Hepatitis Happenings and Updates

By Jasmine West June 25, 2020

NASTAD Updates:

Meet our newest team member, Alex!

The Hepatitis team is excited to introduce and welcome Alex Eanes (he/him/his) to NASTAD as the new Associate, Hepatitis. Alex moved to D.C. from Michigan, having recently graduated with his Master of Public Health with a focus on health behavior and health education from the University of Michigan.

Prior to joining NASTAD, Alex was a research assistant at the University of Michigan School of Public Health, which included the development and onsite delivery of PrEP trainings at a sexual health organization in Flint, MI. Alex brings highly valued viral hepatitis surveillance experience, including the co-creation of the first hepatitis C testing location and local resource guide for the Ohio Department of Health. Alex will be supporting our online hepatitis technical assistance platform, HepTAC, the build out of the viral hepatitis microsite, and the thematic analysis of viral hepatitis elimination plans in the US.

NASTAD’s Commitment to Black Lives

NASTAD issued a statement to address the recent protests across the country, seeking justice for the deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless others, and to express solidarity with the Black Lives Matter movement. The core of NASTAD’s mission is an unwavering commitment to social justice. We recognize that we will not end the HIV and hepatitis epidemics and related syndemics without dismantling the systems of oppression that fuel racial disparities in access and outcomes. We prioritize fighting injustices where we see them, and we value diversity and inclusivity in all forms. To view NASTAD’s full statement, click here.

Accountability as a Public Health Response: COVID-19’s Impact on Communities of Color

In light of the COVID-19 pandemic’s impact on communities of color in the U.S., particularly on Black, Native American, and Latinx communities, NASTAD released a statement and call to action. Click here for the full statement and recommendations.

JUNE IS PRIDE MONTH! #PrideMonth #Pride2020

Each June, communities across the world celebrate Pride Month by commemorating the Stonewall riots of 1969, continuing to fight for civil rights for LGBTQIA individuals, and celebrating the diverse beauty of the LGBTQIA community.

In observance of Pride Month, NASTAD would like to call attention to the need for increased national and local data measuring the impact of viral hepatitis on LGBTQIA people and expanded recommendations for screening and access to treatment for LGBTQiA people. Currently, CDC recommends gay, bisexual, and other men who have sex with men get vaccinated for hepatitis A and hepatitis B, yet adult vaccination rates among this group remain low. CDC has resources which can be tailored with local information, as needed. 

In addition, use the Vaccine Finder that offers a useful map to identify places that provide hepatitis A and hepatitis B vaccinations. The LGBT Foundation also has messaging regarding transmission, symptoms, and treatment for hepatitis A, hepatitis B, and hepatitis C for gay, bisexual, and other men who have sex with men.

Leading through the Epidemics: During the 2019 Transforming the HIV and Hepatitis Workforce to End the Epidemics workshop, NASTAD convened a cross-section of the critical voices of individuals working in HIV and hepatitis prevention. Jennifer Flannagan (Manager, Health Systems Integration), Maegan Samuel (Associate, Prevention), and Alyssa Kitlas (Former Manager, Hepatitis) led this meeting in New Orleans, Louisiana featuring Alethea Miller, Viral Hepatitis Prevention Coordinator from the Delaware Department of Health and Social Services, and Alison Gaye, the Statewide Syringe Services Program Coordinator from the Louisiana Department of Health in a short video to showcase the unique perspective of health department and community-based organization (CBO) staff working in the South.

Request for Proposals—HepTAC Advisory Committee 

NASTAD’s Hepatitis team is seeking technical assistance providers with viral hepatitis expertise to support the capabilities of viral hepatitis prevention and surveillance personnel at state, territorial, and major city/county health departments through NASTAD’s online technical assistance center HepTAC. This project is a joint effort between NASTAD and the Centers for Disease Control and Prevention’s Center for State, Tribal, Local, and Territorial Support (CSTLTS) and the Division of Viral Hepatitis (DVH).

For details on how to apply, link here. Deadline to apply is July 6th

Join us at NASTAD—open positions!

Senior Associate — Washington, DC
NASTAD is seeking a Senior Associate for the Health Systems Integration team. The Senior Associate, Health Systems Integration provides administrative and substantive support for NASTAD’s technical assistance and capacity building assistance for Ryan White HIV/AIDS Programs (RWHAP), with a focus on Ending the HIV Epidemic (EHE) initiative activities. This position works closely with entire Health Systems Integration and Health Care Access teams to support programmatic activities.

Manager — Washington, DC
NASTAD is seeking a Manger for the Policy & Legislative Affairs team. The Manager, Policy & Legislative Affairs plays a vital role in managing the development and implementation of hepatitis-related federal appropriations strategies, including for the NASTAD convened Hepatitis Appropriations Partnership, and legislation related to hepatitis prevention, care and treatment issues.  This position manages the day-to-day activities necessary to implement hepatitis-related federal legislative and regulatory goals.  The Manager also interfaces with governmental agencies, national organizations, coalitions and other non-governmental organizations to promote NASTAD’s legislative and policy agenda.

Associate — Washington, DC
NASTAD is seeking an Associate for the Prevention team. The Associate, Prevention will support NASTAD’s Capacity Building Assistance (CBA) program in providing technical assistance to health departments in the southern U.S. to advance efforts related to integrated HIV prevention activities and structural interventions.  

Manager — Washington, DC
NASTAD is seeking a Manger for the Health Care Access team. The Manager, Health Care Access plays a vital role in expanding the organization’s capacity and priority of addressing the impact of HIV/AIDS and viral hepatitis programs within health departments. Under direction from the Associate Director, Health Care Access, the Manager will play a key role the Health Care Access programs technical assistance efforts, having a strong voice in the development of NASTAD’s cooperative agreement with the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) and Ending the HIV Epidemic (EHE) initiative activities.

Senior Associate — Washington, DC
NASTAD is seeking a Senior Associate for the Prevention team. The Senior Associate, Prevention will work primarily on NASTAD’s CDC-funded Capacity Building Assistance (CBA) project to provide technical assistance to HDs implementing PS18-1802, and to CBOs implementing PS15-1502 and PS17-1704. The position is responsible for providing technical assistance and training related to social determinants of health, HIV stigma and cultural humility/responsiveness.

Public Comments

NASTAD recently submitted comments to the:

 1) FDA in support of the reclassification from Class III to Class II of nucleic acid-based hepatitis C virus (HCV) ribonucleic acid tests intended for qualitative or quantitative detection or genotyping of HCV RNA; and HCV antibody tests intended for qualitative detection of HCV, which is likely to stimulate manufacturers to bring new tests to market, and to adapt tests for use with new sample types; in support of the 2) United States Preventive Services Task Force’s (USPSTF) Draft Recommendation Statement: Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults, noting a grade A recommendation would have provided additional attention to HBV infection as a significant threat to public health and is in process of submitting public comments on the 3) proposed rule by the Homeland Security Department and the Executive Office for Immigration Review on procedures for asylum and withholding of removal credible fear review as detrimental to our public health efforts to ending the intersecting HIV and viral hepatitis epidemics.

Archived Materials from Hepatitis Awareness Month 

Cheers to a successful Hepatitis Awareness Month! Many thanks to everyone who participated in activities throughout the month of May and highlighted your efforts to raise awareness and improve access to viral hepatitis services.

NASTAD archived the events for May and several useful resources to use to continue raising awareness.

CDC’s Hepatitis Awareness Month Resources

Each week of May, CDC released new content about the ABCs of hepatitis. Their Hepatitis Awareness Month Resource Center houses all their free tools that are still useful beyond the month of May. They  also updated the Know More Hepatitis campaign and the Know Hepatitis B campaign with new materials and resources that encourage viral hepatitis testing.

Click here to read the full ‘CDC Letter—May is Hepatitis Awareness Month,’ that was circulated and to sign up for month emails from CDC’s DVH program about new publications, recommendations, new materials, or significant events.

National Hispanic Hepatitis Awareness Day—May 15, 2020

The Latino Commission on AIDS hosted a webinar series:

  1. Hepatitis and Vaccines
  2. Keeping It Real: Addressing the viral hepatitis epidemics among the Hispanic/Latinx communities amid a pandemic
  3. The Impact of Hep C in the United States

The campaign provides informational materials about the impact of viral hepatitis among Latinx/Hispanic communities and the release of new bilingual resources. Check it out here.

HepVU recognized NHHAD leading a Q&A session with Latinx advocate, Guillermo Chacón, President of the Latino Commission on AIDS. Read the blog here as he shares the history of NHHAD and the impact of viral hepatitis on Latinx communities. Also check out HepVu’s new viral hepatitis infographics in Spanish, released during Hepatitis Awareness Month!

Hepatitis Testing Day—May 19, 2020

Twitter Chat #HepTestingDay #HepChat20

Thanks to everyone who participated! Many thanks to our co-hosts HepBUnited, National Viral Hepatitis Roundtable (NVHR), and CDC’s Division of Viral Hepatitis. The Twitter chat highlighted events and allowed partner organizations to share their successes, challenges, and lessons learned from their efforts, particularly during this unique time. 

HepVu emphasized Hepatitis Testing Day while participating in a Q&A with viral hepatitis experts, Lauren Canary, Director of NVHR and Lance Toma, CEO of the San Francisco Community Health Center. Click here to check out their blogs as Lauren describes NVHR’s efforts to increase hepatitis surveillance in the U.S. and Lance discusses the disproportionate impact of HBV on Asian American and Pacific Islanders. 

Other archived webinars during Hepatitis Awareness Month:

Hepatitis Awareness Month Webinar

We kicked off Hepatitis Awareness Month with Hep B United to discuss innovative, online strategies to raise awareness about hepatitis throughout May. CDC’s Division of Viral Hepatitis shared resources that are available to promote testing. Community partners provided an overview of activities including the impact of COVID-19 on programs, strategies to transition community testing events to virtual activities, increasing social media presence, online hepatitis B education, and discuss their plans for this year’s Hepatitis Awareness Month and Testing Day. Click here for the recording and slides.   

National Adult Hepatitis B Vaccination Awareness Day Webinar

On April 30, 2020, in observance of National Adult Hepatitis B Vaccination Awareness Day, NASTAD joined leaders from CDC’s Division of Viral Hepatitis, Beth Israel Medical Center in Boston, and Hepatitis Education Project in a webinar about the importance of expanded adult HBV vaccination. The webinar was hosted Hepatitis B Foundation and Hep B United in partnership with Adult Vaccine Access Coalition, Association of Asian Pacific Community Health Organizations, National Viral Hepatitis Roundtable, The AIDS Institute, NASTAD, Hepatitis Education Project. The webinar and slides are archived at Hep B United’s website.

HBU Legal Protections Against Hepatitis-Based Discrimination in Healthcare Education

Hepatitis B Foundation and Hep B United Coalition presented panelists who discussed cases of discrimination against health care students with hepatitis B, preliminary research findings from an analysis of health professions school admissions policies in two jurisdictions, federal legal protections, and the process for filing complaints. A video recording and presentation materials are available here.

Additional Updates

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) has authorized its Minority AIDS Initiative (MAI) grantees to temporarily use grant funds to purchase HIV and hepatitis C self-test kits that can be mailed to clients receiving substance use disorder treatment. Click here to read more about temporary authorization and current FDA approved self-administered tests.

“HealthHCV released a comprehensive report of the Third Annual HealthHCV State of HCV Care National SurveyTMfindings, which includes first-of-its-kind data on the state HCV care in HIV and primary care settings. The report highlights specific education, training, and financial resources that providers need in order to scale-up HCV services, remain responsive to national guidelines and recommendations, and meet the needs of a growing and diversifying HCV patient population.” Click here to download the report.

Hep B United Request for Funding Proposal: 2020 Hepatitis B Foundation HBU Mini-Grants Program

The 2020-2021 HBU Mini-Grants Program is open for applications. The Hepatitis B Foundation is offering mini-grants for one year to Hep B United coalition partners working on hepatitis B education, screening, and linkage to care activities. Up to 8 awards will be given ranging from $5,000 to $10,000 each. The deadline to apply is by 5:00 PM PDT on August 14th, 2020. The RFP is attached and available at this link. The emphasis of this RFP is focused on Asian American, Native Hawaiian and Pacific Islander (AA & NHPI) communities.

Upcoming webinars/events:  

HCV Training: Current Issues, Strategies for Cure & Addressing Barriers
NATAP
Friday, June 26, 1:30 PM EST
Topics will include: Hepatitis C Treatment & Retreatment; What is “Cure?”; What is the best treatment?; COVID-19 Impact and effects on care & treatment; Barriers to Linkage, Care & Treatment; Special populations: Young men & women, Injection drug users, women of child bearing age and newborns.

Archived Webinars

Overcoming Barriers to Adult Hepatitis B Vaccination
Hepatitis B Foundation
Panelists discussed cases of discrimination against health care students with hepatitis B, preliminary research findings from an analysis of health professions school admissions policies in two jurisdictions, federal legal protections, and the process for filing complaints. Click here to access the webinar recording and slides.

Coping with COVID-19: Insight from the front lines of HIV, hepatitis C, and harm reduction
CATIE
This webinar provides a forum for frontline workers across the country as they discuss issues and ideas on how they are serving vulnerable people in their communities in the face of the COVID-19 pandemic. The panel shares what their agencies and communities are doing and provide a venue for attendees to ask questions and share ideas and resources with each other. Click here to listen to the recording.

Incorporating Opioid Use Disorder Screening and Treatment into HIV and HCV Management
Clinical Care Options (CCO)
CCO’s expert faculty provide insights on the critical role ID specialists and hepatologists can play in addressing the ongoing opioid use disorder epidemic and discussed useful strategies for incorporating OUD screening, patient evaluation, and treatment into HIV/HCV care settings.

Upcoming Meetings (cancellation/postponements in red) 

SYNChronicity, The National Conference for HIV, HCV, STI, and LGBTQ Health

*New Date: September 8-11 (Virtual) 

This conference brings together medical professionals, service providers, government officials, and health advocates to sync effective approaches to address HIV, HCV, STI, and LGBTQ health in the changing and dynamic health care landscape, with a focus on underserved racial/ethnic minorities and LGBTQ communities. Click here for registration information.   

9th International Conference on Hepatitis Care in Substance Users *postponed to 2021

The International Network on Hepatitis in Substance Users (INHSU) is an international, not-for-profit, member-based organization dedicated to scientific knowledge exchange, education, and advocacy focused on hepatitis C (HCV) prevention and care with people who use drugs. The conference covers the latest advances on HCV epidemiology, management and treatment of viral hepatitis among people who use drugs. Through the dissemination of scientific knowledge, the conference aims to contribute to the WHO’s goal of elimination hepatitis C by 2030. 

The National Harm Reduction Conference (HarmRed20) *postponed

Statement from the conference team: “After thoughtful deliberation, we have decided to postpone #HarmRed20. We are not canceling the conference; we are doing what harm reductionists do best; we are pivoting and responding to the emerging conditions. The timing is shifting, but the commitment to our movement and specifically the Puerto Rican community will not waver.”

Job Postings

Viral Hepatitis Prevention, Policy, and Community Coordinator – Philadelphia

The Prevention Coordinator will be responsible for management of activities related to viral hepatitis prevention, including outreach, training, education and collaboration with appropriate programs to facilitate access to hepatitis services. This position works in close coordination with viral hepatitis surveillance activities. Click here to see more.

2020 Viral Hepatitis Policy Fellow – National Viral Hepatitis Roundtable

The Viral Hepatitis Fellowship is a year-long remote position, with the possibility of renewal. Due to the need for meetings with federal lawmakers, the employee shall be based in commuting distance to Washington, D.C. The Fellowship will be awarded to a medical, public health, or policy professional interested in health equity; specifically in strengthening the collaboration between key stakeholders and government, highlighting key gaps in policy and service delivery, and working with partners to address the disparate impact of viral hepatitis among underserved populations.

Director of Operations –Hepatitis Education Project

Director of Operations will maintain positive community partnerships and ensure smooth functioning of the agency. This position will further develop and streamline HEP’s operations infrastructure. They will work with the Executive Team in activities related to improving HEP’s organizational health and enhancing HEP’s strategic vision and commitment to health equity. Click here for the full job description.

Prevention Unit Manager –NC Division of Public Health

This position will be responsible for providing leadership, vision and advocacy for the Injury and Violence Prevention Unit of the Injury and Violence Prevention Branch. The position is responsible for developing and implementing key strategies to reduce the burden of death from the drug overdose epidemic and the leading causes of unintentional and intentional injuries in the state. The position supervises Prevention Unit staff and coordinates with key partners, agencies, and state-wide organizations that support community-level injury and violence prevention activities. Click here for the full job description.

Manager III, TB/HIV/STD –Texas Department of State Health Services

This position will perform complex managerial work overseeing the daily operations and activities of the Health Communications & Community Engagement Group in the Integrated Operations & Policy Unit, TB/HIV/STD Section. Duties include evaluation, direction, and coordination of complex programmatic and administrative activities and participation in the development and evaluation of goals and objectives in addition to preparation of information in response to legislative requests. Click here for the full job description. The closing date to apply is July 2nd.

Articles:

A Structural Competency Curriculum for Primary Care Providers to Address the Opioid Use Disorder, HIV, and Hepatitis C Syndemic: “The interrelated epidemics of opioid use disorder (OUD) and HIV and hepatitis C virus (HCV) infection have been identified as one of the most pressing syndemics facing the United States today. Research studies and interventions have begun to address the structural factors that promote the inter-relations between these conditions and a number of training programs to improve structural awareness have targeted physician trainees (e.g., residents and medical students). However, a significant limitation in these programs is the failure to include practicing primary care providers (PCPs).”

A Modifiable Barrier to Hepatitis C Virus Elimination in Rhode Island: The Prior Authorization Process for Direct-Acting Antiviral Agents: “Hepatitis C virus (HCV) is disproportionately prevalent among different groups of marginalized populations in Rhode Island (RI). Although direct-acting antiviral (DAA) agents are safe and cure HCV, RI payers limit access to these life-saving medications using prior authorizations (PAs). We assessed RI DAA-specific PA criteria. The PA process requires many steps, differing across RI payers, taking 45-120 minutes per patient. To achieve HCV elimination, DAA PA forms and processes should be standardized, streamlined, and ultimately removed.”

Challenges Developing a Hepatitis C Vaccine

Click here to view the video of Andrea L. Cox, MD, PhD, Professor of Medicine at Johns Hopkins University, discuss some of the challenges in developing a vaccine for hepatitis C and details the results of a vaccine trial.  

The Grady Liver Clinic: HCV Micro-Elimination in a Southern Safety-Net Health System

Atlanta’s Grady Liver Clinic The clinic provides HCV screening, care and cure for Grady’s underserved, high prevalence population. Click here to read more about how the clinic is working toward hepatitis elimination.

Telemedicine Program Successfully Treats Hep C in Inmates

“Researchers found that a telemedicine program was highly successful as a means of treating hepatitis C virus (HCV) in a large number of incarcerated individuals, who achieved a high cure rate.”

Intrahepatic Cholangiocarcinoma in a Patient with Hepatitis C:  A Cautionary Tale: “Delayed treatment of hepatitis C virus infection (HCV) can lead to cirrhosis and may increase the risk of associated malignancies including hepatocellular carcinoma (HCC) and less commonly, intrahepatic cholangiocarcinoma. Stigma and misunderstanding surrounding alcohol and/or substance use disorders (SUD) can delay or prevent access to life-saving direct-acting antiviral (DAA) therapies, despite the large body of evidence supporting HCV treatment in people with SUD. We present a case of fatal intrahepatic cholangiocarcinoma in an HCV-infected patient who received unrestricted access to treatment for three malignancies and other chronic health conditions but for whom treatment of HCV was delayed due to SUD.”

Evaluation of a Program to Improve Linkage to and Retention in Care Among Refugees with Hepatitis B Virus Infection –Three U.S. Cities, 2006-2018 –May 29, 2020 MMWR

“Several studies have evaluated initial linkage to HBV care for both refugee and nonrefugee immigrant populations, but none contained standardized definitions for either linkage to or long-term retention in care for chronic HBV–infected refugees. To assess chronic HBV care, three urban sites that perform refugee domestic medical examinations and provide primary care collaborated in a quality improvement evaluation.” Click here to read more.

The Global Prevalence of Hepatitis D Virus Infection: Systematic Review and Meta-Analysis: “An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precisions of burden estimates.”

Source: The Global Prevalence of Hepatitis D Virus Infection: Systematic Review and Meta-Analysis

Blog:

Syringe Services Programs and the COVID-19 Pandemic: Innovations from the Field, Lucy Slater, Senior Director – HIV, STI, and Viral Hepatitis, NAACHO. The blog highlights new strategies used by local health departments across the country to ensure SSP clients can access critical, lifesaving services during the COVID-19 pandemic. 

Message from our team:

NASTAD's Hepatitis team shares the following wisdom and philosophy to inform self-care during this tough time:

"Be stingy with your time and spend it in spaces that fill you up." ~ Janet Mock, Author, Producer, and Transgender Rights Activist

NASTAD’s Hepatitis Team