in the [Alaskan Native] tribal system.” Read more

Georgia’ s HCV Elimination Program progressing toward 2020 goal

Since its introduction in April 2015, the nation of Georgia’s HCV Elimination Program has shown the potential to rapidly expand HCV care and treatment services, but achieving its 2020 goal of HCV elimination will require improved HCV testing and access to treatment services, according to the CDC’s Morbidity and Mortality Weekly Report.

“The Georgia model program provides valuable lessons for hepatitis C elimination globally, including a key lesson that treatment availability alone is not enough,” Muazzam Nasrullah, MD, MPH, PhD, medical officer with CDC’s Division of Viral Hepatitis, told Healio.com/Hepatology. “Eliminating hepatitis C requires a comprehensive approach that includes screening and linkage to care and treatment, high quality diagnostics, surveillance, provision of services to high risk and marginalized populations, and measures to prevent transmission.” Read more

Patients with HCV engage in risky behavior, causing excess mortality

Health risk behaviors, such as alcohol use, cigarette smoking and unhealthy diets, contributed equally toward mortality risk for patients with chronic hepatitis C as the infection itself, according to a recently published study.

“Individuals with [chronic HCV] infection in the U.S. exhibit a considerable excess mortality risk. Yet, about half of this excess may reflect high levels of [health risk behaviors] as opposed to the effects of [chronic HCV] infection itself,” Hamish Innes, MD, from Glasgow Caledonian University, and colleagues wrote. “This study therefore highlights the importance of a public health response to hepatitis C that includes action on [health risk behaviors] as well as access to antiviral therapy.” Read more

Universal screening in Cherokee Nation aims to eliminate hepatitis C

Nearly half of the Cherokee Nation American Indian population received screening for hepatitis C and approximately one-quarter of those with the infection are cured, according to a press release from the World Indigenous People’s Conference on Viral Hepatitis in Anchorage, Alaska, which coincides with the International Day of the World’s Indigenous Peoples on Aug. 9.

“Because Cherokee Nation citizens, under a treaty right with the United States Government have access to medical care, tracking them and screening them is slightly easier than might be so for other U.S. populations,” Jorge Mera, MD, head of the Infectious Diseases at Cherokee Nation in Tahlequah, Oklahoma, said in the release. Read more

Sex dictates liver disease risk in hepatitis B

Men with hepatitis B are at increased risk for severe liver disease compared with women; however, lifestyle and environmental related exposures cannot explain the sex differences, suggesting biological causes, according to data published in PLoS One.

“Previous studies have observed that, among hepatitis B chronic infection patients, males are more likely than females to develop and die from [hepatocellular carcinoma],” Jing Sun, PhD, a post-doctoral fellow at Johns Hopkins University, and colleagues wrote. “Some have speculated that the gender discrepancy may be due to lifestyle-related differences, since previous epidemiologic studies have shown that lifestyle-related exposures (eg, alcohol consumption and smoking habits) increased the risk of hepatocellular carcinoma in hepatitis B infected patients.” Read more

HCV rates climbing in younger HIV-positive MSM

Hepatitis C infection rates continue to increase in Northern Europe in recent years among younger men who have HIV and have sex with men, with those more recently infected with HIV showing higher rates of HCV infection, according to a recently published article.

“No decline in HCV incidence was observed in recent years, although trends seem to differ by geographical region,” the researchers wrote. “HCV screening among HIV-positive MSM should be continued and routinely and frequently offered. Furthermore, targeted preventive measures should be implemented and/or scaled-up to decrease the risk of HCV acquisition.” Read more