Month: August 2014

African Americans and Hepatitis C

Hepatitis C in the African American Community

A black family

reposted from CDC website

Hepatitis C is one of several health issues affecting the African American community. Currently, there is no vaccine for Hepatitis C and the best way to prevent infection is by avoiding behaviors that can spread the virus.

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. This can happen by getting a needlestick injury in a healthcare setting, from receiving blood transfusions or organ transplants before 1992, being born to a mother who has Hepatitis C, and sharing equipment for injecting drugs. Some people don’t know how they got infected.

An estimated 3.2 million persons are living with chronic Hepatitis C in the United States and most of them don’t know it. More than 75% of adults with Hepatitis C are baby boomers, i.e., born from 1945 through 1965. It is important to note that within the African American community, chronic liver disease, often Hepatitis C-related, is a leading cause of death among persons aged 45-64 years. As well, African Americans have a substantially higher rate of chronic Hepatitis C infection than Caucasians and other ethnic groups.

Testing is critical to identify this often silent disease. To help increase testing, CDC recommends anyone, regardless of race or ethnicity, who was born from 1945-1965 (baby boomers) get tested for Hepatitis C. Fortunately, a simple blood test can determine if a person has ever been exposed to the virus.

Remember that early diagnosis and treatment can help prevent liver damage, cirrhosis, and even liver cancer. Find out if you should talk to your doctor about Hepatitis C testing by taking an online risk assessment. If you are a baby boomer, find out why baby boomers should get tested Adobe PDF file [PDF – 1 page].

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a little skinny on tattoos

Logo Hepmag

Tattoos and Hepatitis C: What Are the Risks?

by Cassidy Gardner (reprinted from hepmag.com)

Arm yourself with these facts before you go under the needle.

Unsterile tattooing can transmit the bloodborne hepatitis C virus (HCV), and though it is unclear exactly what percent of people with the virus got it through tattooing, a study last year found that people with hep C were almost four times more likely to report having a tattoo, even when other major risk factors were taken into account. What do you need to know to avoid giving or getting hep C during tattooing? We researched six common questions on the topic and found what might be some surprising results.


How can hep C be spread through tattooing?

Hepatitis C can be spread if poor infection control methods are used. Make sure you are visiting a licensed, professional tattoo parlor. When you receive a tattoo, your skin is being pierced by a needle and injected with small amounts of ink. Make sure that the needle is coming out of a new, sterile package, that the tattoo artist is wearing latex gloves, and that all other tattooing equipment has been sterilized.

What percentage of all people with hep C get it through tattooing?

There is not enough research to determine the percentage of people with hepatitis who got it through tattoos. However, a recent study discovered that people with hep C were close to four times more likely to report having a tattoo, even when other risk factors were accounted for. (Hepatitis C is transmitted mainly through injection drug use or blood transfusions given before 1992.)

Other studies have shown no evidence of an increased risk in infection if tattoos were given in a professional parlor with proper infection control. If the tattoo was done in a prison or non-professional setting, the risk was significantly greater.

How can I protect myself against hep C when getting a tattoo?

1.    Determine if the tattoo parlor and artist are reputable. (Licensing and certification laws vary by state.) One way to do this is to choose a parlor where people you know got tattoos and had a good experience.

2.    Ask tattoo artists what procedures they use for sterilizing their equipment and how often they do it. Their equipment should be tested and serviced routinely.

3.    Autoclaves (sterilizing machines) should always be used. And new sterile needles should always be removed from the autoclave bag in front of you.

4.    Artists must wash their hands before and after putting on a new pair of latex gloves. This should also occur every time the artist leaves or returns to the work area.

5.    Items that comes in contact with blood and cannot be sterilized—such as gloves, ink caps, cotton swabs, ointments, soap bottles, paper towels, etc.—should be disposed of immediately after tattooing and labeled as a biohazard.

6.     Ink- or water-based products should be thrown out after they are used and should not be put back into the container they came from.

7.    Surfaces and other areas the artist uses to work on should be cleaned regularly with a disinfecting cleaner.

I have a tattoo already. What are the chances I have HCV and don’t know it?

There is no evidence that there is an increased risk of hep C if you had your tattoo done in a professional tattoo parlor that practices good infection control. “If the tattoo was done by yourself, by a friend or in prison, the risk is much higher,” says Michael Duncan, clinical director ofVOCAL NY (Voices Of Community Activists & Leaders), a statewide grassroots organization that builds power among low-income people affected by HIV/AIDS, the drug war and mass incarceration—one of its major campaigns involves hepatitis C prevention, care and treatment.

Your hep C risk is also greater if you got the tattoo before the early 1990s, when people first became aware of hepatitis C. Blood tests for hep C did not come out until 1992. (That’s why 75 percent of people living with hep C are baby boomers—those born between 1945 and 1965—they contracted the virus before it was even discovered.) Many people with hep C do not feel any symptoms until years after infection, so it is important to get tested if you suspect you may be at risk.

If I find out I have hep C, what should I do?

You should talk immediately with a doctor who specializes in hepatitis or liver disease. To find one, click here. You will likely need tests to assess your hepatitis viral load (the level of hep C virus in your blood) and the disease’s progression. Some people clear the virus on their own, without any meds. “One in five people exposed to hep C do not become chronically infected,” Duncan says. “If this is the case, you will only need to get take precautions to make sure you are not reinfected.” In other words, you do not become immune to hep C.

If you do have hep C, know that it can be cured. In the past year, hepatitis C treatment has advanced considerably, with fewer side effects, shorter treatment times and much higher rates of success, and these advances will likely continue in the following year. Work with a health professional who can help you decide whether treating the virus now or down the line makes sense.

I have hepatitis C. Can I still get a tattoo?

“Yes,” Duncan says. “Disclosing to your artist is entirely up to you, (but) they should always assume their client is positive and take the necessary precautions.”

Search: tattoos, hepatitis C, precautions, tips, HCV

 

viral hepatitis- for the visual learner

Hepatitis” means inflammation of the liver and also refers to a group of viral infections that affect the liver . The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.

Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected.

 

Tri County Health Department

tri county

According to the CDC an estimated 3.2 million persons in the United States have chronic Hepatitis C virus infection and an estimated 3 in 4 people who are infected don’t know their status (CDC, 2013; CDC, 2014). In response to this silent epidemic, organizations across the state are coming together to find ways to increase access to prevention, testing, and treatment services for people at risk for or living with Hepatitis C.

Tri-County Health Department is able to offer free, rapid, and confidential Hepatitis C testing to those at risk for Hepatitis C. We offer a simple finger-stick test with results in 20 minutes. Testing is offered to clients with the following risk factors:

  • Injection drug use, even once a long time ago
  • Born between 1945-1965
  • Recipient of blood, blood products, or tissue prior to 1992 or anytime outside of the U.S.
  • Recipient of hemodialysis
  • Sexual partner of a person with Hepatitis C
  • Received tattoo in prison or jail

In addition we are able to provide risk reduction counseling, referrals to community resources, and Hepatitis A and B vaccines at low or no cost. To find a clinic near you please visit Tri-County’s website and for other testing sites around the state please visit Hep C Connection’s website.

Why World Hepatitis Day is Important … an account from Project Inform‏

In honor of World Hepatitis Day, which is observed on July 28 every year and is one of only four disease-specific days recognized by the World Health Organization (the others being tuberculosis, malaria, and HIV), Project Inform participated in two events in Washington, DC…. (this article is forwarded by Alan McCord of Project Inform)

The first event on July 29 was a viral hepatitis policy strategy meeting hosted by the National Viral Hepatitis Roundtable and the National Alliance of State & Territorial AIDS Directors. At this meeting, over 70 viral hepatitis stakeholders and government officials met to discuss how to realize the goals of the national Viral Hepatitis Action Plan; how to navigate Medicaid coverage of hepatitis B and C testing, care, and treatment; the opportunities provided by the Affordable Care Act to address viral hepatitis; and action planning for the next six months. Of all the issues discussed the one that elicited the most discussion and debate related to the rationing of hepatitis C treatment in state Medicaid programs.

Some attendees expressed frustration at the high cost of new hepatitis C medications and the concomitant rationing of treatment by state Medicaid programs, with many programs only authorizing treatment for people with advanced liver disease. Others described cost-effectiveness studies that demonstrate that treating everyone living with hepatitis C makes the most long-term fiscal sense and is best for people living with the virus. Critically, what came out of the conversation is the need to assess accurately how many people currently diagnosed with hepatitis C in each state have Medicaid coverage. The costs of hepatitis C treatment will be incurred over a period of decades, not immediately, and, during this time, new treatments for hepatitis C will come to market.

At present, the Centers for Disease Control and Prevention (CDC) estimate that 50-75% of Americans living with hepatitis C do not know they are infected. It will take many years of large-scale testing efforts to identify everyone living with the virus and ensure they are effectively linked to medical providers for assessment, ongoing care, and treatment, as appropriate.

The history of addressing HIV, a similar chronic infectious disease, provides a useful analogy. Even with the significant investment in HIV testing, care, and treatment over the last 30 years, only 33% of Americans living with HIV are prescribed antiretroviral therapy and only 25% are virally suppressed. Given this history, Dr. John Ward, the Director of the CDC’s Division of Viral Hepatitis, stated that it will take at least 15 years to successfully test and treat everyone living with hepatitis C.

Attendees called for payers (e.g., state Medicaid programs), the pharmaceutical industry, and other stakeholders to sit down and talk to one another in order to develop compromises and solutions. Many attendees expressed the need for a 10-20 year roadmap to ensure that everyone living with hepatitis C has the opportunity to know their status and be cured. Dr. Jonathan Mermin, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, noted that, “Hepatitis C is the most important public health opportunity in the next decade”. Dr. Ward noted that “We should be on an emergency footing regarding hepatitis C incidence and prevalence … We are in a crisis and we need relief” and that even small increases in support for testing, treatment, and surveillance would make “a big difference” toward eliminating hepatitis C in the United States.

The second event, on July 30 was the White House Observance of World Hepatitis Day, co-hosted by the Office of National AIDS Policy and the Office of National Drug Control Policy. At the event, Dr. Howard Koh, Assistant Secretary for Health, who recently left government service to return to teaching at Harvard University, was honored for his service and commitment to viral hepatitis. Dr. Koh provided a “top 10 list” of viral hepatitis successes during the last few years:

  1. The release of the second Department of Health and Human Services Viral Hepatitis Action Plan.
  2. The recognition of Hepatitis Testing Day, on May 19, in the United States.
  3. New screening recommendations from the CDC and the United States Preventive Services Task Force for hepatitis B and hepatitis C.
  4. New targeted outreach education materials on hepatitis B and hepatitis C.
  5. Greater attention the hepatitis C among people who inject drugs.
  6. Work to oppose discrimination against people with hepatitis.
  7. Work to eliminate perinatal transmission of hepatitis B.
  8. Exciting new hepatitis C medications that cure most people and have reduced side effects and greater efficacy compared to prior regimens.
  9. Health reform and the full implementation of the Affordable Care Act.
  10. Celebrating World Hepatitis Day in the White House for the last several years.

Ambassador Deborah Birx, the United States Global AIDS Coordinator, provided an overview of the opportunities the President’s Emergency Plan for AIDS Relief (PEFAR) has to integrate viral hepatitis prevention, testing, and care into its portfolio.  Given the similar routes of transmission that HIV and viral hepatitis share, as well as the high percentage of people with HIV who are co-infected with hepatitis B and/or hepatitis C, PEPFAR’s interest in and involvement with viral hepatitis prevention, care, and treatment is critical to international efforts to combat hepatitis B and hepatitis C.

Dr. Paul Farmer, well known for his international health work and his organization, Partners in Health, described the work his organization has done to ensure state of the art treatments are provided equitably in developed and developing areas of the world. He noted the success of providing antiretroviral therapy to people living with HIV and the model this provides for ensuring access to hepatitis C treatments throughout the world, particularly in places with high prevalence like the prisons in Siberia, in which 30% of prisoners are living with hepatitis C.

Project Inform congratulates all of its partners in the effort to address viral hepatitis, and particularly those who were honored for their leadership at the White House event: