Hepatitis Happenings and Updates

By Jasmine West January 23, 2020

As many of you know, we launched HepTAC in August 2019 and have received and fulfilled numerous TA requests to-date. If you didn’t use it last year, there’s no time like the present to submit a request in 2020! 

Getting to Know our HepTAC Consultants 
We continue the new year highlighting our outstanding HepTAC consultants! See below Lindsey Sizemore and her darling daughter and read more about the expertise Lindsey brings to HepTAC.  

Lindsey Sizemore, Viral Hepatitis Program and Surveillance Director, Tennessee Department of Health 

Her work includes, but is not limited to:

  • Building and standardizing VH surveillance through development of a User Manual and in-person trainings;
  • Conducting routine, passive retrospective and prospective surveillance for HCV-positive pregnant females and perinatal HCV exposures;
  • Developing tools to conduct outbreak detection and response, highlighted in the CDC document, “Managing HIV and Hepatitis C Outbreaks Among People Who Inject Drugs: A Guide for State and Local Health Departments”;
  • Implementing HCV testing (in local health departments statewide, partnering Community-Based Organizations, Federally Qualified Health Centers, and the Tennessee Department of Corrections);
  • Administering HAV and HBV vaccine among clients in county jail through an established Jail Vaccination Program; and
  • Initiating VH and Substance Use Resource Navigators to promote linkage to HCV treatment and harm reduction services.

Request TA through HepTAC and we’ll match your needs with the expertise of our consultants.  
 
NASTAD Updates 

The CDC’s Division of Viral Hepatitis provided notification that publication of the forecasted Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments (CDC-RFA-PS20-2009) has been delayed. The new publication date is anticipated during the week of January 27, 2020 with the first Informational call tentatively scheduled for February 3, 2020 at 3:00 PM (EST). The award date remains unchanged for June 1, 2020.  Please see below for the announcement. 


Forecasted Prevention and Surveillance Funding Announcement
Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments
 
Posting Date: Week of January 27, 2020
CDC’s Viral Hepatitis Program has a combined prevention and surveillance funding opportunity (CDC-RFA-PS20-2009) forecasted on grants.gov. The Notice of Funding Opportunity (NOFO) supports integrated viral hepatitis surveillance and prevention programs in states and large cities in the United States.
Important Estimated Dates for Eligible Recipients:

  • Application due date: March 27, 2020 or 60 days after publication
  • Award date: June 1, 2020
  • Informational Webinar: February 3rd and February 18th (same information provided on both calls), 3:00 PM EST, (404) 553-8912 Conference ID: 5754594

Resources 

Upcoming webinars

  • Hep B Clinical Provider Training 
    Empire Liver Foundation & HepCure
    Tuesdays, 4:40-5:30 PM EST
    Join this four-week live webinar CME/CNE/CEU accredited training for free! Click here to view the series and register.
     
  • HepVu Webinar: Best Practices & Challenges in Hepatitis C Surveillance
    HepVu
    Tuesday, January 28, 12:30 - 1:30 PM EST
    HepVu will host this webinar about the current state and local best practices and challenges in conducting Hepatitis C surveillance. Speakers will include Dr. Heather Bradley, HepVu Project Director and Assistant Professor of Epidemiology at Georgia State University, and  Dr. Eli Rosenberg, Associate Professor of Epidemiology and Biostatistics at the University at Albany, as well as representatives from other state- and city-level jurisdictions.
     
  • Employing People Who Use Drugs Beyond Tested, Cured: A Program Designed to Explore Barriers to Care Related to Hepatitis C
    NC Survivors Union, People’s Harm Reduction Alliance, & Atlanta Harm Reduction Coalition
    Tuesday, January 28, 2:00-3:00 PM EST
    This webinar will provide case studies and evidence why hiring individuals who use drugs, including those living with hepatitis C, prove the proposed strategies and policies of Harm Reduction Hiring programs, and drug user led advocacy.
     
  • Hepatitis D Treatment Endpoints: How Do We Measure Success in the Era of Emerging Therapies?
    Hepatitis B Foundation
    Wednesday, January 29, 11:00 AM – 12:00 PM EST
    Hepatitis delta, a dangerous coinfection of hepatitis B, is estimated to affect between 15 and 70 million people across the world. For decades, the only treatment option has been pegylated interferon; an often difficult drug to tolerate with only a small chance of controlling liver disease. With many new drugs now in clinical trials for hepatitis delta, we must ask, what does successful treatment look like? Tune into the webinar to find out!
     
  • Innovative Approaches to Hepatitis C Linkage to and Retention in Care
    Hep C Free WA
    Monday, February 10, 3:00 – 4:00 PM EST
    The mission of Hep C Free WA, the statewide collective impact initiative seeking a multisector response to the public health threat of hepatitis C, is to work together to eliminate hepatitis C in Washington State by the year 2030. In order to achieve elimination, people living with hepatitis C must know their status and be effectively linked to and retained in care. This webinar will highlight innovative approaches to hepatitis C linkage to and retention in care services in Washington.
     
  • Updated AASLD Practice Guidelines and Guidances
    Hepatitis C Guidance 2019 Update: AASLD‐IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

Archived Webinars:

The webinar series and recordings are now available for viewing: 

For more information about HHS efforts to support SSPs in vulnerable communities, questions about SSPs, and to get connected with HHS OASH federal, state, and local partners, reach out to the HHS OASH Regional Health Administrator for your region.

Fact sheets & toolkits

Slideset: Practical Strategies to Address Ongoing Gaps in Viral Hepatitis Care, Clinical Care Options
In this downloadable slide set, review gaps identified in the 2019 National Viral Hepatitis Progress Report and key actions to implement in your practice to address them. Learn how new guidance from AASLD may affect your approach.

Know Hepatitis B Video PSAs Now Available in Multiple Languages!
The Know Hepatitis B Campaign - a national multilingual communications campaign by the CDC and Hep B United - has released 2 new video PSAs! The 30-second PSAs encourage Asian Americans to get tested for hepatitis B. Hepatitis B and Your Liver is available in English, Mandarin, Vietnamese, and Korean. Hepatitis B Doctor Conversation is only available in Vietnamese.

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.  

Prevent Cancer Dialogue | April 15-17
Arlington, VA

This is a national conference that brings a diversity of stakeholders together to discuss the best ways to reinforce cancer screening, prevention and risk reduction initiatives in their communities. The schedule is packed with unique opportunities for participants to immerse themselves in engaging presentations, facilitated conversations, relationship building and more. Abstract submissions accepted through Friday, February 7.

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.  

Job Opportunities  

Perinatal Hepatitis Epidemiologist, Kansas Department of Health and Environment

Closes 1/28/2020

They are seeking an epidemiologist for the Infectious Disease Epidemiology and Response section (IDER) at the Kansas Department of Health and Environment to manage the perinatal hepatitis B prevention program, perform analyses of hepatitis B and C surveillance data, and conduct outbreak investigations.

Epidemiologist II, Texas Health and Human Services

This position will form the core of a full-time staff dedicated to Hepatitis C (HCV) surveillance for Texas. Work involves collaborating with the CDC, local and regional health departments, and other investigators to design, implement and conduct complex data analysis using HCV surveillance data; analyze data; monitor data for changes in disease reporting patterns; disseminate investigation results; and develop training materials.

Sr. Director HIV, STI and Viral Hepatitis, NACCHO

The Senior Director will oversee the HIV, STI and Viral Hepatitis portfolio at NACCHO, and is responsible for both developing the strategic direction and ensuring the achievement of results within this portfolio. This position is expected to integrate complex activities within their portfolio and across the organization.

Hepatitis B Policy Fellow, AAPCHO

This Fellowship is a year-long position, with the possibility of renewal, based in Washington, D.C. The Fellowship will be awarded to a medical, public health, or policy professional interested in strengthening the collaboration between key stakeholders and the federal government, highlighting key gaps in policy and service delivery, and working with partners to address the disparate impact of hepatitis B on Asian Americans and Pacific Islanders. Please disregard the application deadline noted in the announcement. For questions regarding eligibility or to apply, please email hepbfellow@aapcho.org

Research Data Analyst IV, Senior Epidemiologist, CDPH

This position will serve as a senior epidemiologist to support the design and implementation of prevention activities related to HIV, STDs, and viral hepatitis. The individual will design, implement, and evaluate core and enhanced public health surveillance projects, including conducting analysis matching variables across multiple complex datasets (such as HIV, STD, and HCV registries, birth and death records, hospitalizations, etc.). Click here to read more about this position.

Deputy Director, Center for Infectious Diseases and State Epidemiologist, CDPH

The Deputy Director serves as the State Epidemiologist and provides guidance and consultation on communicable disease surveillance and epidemiology to 61 local health jurisdictions, other state agencies, and community-based organizations, health care providers, and professional organizations. 

Deputy Director, Office of Health Equity, CDPH 

The Deputy Director is responsible for the development of priorities, policies, practices, and implementation of a strategic plan related to reduction and elimination of health disparities and health inequities within specific vulnerable population and affected geographic locations, including racial and ethnic communities, women, persons with disabilities and lesbian, gay, bisexual, transgender and queer communities. 

Maternal and Child Health

Requests for Information: 

We received a request for resources about hepatitis C in pregnancy in other languages, specifically Russian or Uzbek. Please reach out to if you have access to these and/or know of someone in your network that does. These resources will be uploaded to NASTAD’s Hepatitis Technical Assistance Center (HepTAC) for easy access in the future.

Shout out to our HepTAC consultants and other contributors, Lindsey Sizemore (TN) and Emilia Prebish (UT), and Bree Barbeau (UT), for their featured publications!

Pregnancy Status, Risk Factors, and Opportunities for Referral to Care Among Reproductive-Aged Women with Newly Reported Chronic Hepatitis C Virus Infection in Tennessee

‘From 2006 through 2012, the number of acute hepatitis C virus (HCV) infections increased 364% among persons aged ≤30, including reproductive-aged women, in Central Appalachian states. Outreach to reproductive-aged women with newly diagnosed HCV infection affords a unique opportunity to provide counseling, further testing, and linkage to treatment. We modeled a centrally located statewide effort to reach this population and their health care providers to ascertain pregnancy status, HCV risk factors, and opportunities for linkage to additional services.’

Maternal and neonatal outcomes among pregnant women with Hepatitis C in Utah, 2009-2017

‘The United States is in the midst of perinatal hepatitis C viral infections (HCV) and substance use syndemic, defined as two or more concurrent epidemics clustered in a population with biological interactions. Both perinatal substance use and HCV are associated with adverse maternal and neonatal outcomes. However, whether HCV is an independent risk factor for adverse outcomes remains unknown.’ This article dives into the risk of adverse maternal and neonatal outcomes attributable to HCV.

The paediatric population: the forgotten element to eliminating hepatitis C virus

‘Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide. However, global estimates of HCV prevalence, morbidity, and mortality are mostly based on data derived from adults. The increasing number of young women who inject drugs, linked to the opioid epidemic, has resulted in an increase in vertical transmission rates since 2015 in some high-income countries.’

Global prevalence of hepatitis C virus in children in 2018: a modelling study

‘Hepatitis C virus (HCV) prevalence estimates for adults and high-risk groups have been widely published, but the disease burden in children is poorly understood.  Reliable prevalence estimates for this population are needed to inform scale-up of treatment and national strategies. This analysis combines past modelling and epidemiological work in 104 countries and territories to estimate global HCV prevalence in children in 2018.’


Figure 2: Countries and territories with highest numbers of HCV infections for children aged 0-18 years for 2018. (A) Countries and territories shown accounted for 80% of global paediatric HVC infections.

If you have articles, publications, or other hepatitis related news to share, please send to hepatitis@nastad.org so we can showcase your work in our newsletter!

News Bulletin 

Domestic Articles of Interest:

Project ECHO: democratising knowledge for the elimination of viral hepatitis

‘15 years ago, the HCV epidemic in New Mexico, USA, reflected these national challenges: in 2003, fewer than 5% of the 28 000 New Mexicans diagnosed with chronic HCV infection had received treatment, primarily because of a chronic shortage of liver disease specialists. The solution in New Mexico was an initiative called Project ECHO (Extension for Community Healthcare Outcomes), a tele-mentoring programme launched at UNMHSC.3 Project ECHO connected a multidisciplinary team of specialists with primary-care providers at community clinics across the state to share specialist hepatitis knowledge, creating community-based centres of excellence for HCV treatment.’

Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington

‘With the goal of eliminating hepatitis C virus (HCV) as a public health problem in Washington State, Public Health–Seattle & King County (PHSKC) designed a Hepatitis C Virus Test and Cure (HCV-TAC) data system to integrate surveillance, clinical, and laboratory data into a comprehensive database. The intent of the system was to promote identification, treatment, and cure of HCV-infected persons (ie, HCV care cascade) using a population health approach.  The data enabled PHSKC to report the number of patients at various stages along the HCV care cascade. Of 7747 HCV RNA-positive patients seen by a partner site, 5377 (69%) were assessed for severity of liver fibrosis, 3932 (51%) were treated, and 2592 (33%) were cured.’

Engagement in the Hepatitis C care continuum among people who use drugs

‘A qualitative study was conducted among adults admitted for inpatient detoxification for opioid use disorder (OUD) in New York City (n = 23) to assess barriers and facilitators with HCV prevention, screening, treatment, interactions with primary care providers, and experiences with integrated care approaches.  Major gaps persist in knowledge regarding HCV harm reduction strategies, voluntary HCV testing services, and eligibility for HCV treatment. Treatment coordination challenges reinforce the importance of enhancing linkages to HCV care in key access-points utilized by PWUDs (e.g., emergency rooms, specialty addiction treatment settings). Peer networks combined with frequent patient-physician communication were elicited as important factors in facilitating linkage to HCV care.’

Global Articles of Interest:

WHO Global Health Bright Spots 2019 

Despite serious challenges, there’s been plenty of good global health news in 2019. These are just a few of the brightest spots—including this article highlighting Egypt as a global leader in HCV treatment.

Hepatitis C screening among PrEP users could eliminate hepatitis C infections in gay men in the UK

‘Increasing the frequency of hepatitis C screening in gay and bisexual men taking pre-exposure prophylaxis (PrEP) in the United Kingdom has the potential to reduce new hepatitis C infections in the UK by 2030, especially if the proportion of men taking PrEP increases to 25%, researchers report in the journal EClinical Medicine.’

Sexually transmitted HCV rates high among MSM regardless of HIV status

‘“HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM),” Elske Hoornenborg, MD, from the Public Health Service of Amsterdam, Netherlands, and colleagues wrote. “Increased uptake of pre-exposure prophylaxis (PrEP), which successfully prevents HIV-infection but not HCV-infection, could usher increasing overlap in sexual networks between HIV-negative and HIV-positive MSM, eventually resulting in an expanding HCV epidemic among MSM irrespective of HIV-status.”’

Collecting Real-World Data on HCV Treatment as Prevention in PWID: The Scottish Experience

‘The HCV treatment as prevention (TasP) model is an innovative and promising approach to eliminating HCV, yet it remains to be proven in real-world populations of persons who inject drugs (PWID). Here, we share our progress in evaluating this model administered through our regional health board in Tayside, Scotland.’

The Lancet: Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Updates include Elimination of viral hepatitis by 2030: ambitious, but achievable; Civil society's critical role in the elimination of viral hepatitis; and Accelerating the elimination of viral hepatitis for Indigenous peoples.