Hepatitis Happenings and Updates

By Jasmine West December 19, 2019

NASTAD Updates

A warm thank-you to everyone who was able to join NASTAD’s 2019 National HIV and Hepatitis Technical Assistance Meeting in early December. What a great way to end the year with several opportunities for information sharing, networking, and to engage in dialogue with federal and community partners. We couldn’t have done it without your expertise as we collectively took a step forward to further plans of viral hepatitis elimination!

See NASTAD’s compilation of meeting materials and resources here. We encourage everyone to reach out with any questions about the meeting or any additional requests to, hepatitis@nastad.org.

Our team would like to wish you all, happy holidays! Please note, the NASTAD office will be closed December 24, 2019 – January 2, 2020. We look forward to continuing our work in the new year!

Policy Updates

After a recent meeting, House and Senate appropriators, Congressional leadership, and the Trump administration announced that all sides came to an agreement over funding for all 12 outstanding fiscal year (FY) 2020 appropriations. Appropriators agreed to flat funding of $1.375 billion for a wall at the southern border, as well as an agreement not to interfere with President Trump's ability to divert Pentagon funding to the wall. The 12 appropriations bills were passed in the House today by a 280-138 vote and after passing the Senate the President is expected to pass the bill by Friday’s deadline. The first package will include the Defense, Homeland Security, Commerce-Justice-Science, and Financial Services bills while the other bills will be included in a second minibus. The agreement will allow for the Ending the HIV Epidemic initiative to be implemented in full as intended, but funding for the viral hepatitis programs at CDC were flat funded, remaining at $39 million. The Infectious Diseases and the Opioid Epidemic line item has increased to $10M, which is $5M more than last year.  We anticipate some of these funds will be used to support hepatitis programs at CDC and will provide updates as they are announced. If you have any follow-up questions, we are happy to connect you with Garrett Eberhardt, Manager for Policy and Legislative Affairs at NASTAD.

Funding Opportunity: Hepatitis Prevention and

Surveillance Cooperative Agreement 

The CDC has announcement a new funding opportunity for 2020! The Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments will distribute approximately $91 million dollars among an estimated 58 recipients. Eligible applicants are:

  • County governments
  • City or townships governments
  • State governments
  • Special district governments

The official announcement is set to be posted on January 6, 2020. Applications are estimated to be due on March 9, 2020 at 11:59 PM ET. 

Search for CDC-RFA-PS20-2009 on grants.gov for a full description of the grant.

As disucssed on our recent NASTAD Hepatiits Work Group calls, the combined CDC NOFO is expected to be released on January 6,2020. We will be sure to circulate any information we recieve as the date nears. The forecast for the upcoming NOFO is available at this link.

NIH strategic plan details pathway to achieving Hepatitis B cure

The Strategic Plan for Trans-NIH Research to Cure Hepatitis B supports and aligns with NIH's ongoing efforts to intensify innovative hepatitis B research, and with the U.S. National Viral Hepatitis Action Plan. The strategic plan proposes priorities to develop a hepatitis B cure and improved strategies for vaccination, screening, and follow-up to care (Box 1). The plan is structured around three research areas that are vital to developing a cure. Find the Strategic Plan here.

Resources

Recap from the 2019 National Viral Hepatitis Program Planning Meeting

Interested in meeting materials and presentations from ASTHO and CDC’s National Viral Hepatitis Program Planning Meeting? Click here to read a guest blog for a recap of the meeting that took place in July 2019.

The National Viral Hepatitis Roundtable (NVHR) has launched a new national provider advocacy network to bring the voice of health care providers to the fight to eliminate viral hepatitis.

Join NVHR, the ‘Voices4Hep’ Advocacy Network to connect with fellow advocates, gain support for the local initiatives, and access resources to help you have a bigger impact. Feel free to share with your extended networks!

The Important Role of Substance Use Disorder Treatment Providers in Ending the HCV and HIV Epidemics

Check out the customizable technical assistance slide set from the National Alliance for HIV Education and Workforce Development (NAHEWD) that helps to educate treatment providers for people who use drugs—specifically recognizing their critical role in diagnosing and treating those with HCV and HIV.  

Put it on your calendar for 2020!

Upcoming webinars:

Efforts to Increase Hepatitis B Testing and Vaccination in Correctional Facilities
Innovative Collaboration to Improve Social Determinants of Health in Philadelphia | January 21 at 2:00 PM EST
This webinar provides attendees an overview of the Philadelphia Nursing-Legal Partnership (NLP), a collaboration between public health nurses and attorneys that remediates mothers, children, and families’ unmet social, legal, health, and education needs. Attendees will hear from the NLP’s multidisciplinary team to better understand the core components of a successful nursing-legal partnership, ways to measure success, and lessons learned.

Some added listening during the holidays!

Archived Recordings:

Reducing barriers to access and engagement in hepatitis C care through integration
CATIE
The integration of hepatitis C care within broader harm reduction or related HIV service models could remove some of the barriers to access and engagement. This webinar discusses potential strategies to overcome these barriers by focusing on promising models of frontline programs for people who use drugs or who are marginalized from mainstream healthcare, such as co-location and integration of services.

Hepatitis B Health Disparities
APPEAL
Chronic infection with the Hep B and Hep C viruses are the most common risk factors for liver cancer in the United States. Despite the significant decline in viral hepatitis B infection in the U.S. since the 1990s, hepatitis B remains a significant cause of health disparities in communities of color, especially in Asian and Pacific Islander (API) and African American communities. This webinar focuses on addressing these health disparities and highlight prevention efforts for these priority populations.

Hep C Free Washington: Sharing Lessons to Date from a State Hepatitis C Elimination Initiative
HepCure
The Washington State Department of Health (Emalie Huriaux and Jon Stockton) as well as a representative from the Treatment Action Group (Annette Gaudino), presented on Washington State’s road to hepatitis C elimination. See slides and the recording here.

Expanding hepatitis C testing and treatment through task-shifting
CATIE
Task shifting is an approach that decentralizes service delivery by expanding the types of providers who are able to offer services. This webinar explores the concept of task shifting, the opportunities and benefits it offers, and will examine how Scotland has implemented this concept to scale up access to their hepatitis C services.

Cross paths with NASTAD staff at upcoming meetings and conferences in 2020!

Upcoming Meetings

National Hepatitis Corrections Network | April 1, 2019

This is a one-day meeting that’ll take place in advance of the Academic Health & Policy Conference on Correctional Health (see below). This will serve as a great opportunity to connect with colleagues from across the US who are working to address hepatitis in corrections. If you are interested in attending this meeting, reach out to mandy@hepeducation.org.

The Academic Health & Policy Conference on Correctional Health | April 2 – 3, 2020

The Correctional Health Conference provides a forum for researchers, clinicians, administrators, educators, policy makers, and grant funding leaders to network, share evidence, and learn about emerging research and relevant policy updates in the field of correctional health care. If you are interested in attending this meeting, reach out to mandy@hepeducation.org.

National Latinx Conference on HIV/HCV/SUD | April 3-5, 2020

Albuquerque, NM

This conference aims to provide healthcare and social service providers with innovative concepts, best practices, and new information on how to better serve Latinx communities. It represents an important step towards fulfilling the goals of the 2020 National HIV/AIDS Strategy and bringing the needs of Latinx community to the forefront in the fight against HIV, HCV and SUD. Registration here.

The RX Drug Abuse & Heroin Summit | April 13 – 16, 2020

Nashville, TN

This summit is the largest national collaboration of professionals from local, state and federal agencies, business, academia, clinicians, treatment providers, counselors, educators, state and national leaders, law enforcement/public safety, and advocate impacted by the opioid crisis. Register early for low rates.

SYNChronicity, The National Conference for HIV, HCV, STI, and LGBTQ Health | May 11-12, 2020

Washington, DC

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.

Council of State and Territorial Epidemiologists (CSTE) | June 28 – July 2

Seattle, WA

Conference attendees meet and share their expertise in surveillance and epidemiology as well as best practices in a broad range of areas including informatics, infectious diseases, substance use, immunizations, environmental health, occupational health, chronic disease, injury control, and maternal and child health. Abstracts must be received no later than Friday, January 10, 2020 by 11:59 PM EST through the online CSTE abstract submission site. 

News Bulletin

Want some good reads over the holidays? Check out these articles of interest:

Domestic

Nine States Join the 2020 Hepatitis C Medicaid Affinity Group

December 9, 2019 | U.S. Department of Health and Human Services

HHS OIDP launched the third year of the Hepatitis C Medicaid Affinity Group – an initiative to increase the number of Medicaid enrollees cured of hepatitis C.

HCV Screening: How Can Pharmacists Get Involved?

‘Pharmacists are highly accessible healthcare providers; approximately 90% of Americans live within 5 miles of a community pharmacy. To help expand HCV screening nationwide, community pharmacists can implement a fingerstick HCV antibody screening into their workflow. This should only be implemented after developing a linkage to care procedure that will ensure patients have ready access to follow-up with a provider for confirmatory testing in the event of a positive HCV antibody test.’ 

Hepatitis C Virus Screening and Care: Complexity of Implementation in Primary Care Practices Serving Disadvantaged Populations

‘Hepatitis C virus (HCV) disproportionately affects disadvantaged communities where this article

examines processes and outcomes of Screen, Treat, Or Prevent Hepatocellular Carcinoma (STOP HCC), a multicomponent intervention for HCV screening and care in safety-net primary care practices.’

Hep B Moms: A cross‐sectional study of mother‐to‐child transmission risk among pregnant Asian American women with chronic hepatitis B in New York City

Mother‐to‐child transmission (MTCT) is responsible for the majority of chronic hepatitis B virus (HBV) infections worldwide. NYC performed a retrospective cross‐sectional analysis of Asian American women with chronic HBV evaluated with HBV DNA during prenatal care at two community health sites from 2007 to 2017. Click here to read the full assessment of HBV pregnant women emphasizing why early coordinated care is needed to deliver interventions to prevent MTCT during critical windows of time.

Letter to the editor: Consider safe-injection sites as tool to fight hepatitis C in Maine

“The discussion of syringe exchange programs in the Nov. 24 article on hepatitis C prevention in Maine omits a key element, which is the provision of safe-injection sites supplementing syringe exchange.”

Liver transplantation in the USA: ethical issues

“Of all medical disciplines, organ transplantation is perhaps the most fraught with thorny ethical issues. This was apparent at The Liver Meeting 2019, held in Boston, MA, USA, when hepatologists from around the world gathered to present new science and discuss controversies in the field. High on the agenda were considerations around the use of hepatitis C virus (HCV)-infected organs for uninfected recipients (D+R– transplantations). The ongoing opioid crisis has led to more organs from donors with HCV becoming available, and research shows that D+R– transplantations are feasible and safe, due in part to the advent of direct-acting antiviral (DAA) therapy. However, as Emily Blumberg (University of Pennsylvania, PA, USA) noted, while use of HCV-positive organs expands the donor pool, there are unresolved ethical questions.”

Global

Chronic hepatitis B: a global health problem requiring coherent worldwide treatment strategies

‘Chronic hepatitis B virus infection is a major cause of end-stage liver disease and hepatocellular carcinoma is a worldwide health concern. While the past two decades have brought major advances in the availability of treatments to help delay or prevent these outcomes, treatment of chronic hepatitis B remains a serious challenge, not least due to the ability of the virus to remain in hepatocyte nuclei as a source of potential reactivation—hence the term chronic hepatitis B infection.”

New Study has Global Impact on Hepatitis C Elimination Efforts

‘Chronic hepatitis C virus (HCV) affects over 70 million people worldwide and is a leading cause of cirrhosis and liver cancer. An estimated three to four million Americans have chronic HCV infection, with many of them being baby boomers born between 1945 and 1965.’

Early start of tenofovir treatment achieves better viral suppression in pregnant women with a high HBV viral load: A real-world prospective study

‘Researchers examined whether pregnant women with hepatitis B virus (HBV) could achieve higher benefits with initiating their drug treatment regimen in the second trimester vs the third trimester.’ Click here to read the full analysis.

Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis

‘We found that, for 2018, an estimated 2·2 million infection-attributable cancer cases were diagnosed worldwide, corresponding to an infection-attributable ASIR of 25·0 cases per 100 000 person-years. Primary causes were Helicobacter pylori (810 000 cases, ASIR 8·7 cases per 100 000 person-years), human papillomavirus (690 000, 8·0), hepatitis B virus (360 000, 4·1) and hepatitis C virus (160 000, 1·7).’