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Raising Awareness on National Hepatitis Testing Day

Emalie Huriaux is the director of federal and state affairs at Project Inform. She works on hepatitis C advocacy on the state and federal levels. She also coordinates the California Hepatitis Alliance, a coalition that consists of about 100 organizations from around the state, including local health departments, FQHCs, drug treatment programs, syringe exchange programs, HIV service organizations, etc.

May 19 is National Hepatitis Testing Day, so we caught up with Emalie to learn more!

What is National Hepatitis Testing Day and why is it important?

May is National Hepatitis Awareness Month and specifically May 19 is National Hepatitis Testing Day. Drawing attention to hepatitis generally, along with highlighting a day for testing, is important because there are such high percentages of people living with hepatitis B and C than who don’t know their status. It’s estimated that 50 to 75% of people living with hepatitis B or C don’t know their status, so this day is critical to draw attention to the importance of testing.

Also, according to a new report from the Centers for Disease Control (CDC), the number of new acute hepatitis C infections nearly tripled between 2010 and 2015. Acute hepatitis B infections also went up 20% in the same time period. There is an immediate need for increased awareness, testing, treatment, and prevention.

Can you give us an overview of Hepatitis B and C in the United States?

An estimated 850,000–2.2 million people are living with hepatitis B in the US. Hepatitis B cannot be cured, but we do have a vaccination for it. Like HIV, it’s something that can be treated, but requires lifelong treatment. In the US, hepatitis B is more prevalent among people who immigrated from Asian or African countries. Additionally, we’re starting to see outbreaks of hepatitis B among young people who inject drugs in parts of Appalachia who should have been vaccinated as children and for whatever reason weren’t.

An estimated 3.5-8 million people are living with hepatitis C in the United States. About 25% of people also living with HIV are co-infected with hepatitis C. Almost everyone living with hepatitis C can be cured – whether or not they have HIV. However, hepatitis C causes more deaths than all 60 reportable infectious diseases in the US combined. Hepatitis C is primarily transmitted through blood-to-blood contact, especially when sharing injection drug equipment. Hepatitis C can also be acquired during certain types of sex, particularly among people living with HIV. As more young women are living with hepatitis C due to the increases in opioid use and the transition to injection, we are also starting to see increased mother-to-child transmission of hepatitis C in the US.
Hepatitis B and C are the leading causes of liver cancer in the US, and liver cancer is one of the only major cancers on the rise, rather than declining.

What should people living with HIV know about viral hepatitis?

Regarding hepatitis B, people living with HIV should be tested and, if negative, vaccinated. Regarding hepatitis C, many people living with HIV are tested initially when they get into care, but are not tested again. Depending on substance use and sexual activity, it may be appropriate to be tested for hepatitis C annually or even more often than that. We need to raise awareness about this among people living with HIV and their providers.

Can you describe how social factors may drive viral hepatitis?

Viral hepatitis disproportionately affects people of Asian descent, African Americans, Native Americans, and Latino/as. Much of this impact is related to the larger pervasive and historical issues of access to health care in our country. A lot of the social determinants of health map closely on to hepatitis B and C.

For hepatitis B, in certain affected communities, there are challenges related to cultural beliefs about disease, stigma, and talking about illness. Additionally, providers may lack knowledge about the disease and its seriousness. More recently, we’ve been hearing anecdotal concerns that people didn’t sign up for health insurance because of fears related to their immigration status or are dis-enrolling from Medicaid because they are afraid of retribution or attention from the federal government.

People who inject drugs are at increased risk for acquiring hepatitis B and C and face an immense amount of stigma. The fear of arrest affects people’s ability use drugs in the safest way possible. And, in many communities, people don’t have access to harm reduction services, like access to sterile syringes and other injection equipment, due to the lack of political will to provide those services and the misperception that these services somehow degrade communities, instead of enhancing community wellness and safety.

Can you tell me about the upcoming programming you’re working on for USCA?

Project Inform is coordinating with AIDS United and other partners to create a viral hepatitis track at USCA. We are exploring topics such as the link between opioid crisis and viral hepatitis, supervised consumption services, and sexual transmission of hepatitis C. We are in the planning stages now, so more to come!

What do you enjoy most about your work?

Achieving success in this field is very gratifying because there is such a great need to address these epidemics. And even in the past three years, we’ve had several achievements. For example, we have a new document from the National Academies of Sciences, Engineering, and Medicine that says that hepatitis B and C can be eliminated as public health threats in the US by 2030. We really do have the tools we need to eliminate both viruses, it’s a matter of getting the right resources in place and having supportive policies to achieve that goal.

Any parting thoughts?

There’s been a lot of recognition among HIV organizations that they also need to be working on hepatitis, which is critical. In this time of concerning changes at the federal level, we need to be coordinated and allied in our efforts. If we work together to raise the profile of viral hepatitis and sound the alarm, we’ll be able to make a greater difference in people’s lives.

Access additional resources on viral hepatitis:

Hepatitis C and HIV Co-Infection
Screening for Hepatitis C in People Living with HIV
Screening for Hepatitis C in People Who Inject Drugs

Posted By: Sarah Hashmall, Communications Manager - Wednesday, May 17, 2017

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