Hepatitis Happenings and Updates

By Jasmine West February 19, 2020

Getting to Know our HepTAC  Consultants!
This month we are delighted to feature Melissa Ip, one of our many stellar HepTAC Consultants!

Melissa Ip is a freelance health communications consultant as well as continuing education coordinator at CAI. Melissa previously worked at the New York City Health Department Viral Hepatitis Program, creating capacity building resources to improve hepatitis B and C screening and linkage to care in NYC, including: annual reports and slide decks on surveillance data and programmatic activities of the hepatitis unit; health promotion manuals for hepatitis B patient navigators; hepatitis C patient navigation e-learning modules; and digital content disseminating best practices, resources, and trainings to NYC providers. She also worked on public education initiatives, including social media marketing, bus ads, and text message campaigns promoting hepatitis C testing and linkage to care among high risk groups. Melissa is currently based in the San Francisco Bay Area.

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

NASTAD Updates

NASTAD is pleased to announce the appointment of Dr. Stephen Lee as Executive Director!

In this role, Dr. Lee will oversee all NASTAD programs – Health Care Access, Prevention, Hepatitis, Drug User Health, Health Equity, Policy & Legislative Affairs, and Health Systems Integration – as well as NASTAD’s overall operations. Dr. Lee has deep expertise in program and organizational management, and his experience as a physician brings a much-needed practical perspective with regard to policy and program implementation.

“I am pleased to take on the role of Executive Director of NASTAD at such a crucial moment in the fight to end the HIV and hepatitis epidemics,” said Dr. Lee. “We know that we have the knowledge and tools needed to accomplish our goal. NASTAD and its membership is committed to ending stigma and to dramatically reducing new HIV and hepatitis infections through policies and public health practice grounded in science. I look forward to working alongside NASTAD staff, our members, and our partners to improve health outcomes for people living with HIV and hepatitis and end these epidemics once and for all.”

Come join our team—Associate, Hepatitis!

This position will support NASTAD’s viral hepatitis program in providing technical assistance and capacity building to health departments throughout the nation to advance efforts related to integrated viral hepatitis prevention and surveillance activities supporting cross-program collaborative activities. Interested?! Click here for more information and to apply.

Congratulations Corner

A warm congratulations to our hepatitis colleagues who were accepted into NASTAD’s Minority Leadership Program (MLP)! We are extremely excited for them to join the 2020 cohort and attend program activities next month. Read their excerpts below to see what they’re most excited about.


Arlis Jenkins, Viral Hepatitis Coordinator Arizona Department of Health Services

“I am very excited to begin my journey in participation with the NASTAD Minority Leadership Program, a program that emphasizes the importance of community. This opportunity will not only enhance my ability to connect with others, but also to develop my leadership style and ability to empower others both in my professional and personal roles. I look forward to putting in the hard work and building momentum to follow my dreams and collaborate on the promotion of equitable positive health outcomes for all.”


Ayiasha Pratt, Public Health Representative-2, NJ Department of Health 

‘I am most excited to build a support system of people of color in public health and learn tools that will help me to grow as a professional. In my work environment, I am usually the only person of color. Therefore, I look forward to meeting others that understand the trials and tribulations of trying to work your way up the ladder of success, in a system where you are underrepresented. I plan to use the knowledge that I learn from my participation in the program to become a better leader in the scientific community, but also to empower and encourage other public health scientists of color.’


Dan-Tam Phan-Hoang, Viral Hepatitis Prevention and Community Outreach Coordinator, Minnesota Depart of Health

‘I am excited to participate in a program that will challenge my thought process and help me become an innovative leader who works toward advancing health equity. I also appreciate the opportunity to connect with a diverse group of individuals who are passionate about promoting social justice.’

Please check out NASTAD’s Minority Leadership Program to read more about past cohorts and tune into alumni success stories and health department connections. Don’t hesitate to reach out to hepatitis@nastad.org for additional information. 

Update on 340B Eligibility for Programs Authorized Under Section 318 of the US Public Health Service Act

NASTAD and NCSD released a joint memo, letting our members know that CDC grantees and subgrantees of certain HIV and viral hepatitis NOFOs may be eligible to participate in the 340B Drug Pricing Program. Last year, the Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs (OPA) indicated that, in addition to STD programs, HIV and viral hepatitis prevention CDC grantees and subgrantees, authorized under Section 318 of the US Public Health Services Act, may qualify to participate in the 340B Drug Pricing program. STD programs are funded under Section 318 and have had robust participation in the 340B program to purchase STD treatment medications, but this indication from HRSA suggests that HIV prevention and viral hepatitis prevention programs may also be eligible to participate. Stay tuned as NASTAD continues to work with our partners on expanding resources on 340B Drug Pricing program.

CDC Updates


Many of you are aware that CDC has delayed their release for of the Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments NOFO. Dr. Wester provided the information below with state viral hepatitis programs. “CDC’s Viral Hepatitis program would like to reiterate its commitment to working on releasing the NOFO as soon as possible and to providing updated information as soon as it is available.” NASTAD will keep colleagues informed as information is released.

In other CDC news…

CDC released the Notice of Funding Opportunity (NOFO) announcement for EHE & Viral Hepatitis: CDC PS20-2010 Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States. This is part of the Administration’s Ending the HIV Epidemic (EHE) by 2030 initiative.

Of note, the NOFO states that applicants are eligible to use up to 10% of the approved funding amount to support enhanced and expanded viral hepatitis screening and linkage to prevention and care, conducted in conjunction with HIV testing. Please review the PS20-2010 NOFO and communicate with leadership and colleagues in your respective jurisdictions to identify opportunities to incorporate viral hepatitis activities into your application. If you have any questions, please reach out to hepatitis@nastad.org.

Requests for Information:  

1) Opportunity to publish with the Coalition for Global Hepatitis Elimination!

The Coalition for Global Hepatitis Elimination is partnering with Clinical Liver Disease (a journal of AASLD) to launch a new series to highlight efforts to advance hepatitis B and C elimination globally. See here for additional details and the submission process.

2) HHS Mapping Hepatitis Elimination in Action

The HHS Mapping Hepatitis Elimination in Action effort continues to accept projects! Please be sure to add your organization/hepatitis B project to the map (there are many HBV projects missing from the map!). Please email Corinna Dan at Corinna.Dan@hhs.gov with a brief description of your project and a link to online information. Check out the map and projects here.

3) Given the CDC NOFO announcement for EHE & Viral Hepatitis, health departments and partner organizations are starting to think about opportunities to include hepatitis models for integrated HIV and HBV/HCV testing.

a. What are you thinking in terms of incorporating hepatitis into this new funding opportunity?
b. Do you have successful models for integrated HIV and hepatitis testing (either community based or within healthcare setting) that others should consider during this process?

Please reach out to Alyssa Kitlas and kindly cc hepatitis@nastad.org if you have responses and/or comments to the questions above.

Centers for Medicare and Medicaid Services Request for Information Regarding Rural Maternal Health Care

“CMS is seeking public comments regarding rural maternal and infant health care. We are releasing a request for information to learn about opportunities to improve access, quality, and outcomes for women in rural communities before, during and after pregnancy.” Noted by our partner NVHR, illegal restriction of access to hepatitis C treatment through Medicaid prior authorization is contributing to vertical transmission and limiting access to care in rural areas. Read more about the Request for Information here and submit comments by April 12 at 11:59 PM ET.

Resources  

NVHR Grassroots Advocacy Calls

Join NVHR on the third Thursday of each month to learn about updates in viral hepatitis advocacy and to share progress in your jurisdiction. Click here to register.

The Virginia HEPC Network is Growing! 

Virginia HEPC continues to expand their network to provide accessible HCV treatment to patients anywhere in Virginia. Check out their Provider Trainings and Telemedicine approaches as they work with specialists on hepatitis care coordination. Subscribe to their newsletter here for more updates!

Upcoming webinars:  

Innovative Outreach Strategies for Hepatitis B: Lessons from Hep B United Grantees
February 20, 3:00 – 4:00 PM
Join Hep B United for a featured webinar to hear from hepatitis B experts and past mini-grant recipients around the country to learn about innovative approaches to outreach. Three expert panelists from the Colorado Children’s Immunization Coalition, Korean Community Services in New York, and Midwest Asian Health Association from Chicago will report on strategies for hard to reach populations and hepatitis B.

US Conference on HIV/AIDS Scholarship Webinar
February 24, 3:00-4:00 PM EST
NMAC has committed to doubling the number of A & B scholarships awarded this year. Join this webinar to review the submission and application process.  The scholarship application portal                    will open on the USCHA website on March 3.

Webinar series on Indigenous-centered approaches to harm reduction, HIV, and hepatitis C

The Canadian Aboriginal AIDS Network (CAAN), the Interagency Coalition on AIDS and Development and CATIE will be presenting a two-part webinar series on Indigenous-centred and reconciliatory harm reduction approaches this February and March.

  • Webinar 1: February 24, 2020 at 12:00 PM EST
    Overview of the link between colonialism and substance use, HIV and hepatitis C, and examples of the Indigenous-led response.

 

  • Webinar 2: March 3, 2020 at 12:00 PM EST
    Explore what Reconciliation means in the context of harm reduction, what services providers can do to off person-centered services and how to address stigma in our healthcare system.

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.  

Archived webinars: 

Incorporating Hepatitis C in Integrated HIV Prevention and Care Planning
Target HIV
Learn more about health department challenges and lesson learning in aligning resources, strategies, and services to end the epidemics.

Hepatitis D Treatment Endpoints
Hep B United
Hepatitis delta is estimated to affect between 15 and 70 million people worldwide. With new drugs in clinical trials for this, we ask ourselves what successful treatment looks like? How can we measure success? Is a cure for hepatitis B the only endpoint of treatment? Learn more from Dr. Ohad Etzion, hepatitis delta expert, as he discusses all the proposed questions.

Fact sheets & toolkits:

NAACHO Op-Ed Toolkit for Local Health Department HIV, STI, & Viral Hepatitis Programs


LHDs play a critical role in promoting and protecting the health, safety, and well-being of their communities but don't always know how to raise awareness of their excellent work. This toolkit is designed to help LHDs demonstrate the value and impact of their work through op-eds. This resource includes tips for getting started, a sample op-ed, and recommendations for tailoring messages based on local needs, trends, and priorities.

Hepatitis C resources for immigrants and newcomers and for service providers who work with them

 

Rates of hepatitis C testing and treatment uptake among immigrants can be increased by raising the awareness of clients and service providers who work with them. Providing culturally appropriate information in immigrants’ own language is important when delivering hepatitis C education and care to those who may not be fluent in the local language. This article will highlight some important resources and tools contained in this portal that can be used when providing hepatitis C services to these communities, available in print, video, and online formats.

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.   

2020 World Indigenous Peoples' Conference on Viral Hepatitis | Sept. 23-26 | Saskatoon, Canada
Indigenous people, including those with lived and living experience of viral hepatitis, clinicians, researchers and policy-makers will gather in Saskatoon, Saskatchewan, Canada, September 23-26, 2020 for the third World Indigenous Peoples’ Conference on Viral Hepatitis (WIPCVH). Abstracts submission opens March 7, 2020. More information here.

 Job Opportunities   

  Come join our team—Associate, Hepatitis, NASTAD

This position will support NASTAD’s viral hepatitis program in providing technical assistance and capacity building to health departments throughout the nation to advance efforts related to integrated viral hepatitis prevention and surveillance activities supporting cross-program collaborative activities. Interested?! Click here for more information and to apply.

Hepatitis C Outreach Specialist, Philadelphia Department of Public Health
This position will work to improve HCV infection and substance use disorder outcomes for people living in Philadelphia. This project will use data to care approaches to identify people who use drugs and are living with HCV and connect them with any services or resources they need. Closing March 27, 2020.

Drug User Health Research Project Manager, San Francisco, Heluna Health   
This position oversees the implementation of the overdose prevention project in supportive housing sites, and supports programs related to hepatitis C and other drug user health issues. This position will work closely with CHEP and The Center on Substance Use and Health (CSUH), as well as the Harm Reduction Coalition, Homelessness and Supportive Housing, and housing management agencies and staff, to expand overdose prevention activities in supportive housing. 

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. 

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.). 

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. Closing February 24, 2020. 

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. Closing February 24, 2020.

Advisor, Viral Hepatitis Prevention & Control, PAHO/WHO
Advise, guide and coordinate the Organization’s technical cooperation for the implementation of interventions on Viral Hepatitis, in line with the WHO Global Health Sector Strategy for the Prevention and Control of Viral Hepatitis 2016-2021. Technical Expertise: Expertise in prevention and control of viral hepatitis, with focus on Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV); in-depth knowledge and understanding of infectious disease control methods, health information systems, public health surveillance and epidemiology with emphasis on viral hepatitis.  Very good knowledge of English or Spanish with a working knowledge of the other language. Knowledge of French and/or Portuguese would be an asset. Closing February 25, 2020.

Maternal and Child Health

Articles of Interest:

 More Than 3 Million Children Worldwide Have Hepatitis C

‘…there is a strong association between the prevalence of hep C among adults and that seen among children. In particular, HCV prevalence among women was strongly associate with prevalence of the virus among children 4 years old and younger. Mother-to-child transmission during pregnancy or childbirth is not the only source of new infections of hep C among children, the investigators found. Children are still at risk for the virus as they age.’ Read the full abstract in the article below.

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.’ 

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:

Surveillance-Based Estimate of the Prevalence of Chronic Hepatitis B Virus Infection, New York City, 2016 First Published Oct 2019.  
‘Chronic hepatitis B virus (HBV) infection is a lifelong infection that can cause serious liver damage and liver cancer. The last surveillance-based prevalence estimate of chronic HBV infection in New York City was 1.2% in 2008; however, it did not account for persons with undiagnosed infection. The objective of this study was to calculate the prevalence of chronic HBV infection, including undiagnosed infection, for 2016 by using surveillance data and literature-based information.’

Department of Veteran Affairs Blog: VA Career Providers Help Cure 100K Veterans of Hepatitis C
Career nurses, pharmacists, physicians and medical professionals establish VA as a global leader in hepatitis C diagnosis and treatment. Full blog available here, and visit Mapping Hepatitis Elimination in Action to learn more about hepatitis elimination efforts from the VA and other groups.

Addressing Hepatitis C in the American Incarcerated Population: Strategies for Nationwide Elimination
‘The prevalence of Hepatitis C virus (HCV) in the US incarcerated population is disproportionately high, and when inmates with infection are released back into the general population, they play a substantial role in the spread of disease. This review provides support for targeting the jail/prison population to eliminate HCV in the general population. It will also summarize various screening/treatment models to curtail the burden of disease behind and beyond bars.’

Global Articles of Interest: 

  

Hepatitis B and HIV Coinfection is Very Common Worldwide
‘Researchers analyzed more than 350 studies to estimate the prevalence of hepatitis B among people with HIV around the world…Among people living with HIV globally, coinfection with HBV is concerningly high. However, prevalence of HBV in the HIV populations varies by region, a nation’s level of development and local prevalence of HIV.’

Global timing of hepatitis C virus elimination: estimating the year countries will achieve the World Health Organization elimination targets, (view tables and figures highlighting year of elimination of HCV by country or territory)
Conference Reports for NATAP, The International Liver Congress
EASL, European Association for the Study of the Liver.

Global elimination of hepatitis C virus by 2030: why not?
‘The World Health Organization’s targets for eliminating hepatitis C virus by 2030 have been deemed ambitious by many. However, we believe they are achievable, provided they are supported by global commitment.’

Academic and Scholarly Articles/Posts:

Hepatitis D prevalence: problems with extrapolation to global population estimates
‘We read the meta-analysis of global hepatitis D prevalence by Chen et al and have some serious concerns relating to the proposed epidemiological estimates. Seroprevalence of hepatitis delta virus (HDV) was not adequately defined. In the methods, hepatitis delta antibody (anti-HDV), HDV RNA and HDV antigen (HDAg) were described as markers of HDV infection. In Supplementary Table S8, it is evident that total, IgG and IgM anti-HDV and HDAg were variably used to define HDV infection. HDAg is a transient marker of HDV infection, whereas IgM expression is inconsistently associated with both acute and chronic infection; neither are suitable epidemiological markers of chronic HDV infection.’

Hepatitis C Virus Structure: Defined by What It Is Not : ‘This review will focus on structural progress on HCV virion, core protein, envelope glycoproteins, and specific host receptors.’

Very Low Hepatitis C Viral Loads in Treatment-naive Persons: “Do They Compromise Hepatitis C Virus Antigen Testing?: ‘Hepatitis C virus (HCV) antigen testing is less expensive than quantitative reverse-transcription polymerase chain reaction but has lower sensitivity for very low viral load (VLVL; HCV RNA ≤3000 IU/mL). Currently the benefits of antigen testing for screening are discussed, but data on prevalence and outcomes of persons with VLVL are scarce. We assessed prevalence and predictors of VLVL by logistic regression in treatment-naive participants in the Swiss Hepatitis C Cohort Study. We analyzed if the last viral load after VLVL was low, compared cirrhosis and mortality in persons with and without VLVL, and evaluated the number of samples with VLVL that were reactive by antigen testing.’