CDC, WHO look to eliminate viral hepatitis through strategic plans

World Hepatitis Day is today, and to date, nearly 5.7 million people in the United States are living with hepatitis B or C virus infection, according to the CDC. On a global scale, 1.4 million deaths per year are attributed to acute infection and hepatitis-related liver diseases, according to WHO. Both organizations launched strategic plans this year to help eliminate the burden of viral hepatitis.

“The world has ignored hepatitis at its peril,” Margaret Chan, MD, MPH, director-general of WHO, said in a press release. “It is time to mobilize a global response to hepatitis on the scale similar to that generated to fight other communicable diseases like HIV/AIDS and tuberculosis.”

At the World Health Assembly in May, 194 governments adopted the Global Health Sector Strategy on viral hepatitis and agreed to establish a list of global targets. The strategy includes a target to treat 8 million people for HBV or HCV by 2020, according to WHO.

Their strategy defines a set of actions countries, as well as WHO, can take to eliminate the burden of viral hepatitis. These actions include:

develop a strong information system to fully understand viral hepatitis epidemics;
define important interventions on viral hepatitis services that can be included in health benefit packages and will make an impact;
strengthen health and community systems to make high-quality services available to achieve maximum impact on people effected by hepatitis;
develop and propose strategies to reduce costs of these services to decrease financial hardships; and
promote innovation to encourage fast progression.

The strategy includes a goal of eliminating viral hepatitis as a major public health concern by 2030, according to WHO. The organization also hopes between 6 million and 10 million infections are reduced to less than 1 million by 2030, and 1.4 million deaths reduced to less than 500,000.

“We need to act now to stop people from dying needlessly from hepatitis,” Gottfried Hirnschall, MD, MPH, WHO’s director of the HIV/AIDS department and global hepatitis program, said in the release. “This requires a rapid acceleration of access to services and medicines for all people in need.”

Gottfried Hirnschall

At the International Liver Congress 2016, presidents from the American Association for the Study of Liver Diseases, European Association for the Study of the Liver, Asian Pacific Association for the Study of the Liver, and Latin American Association for the Study of the Liver signed the Joint Society Statement for Elimination of Viral Hepatitis promising to assist in the elimination of viral hepatitis and its health burden worldwide. At the time, Hirnschall called the joint statement a “groundbreaking” and pivotal movement.

“This means that the thousands of hepatologists, clinicians and experts who are members of the four organizations will be ambassadors of eliminating hepatitis in your own countries,” Hirnschall said at the conference.

Also in May, the CDC released a report stating the number of HCV-related deaths reached an all-time high of 19,659 in 2014, making HCV the No. 1 infectious disease that kills people.

To reduce this burden of HCV and other strands of hepatitis by 2020, the CDC Division of Viral Hepatitis developed a strategic plan that will:

prioritize, target and improve policies and programs using data from surveillance, modeling and other programs to further research efforts;
address important gaps in identifying and evaluating interventions and policies;
increase knowledge of viral hepatitis, TB, sexually transmitted diseases and HIV and adopt specific behaviors to prevent infection and transmission;
maximize opportunities afforded by the health care system to help prevent infections and death;
promote collaboration between other divisions of the CDC and its partners to support service integration and utilize various resources effectively;
ensure efficient business and scientific administration, communication and policies are in effect to enhance skills and communications of current staff; and
develop the public health workforce.

As part of its strategic plan, the CDC Division of Viral Hepatitis states it will “prioritize the public health actions needed to prevent transmission, reduce morbidity and mortality, and meet the needs of disproportionately impacted populations, further prioritizing those populations at highest risk for adverse health outcomes in the absence of interventions.”

One of the obstacles for fighting the viral hepatitis burden is the ability to find people who are at risk for infection and encouraging them to get tested. According to the CDC, half of Americans infected with hepatitis are unaware of their infection. In the strategic plan, the CDC states: “Only through testing and knowledge of infection status can these persons receive the care and treatment that can vastly improve their health outcomes.”

Top viral hepatitis stories

To commemorate World Hepatitis Day, Infectious Disease News compiled a list of the most relevant research and FDA approvals related to viral hepatitis:

CDC: More people die of HCV than any other infectious disease

The CDC reports that the number of hepatitis C virus infection-related deaths reached an all-time high of 19,659 in 2014, making hepatitis C the No. 1 infectious disease that kills people. Read more.

Women of childbearing age show increased risk for HCV

Women of childbearing age in Kentucky and nationally had increased rates of hepatitis C virus detection between 2011 and 2014. The rate of children born to mothers with the infection also increased, indicating potential increased risk for mother-to-child transmission. Read more.

Collaboration improves HBV screening, linkage-to-care for Asians

Researchers from the University of California, Davis Comprehensive Cancer Center engaged organizations in Sacramento County, California, to link Asian populations to hepatitis B virus infection care. They found that more screening led to more linkage-to-care, in turn preventing the spread of infection and liver disease. Read more.

FDA approves Epclusa for all HCV genotypes

The FDA announced it has approved Epclusa for the treatment of all chronic hepatitis C virus genotypes in adults with and without cirrhosis. For patients with moderate to severe cirrhosis, it is approved in combination with ribavirin. Read more

Integrated HCV testing model successfully increases linkage-to-care

Researchers from the National Nursing Centers Consortium and Philadelphia Department of Public Health successfully implemented a routine hepatitis C virus infection testing model that increased testing and linkage-to-care among at-risk populations. Read more – by Melinda Stevens

References:

CDC. Division of Viral Hepatitis (DVH) Strategic Plan, 2016–2020: Bringing Together Science and Public-Health Practice for the Elimination of Viral Hepatitis http://www.cdc.gov/hepatitis/pdfs/dvh-strategicplan2016-2020.pdf. Accessed July 28, 2016.

WHO. Global Health Sectors Strategy on Viral Hepatitis 2016–2021 TOWARDS ENDING VIRAL HEPATITIS. http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdf?ua=1. Accessed July 28, 2016.

Disclosure: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.