World Hepatitis Day takes places every year on July 28 to raise awareness of the global burden of viral hepatitis and influence real change. Viral hepatitis is a major global health threat with around 240 million people living with chronic hepatitis B virus (HBV) and up to 150 million people living with chronic hepatitis C virus (HCV). Viral hepatitis is one of the leading causes of death globally, accounting for 1.34 million deaths per year; and, together, hepatitis B and C cause 80% of liver cancer cases across the globe.
In the U.S., hepatitis B and C infections are increasing. New hepatitis B infections increased by 20.7 percent in 2015 and new hepatitis C infections have nearly tripled over five years. Chronic infection remains a major public health challenge as well. Approximately 850,000 persons are living with HBV, although other studies have estimated this number to be as high as 2.2 million. More than 3.5 million Americans are living with HCV, making it the most common chronic blood-borne infection in the U.S. Baby boomers are six times more likely to be infected with hepatitis C than those in other age groups, however, the highest rates of new hepatitis C infections are among young persons who inject drugs.
Although we are experiencing increasing rates of hepatitis B and C, it is also a time of great opportunity. In 2016, the World Health Organization released its first-ever global health sector strategy for addressing the viral hepatitis pandemic (2016-2021), and earlier this year, the National Academies of Sciences, Engineering, and Medicine released a national strategy for the elimination of hepatitis B and C, which states that we can eliminate hepatitis B and C as public health threats by 2030 if the appropriate leadership, investment, and strategies are fulfilled.
There is an effective vaccine and treatments for hepatitis B and a cure for hepatitis C, evidence-based prevention modalities, including syringe services programs and opioid agonist therapy/medication assisted treatment, and effective diagnostic tests. We have the means required to advance elimination strategies; however, a significantly greater investment must be made and stronger leadership must be provided to achieve elimination goals. As community chief health strategists, local health departments (LHDs) are uniquely positioned to provide this leadership at the local level.
Through education and outreach, LHDs can increase awareness of who should be vaccinated for HBV and when, where to go to receive the vaccine, and the potential consequences of untreated HBV. LHDs can leverage existing health department programs, such as HIV, STI, and substance abuse, and partnerships with healthcare and community partners to expand reach by integrating education, prevention, testing, and linkage to care services. Just a few weeks ago at NACCHO Annual in Pittsburgh, PA, we heard about a number of local efforts to address hepatitis C. Greene County Public Health in Ohio collaborated with Equitas Health to increase HCV testing and linkage to care in a rural community. The Northern Kentucky Health Department shared their experience advocating for syringe exchange in a conservative region by counteracting stigma, educating about syringe exchange, and building community support. Howard Brown Health in Chicago shared best practices for integrating opt-out HCV testing into an existing framework for opt-out, rapid HIV testing. Officials from Georgia, Kentucky, New Jersey, and Pennsylvania discussed the interconnections between the opioid epidemic and hepatitis C, and shared their efforts to monitor and respond to trends through harm reduction and expanded HCV testing. Additionally, NACCHO hosted a special dinner event featuring experts from Philadelphia, Seattle-King County, and West Virginia, who discussed LHD efforts to improve access to HCV care and treatment.
To achieve elimination goals, cooperation and collaboration across all levels of government and sectors will be required; there will need to be increased political will; and, most certainly, additional resources will be needed to build capacity, infrastructure, and systems to prevent, diagnose, and treat viral hepatitis. NACCHO is committed to supporting LHD efforts to address viral hepatitis and advocating for the funding and other resources necessary to support this work. Check out:
- NACCHO’s hepatitis C resources, including NEW Hepatitis C Public Health Detailing Kit
- NACCHO’s immunization policy statement
- NACCHO Exchange Winter 2017, which is focused on the opioid epidemic and includes articles about the interconnections between the opioid epidemic and the spread of infectious diseases
Learn how your LHD can participate in World Hepatitis Day.