Hepatitis B and C were among the important public health issues examined at the recent annual meeting of the American Public Health Association (APHA) . The annual meeting, held November 14-19, 2014 in New Orleans, Louisiana, is one of the nation’s largest gatherings of public health professionals, including clinicians, researchers, policy makers, students, and others committed to public health. The meeting program covered a broad array of topics on emerging health issues, best practices, and advocacy, including several presentations on viral hepatitis.
Hepatitis B and C, the most common blood borne viruses in the U.S., as well as globally, represent excellent opportunities for public health intervention given the availability of a safe and effective vaccine for hepatitis B (HBV) that has reduced new infections by 64 percent since 2000 and all-oral curative treatments for hepatitis C (HCV). Viral hepatitis-related sessions at the APHA meeting addressed health disparities, trends in infection rates, and model programs, highlighting opportunities for the public health community to move closer toward achieving the goals of the national Viral Hepatitis Action Plan (Action Plan) [PDF 3MB].
Several of the 2014 APHA presentations reported on successful community initiatives to improve outcomes related to viral hepatitis.
- Culturally and linguistically appropriate approaches to reaching Asian American and Pacific Islander communities with HBV resources. The U.S. Centers for Disease Control and Prevention (CDC) developed the Know Hepatitis B campaign to increase awareness of HBV infection in the United States. An estimated 10% of Asian Americans and Pacific Islanders are infected with HBV, many of whom may experience barriers to healthcare due to language and cultural differences and, thus, represent a difficult-to-reach population. Kate Moraras, MPH, from the Hepatitis B Foundation presented on approaches to conducting culturally and linguistically appropriate hepatitis B efforts to increase screening, vaccinations, and linkage to HBV care. (Moraras, et al. Abstract #303249 )
- Increasing HBV vaccination via a mobile clinic in Philadelphia. A community-based coalition established a mobile HBV vaccination clinic to address challenges within the Asian and Pacific Islander community that included limited transportation and stigma associated with visiting free clinics. In approximately 18 months, the mobile clinic administered over 400 doses of HBV vaccine at 28 events, demonstrating a successful model for increasing vaccination within a difficult-to-reach community. (Cohen, et al. Abstract #302099 )
- Reaching those at risk for HIV and HCV infection in the municipal court system in New Orleans. Project IMPACT introduced a program in which voluntary HIV and HCV testing was offered to all persons summoned to court. Those opting in received screening, counseling, and referrals as appropriate. In the first year of the program, 1350 HIV tests (0.96% positive) and 55 HCV tests (28% positive) were administered, highlighting an effective approach to reaching at-risk individuals who may have limited engagement with clinic-based testing. (Burgess, et al. Abstract #312491 )
Additional viral hepatitis highlights from the 2014 APHA conference include work to understand occupational exposure risks of infectious diseases among emergency workers, and an analysis of factors contributing to health disparities among African Americans infected with HCV.
- One of the priority areas identified in the Action Plan is to protect patients and workers from health-care associated viral hepatitis, focusing on those workers who are at risk of exposure given their frequent contact with blood. In addition to workers in traditional health care settings, emergency workers (e.g., paramedics, firefighters, or police officers) may also experience an increased risk of exposure during their regular work activities. A literature review on the seroprevalence of HIV, HCV, and HBV among emergency workers revealed limited published data on the seroprevalance and exposure risk among emergency workers, suggesting that further studies are needed to both understand and take action to prevent occupational exposure and transmission of viral hepatitis and other blood-borne infectious diseases. (Folkert, Abstract #296855 ).
- African Americans are disproportionately affected by chronic HCV infection, particularly African American men born between 1945 and 1965. In his presentation, Omar Sims, PhD, MSW, discussed key barriers to care that contribute to suboptimal HCV outcomes in the African American community. Because most individuals with HCV are not aware they are infected, healthcare providers must prioritize raising patient awareness and providing screening so as to improve access to needed viral hepatitis services. Unfortunately, African Americans are less likely to receive HCV testing, be referred to and linked to HCV care, and receive treatment for HCV. (Sims, Abstract #303546 )
The APHA annual meeting remains an important forum for sharing emerging research and best practices related to public health and health promotion in areas of significance to the nation’s health, including addressing the epidemic of viral hepatitis. Our public health partners are vital allies in our collective efforts to achieve the goals of the national Viral Hepatitis Action Plan.