November 18, 2013 • 0 comments • By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services
Earlier this month, the “Liver Meeting” – the annual meeting of the American Association for the Study of Liver Diseases (AASLD )– took place in Washington, DC. As part of a session re-capping the major viral hepatitis highlights from the conference, I had the pleasure of sharing with several thousand scientists and healthcare professionals from around the world who specialize in liver disease, updates on federal activities aimed at ending the silent epidemic of viral hepatitis in the United States.
The meeting featured exciting new research announcements from experts working to make progress toward expanding what we know about viral hepatitis and liver disease. Working in parallel, improved policies and clinical advances can pave the way to a future in which people are routinely screened for viral hepatitis and once identified, receive timely, high quality care and, in many instances, treatment that results in a cure.
The conference also featured a number of presentations highlighting research, clinical practice models, and other important activities underway at federal agencies including the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA) and others. These included a presentation by my former colleague at the U.S. Department of Veterans Affairs (VA), Dr. Lisa Backus who presented on VA research that supports the CDC recommendation to screen “Baby Boomers” for hepatitis C (HCV) and steps that the VA is taking to enhance their already impressive HCV screening rates. Dr. Backus and her colleagues believe that additional screening efforts could find up to an additional 51,000 veterans of the baby boomer generation who are infected with HCV and not yet diagnosed.
This year, advances in the treatment of hepatitis C captured tremendous attention at the Liver Meeting. These advances herald a new era in which people who are chronically infected with HCV could access vastly improved and easier to take treatments. New treatments on the horizon have fewer side effects and a shorter duration of therapy and some result in cure rates of up to 90 percent – or more. But improved treatments alone cannot turn the tide of an epidemic. As my colleague, Corinna Dan, R.N., M.P.H., Viral Hepatitis Policy Advisor noted, “In order to realize the goals of the national Viral Hepatitis Action Plan, we must learn to use the improved therapies effectively and work with new partners to identify all patients who can benefit from them, especially the hundreds of thousands of individuals who are undiagnosed and therefore unaware of their infection.”
Toward that end and guided by the Action Plan for the Prevention, Care & Treatment of Viral Hepatitis, federal partners have prioritized a number of efforts to engage greater numbers of health care providers and increase their capacity to diagnose, care for, and treat hepatitis C, hepatitis B and other forms of viral hepatitis. Among the examples I shared during my presentation at the Liver Meeting, the Centers for Disease Control and Prevention (CDC) funds a number of training initiatives:
- Hepatitis Web Study , a free education service developed by the Seattle STD/HIV Prevention Training Center and the University of Washington which offers free continuing medical and nursing education on hepatitis A, B, and C on a state-of-the-art website. Case-based learning modules provide training on diagnosis and care for health care providers as well as training on counseling for health educators.
- In response to the rapidly evolving HCV treatment field, the Hepatitis C Online Course for healthcare providers currently offers four modules and soon will include two additional modules on hepatitis C treatment.
- The CDC-funded National Hepatitis Training Institute , offered by the University of Alabama at Birmingham, provides training on hepatitis prevention, diagnosis, management, treatment, and the integration of viral hepatitis into existing activities via practice-focused distance learning programs for frontline HIV and STD prevention workers in community-based organizations and clinics.
The Department of Veterans Affairs (VA) has long led the charge on improving care and treatment of Americans with chronic hepatitis C. The VA is the single largest provider of medical care to people living with HCV in the U.S. and is making significant contributions to increasing provider capacity through the National Hepatitis C Program. The online resources for providers include useful guidelines, best practices, clinical tools, and much more. Equally important are the resources for Veterans and the public including an introductory guide for patients, information on the importance of reducing alcohol intake, and simple handouts on how to take the current treatment.
Non-federal partners such as AASLD, the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease, and the Infectious Diseases Society of America (IDSA) , an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care, play critical roles in building health care provider capacity to diagnose and treat chronic HCV.
Recognizing that the confluence of the rapid development of new HCV treatments along with increasing numbers of people being identified with HCV will greatly increase the need for updated expert clinical guidance, AASLD announced on World Hepatitis Day in July 2013 that they are collaborating with IDSA to develop clinical recommendations for the management of HCV. Working together, leadership from these organizations will review current treatment recommendations and use evidence-based, consensus guidance to develop updated recommendations for managing patients. These recommendations will be updated regularly and made available online. AASLD and IDSA are key partners in the national, indeed global, response to viral hepatitis.