The Viral Hepatitis Epidemic = Comprehensive Public Health Leadership Opportunities

With up to five million Americans living with viral hepatitis, the leading cause of liver cancer and need for liver transplant, public health leaders are essential to responding to this urgent and evolving threat.  Although we have more tools than ever before to respond to viral hepatitis, including preventive services without cost-sharing under the ACA and curative therapies for hepatitis C, most people living with viral hepatitis remain unaware of their infection.  CDC estimates 38,000 new cases of viral hepatitis A, B, and C in 2011.  In 2007, the number of deaths from hepatitis C outpaced deaths from HIV.    In the decade to come, more than 150,000 Americans are expected to die from viral-hepatitis-associated liver cancer or end-stage liver disease unless steps are taken to increase awareness, diagnosis, and access to necessary care and treatment. 

Viral hepatitis, known as the “silent” epidemic, often has no symptoms, and patients and health care providers may be unaware of the importance of hepatitis testing.  Viral hepatitis disproportionately impacts Baby Boomers, young people who abuse prescription drugs, and minority communities.    

About 3 million baby boomers (persons born 1945-1965) will reach the retirement/Medicare eligibility age every year for about the next 20 years. CDC estimates that although Boomers account for an estimated 27% of the population, they represent approximately 75% of all hepatitis C infections in the US, 73% of HCV-associated mortality, and are at greatest risk for liver cancer and other HCV-related liver disease sequelae.  Although the government recommends that all Boomers be tested for hepatitis C, most remain unaware of their status.  

Public health schools can provide opportunities to engage in viral hepatitis prevention efforts through community outreach, provider education, and program evaluation.  Students can develop skills in epidemiology and surveillance, health policy analysis, and strategic communications. Public health and primary care can be bridged to explore diverse models of integrated care.      

The proposed panel will include at least 3 speakers to discuss the following:   

I. Office of HIV/AIDS and Infectious Disease Policy topics will include:

• Epidemiology of viral hepatitis in the US and globally with a focus on priority populations, including Boomers, young people who inject drugs, racial and ethnic minorities, and immigrants and refugees.
• Current testing recommendations for hepatitis B and C by the CDC and the US Preventive Services Task Force.
• Tools: National Viral Hepatitis Action Plan, curative treatment for hepatitis C, vaccines, national educational campaigns.  
• Proposed educational opportunities: practicums/student field experiences, Grand Rounds, research institutes and centers, interviews with public health experts.

II. National Alliance for State and Territorial AIDS Directors  

• Role of state and local departments of public health
• Technical assistance for capacity building and strategic partnerships
• Opportunities around the Affordable Care Act
• Role of public health advocacy

III. Role of Departments of Public Health (DOH TBD)  

• Epidemiology and Surveillance to measure progress; related challenges  
• Why and how departments of health are getting engaged in viral hepatitis;  Best practices for integrating care and services (i.e. behavioral health/infectious disease/injury prevention) and leveraging resources.