Hepatitis C Screening May Boost Opioid Treatment Success

By Robert Preidt, HealthDay Reporter

FRIDAY, Oct. 20, 2017 (HealthDay News) — Opioid abuse therapy may be more effective if patients are screened for hepatitis C as part of the program, a new Canadian study says.

The research found a sharp drop in opioid abuse among patients after they were told they tested positive for the hepatitis C virus (HCV). Hepatitis C causes liver disease that can lead to cirrhosis (scarring of the liver), liver cancer and liver failure, the researchers said.


“Our study showed awareness of HCV infection among this particular population may motivate them to reduce their consumption and hopefully high-risk behavior,” said lead investigator Dr. Hooman Farhang Zangneh, a postdoctoral research fellow at the Toronto Centre for Liver Disease at Toronto General Hospital.



Hepatitis C Testing Rates and Care Quickly Increase After Adoption of State Law

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

A New York State law requiring healthcare providers to offer hepatitis C virus (HCV) antibody testing to patients born between 1945 and 1965 led to rapid increases in HCV testing and linkage to HCV care. The findings appear in MMWR.

The law, enacted in 2014, mandated that clinicians in primary care or inpatient settings offer HCV screening to age-appropriate patients who hadn’t been offered screening previously. (Since 2012, the CDC has recommended one-time HCV testing for this population.)

Laboratory data showed a 51% increase in the number of specimens collected for HCV testing in this age group during the first year of the law’s implementation, compared with the prior year. A similar increase was seen among Medicaid patients alone. In addition, the percentage of patients with newly diagnosed HCV infection who were linked to care increased by 40% (from 24% to 34%) between the two periods.

Read more here

Science Over Stigma: The public health case against HCV treatment sobriety restrictions

The National Alliance of State and Territorial AIDS Directors (NASTAD) recently released an important report exploring the discriminatory, biased, and unnecessary practice of requiring a period of sobriety prior to receiving hepatitis C (HCV) curative treatment.
Among people who inject drugs (PWID), the prevalence of HCV is a staggering 70% and while clinical recommendations suggest that everyone diagnosed should receive curative treatment, only a fraction of these individuals are currently eligible due to onerous and discriminatory sobriety restrictions. To achieve our goal of ending the HCV epidemic, stop the spread of the disease, and improve community health outcomes, we must reverse these devastating policies.


Key finding of Science Over Stigma include:
  • People who use drugs can adhere to treatment
  • Risk of re-infection among PWID is minimal
  • Offering HCV curative treatment reduces the amount of transmissible disease within communities most affected
  • Treatment of HCV among PWID is cost-effective and demonstrates the need for accessible, equitable insurance for all


Liver Health Connection is pleased to welcome Darcy Strayer

Darcy is the new Colorado HIV and AIDS Prevention Project (CHAPP) coordinator for LHC. As CHAPP coordinator, she works with patients at the addiction treatment center Crossroads Turning Points in Pueblo where she provides sex education and harm reduction workshops and performs free HIV and Hepatitis C testing.  We are very pleased to have her working with us on this exciting project!


We’ll let Darcy introduce herself:
I come to the Liver Health Connection from a reproductive justice background. After relocating to Denver from Nebraska 7 years ago, I quickly became involved in the social justice community. I took a four year turn as a co-organizer for an annual event to combat sexual assault stigma and victim blaming. From there, I started my formal career at Planned Parenthood of the Rocky Mountains. I wore several different hats at PPRM, most notably opening their field organizing office for a grant funded project in Santa Fe, New Mexico for a year. After my yearlong sabbatical, I returned to Denver and started working in PPRM health centers as a medical assistant but soon chose to return to a focus on sexual health education. I am so thrilled to be working as the CHAPP coordinator at LHC!
When not wearing my sex educator/HIV prevention/program coordinator hat, I enjoy living life to its fullest in central Denver with my spouse, our two cats, and the world’s most adorable dog. My spouse, Jack, keeps us rolling in good literature as an IT specialist at the Tattered Cover bookstore. When we’re not reading or watching Parks and Rec on Netflix, we commit our time to volunteer advocacy work with Planned Parenthood and various other GLBTQ and social justice non-profit organizations. Like all good Coloradans, we also look forward to escaping to the mountains for hiking and camping whenever we get the chance! Autumn hiking near Kenosha to see the Aspens change is my favorite! Random talents include baking gourmet cheesecakes, which you can learn for yourself by bidding on my cheesecake tutorial package for Future: Perfect!



World Hepatitis Day July 28, 2017

DENVER — No-cost, no-appointment hepatitis C testing will be offered Friday, July 28 for people who may be at risk for the blood-borne virus which infects people of all walks of life but most especially baby boomers.
Most people who have chronic hepatitis C don’t know it. Of those, 75 percent were born between 1945-1965. Those ages 51-60 reported the highest number of chronic hepatitis C, based on the state’s Hepatitis C in Colorado 2015 Surveillance Report.
Liver Health Connection, the Colorado Department of Health and Environment and other concerned groups are getting together for World Hepatitis Day from 9:30 a.m.-3:30 p.m., Thursday, July 28, 2016, at Denver’s Skyline Park.
All are invited to recognize World Hepatitis Day and join in fun and games while learning about hepatitis in all its destructive forms. Viral hepatitis is one of the world’s most pressing health concerns.  The World Health Organization reports “hepatitis B virus (HBV) and hepatitis C (HCV) are the leading cause of liver cancer in the world, accounting for 78 percent of cases. Nearly one out of every three people in the world (approximately 2 billion) has been infected by HBV, and one in 12 live with chronic HBV or HCV infection.”
Last year the World Hepatitis Alliance, a division of the World Health Organization, launched NOhep 2030, a global movement to eliminate viral hepatitis by 2030. At the 2016 World Health Assembly, 194 Member States made an historic commitment to adopt a global strategic plan targeting viral hepatitis. Denver-based Liver Health Connection, one of the nation’s top hepatitis advocacy groups, is working closely with World Hepatitis Alliance to support NOhep 2030 in Colorado and throughout the United States.

When: 9:30 a.m. – 3:30 p.m., Friday, July 28, 2017
Where: Skyline Park at 16th Street & Arapahoe, Denver, CO

Helpful Viral Hepatitis Links:

Liver Health Connection
Homepage: http://liverhealthconnection.org
Hepatitis quick facts: http://www.liverhealthconnection.org/hepatitis-c
Colorado Department of Pulbic Health and Environment
Hepatitis information: https://www.colorado.gov/pacific/cdphe/hepatitis
Colorado data: https://www.colorado.gov/pacific/cdphe/hepatitis-data
World Hepatitis Alliance
NOhep 2030 official website: http://NOhep.org
World Hepatitis Alliance: http://www.worldhepatitisalliance.org/
Media Center: http://www.who.int/mediacentre/factsheets/fs164/en/
#NOhep | #Hepatitis


New hepatitis C infections triple due to opioid epidemic

By Susan Scutti, CNN – Read more at CNN

New hepatitis C virus infections in the United States nearly tripled between the years 2010 and 2015.

The number of new nationally reported infections with the virus swelled from 850 in 2010 to 2,436 cases in 2015, with the highest rates among young people, mainly 20- to 29-year-olds, who inject drugs, according to a new report released Thursday by the Centers for Disease Control and Prevention.

However, the CDC estimates the true number is much higher– about 34,000 new infections nationally for 2015 since hepatitis C has few symptoms and most newly infected people do not get diagnosed.
. . .
Ward and his colleagues believe states can reduce the number of people risking a hepatitis C infection by adopting laws and policies that would increase access for IV drug users to services intended to prevent and treat the infection.
For the new report, then, Ward and his colleagues assessed state laws and Medicaid policies that impact IV drug users.
To decide whether a state had comprehensive needle laws, the CDC explored five questions: Did the state explicitly authorize a needle exchange program? Did the state exempt syringes from the definition of drug paraphernalia? Did the state decriminalize possession and distribution of needles for participants of needle exchange programs? Did the state permit a person to disclose possession of a needle to an arresting officer to avoid criminal prosecution? Finally, did the state allow the sale of needles, without prescriptions, to injected drug users?
With regard to Medicaid, the researchers looked at whether a state imposed sobriety requirements on drug users before approving treatment for an infection. Permissive Medicaid treatment policies, as defined by the CDC, would mean states either do not require a period of being sober or only require screening and counseling for a person to receive treatment.
. . .
Between 2009 and 2014, rates of hepatitis C virus infection among US women giving birth doubled, according to a second CDC study published Thursday.
“In 2014, 35 infants a day were exposed to the virus,” said Dr. Stephen W. Patrick, author of the study and assistant professor of pediatrics and health policy at Vanderbilt University School of Medicine. He explained the risk of transmission from mother to infant is estimated to be just about 6%, but research suggests follow-up on infants is poor.
“My worry is that some infants will convert to having hepatitis C without anyone knowing, or treating the infant,” said Patrick.
. . .
With treatment for hepatitis C, there must also be counseling to get these patients into care for their addiction to avoid an “exercise in futility” by treating only “a consequence of the substance use disorder.” according to Chung.
Coordinated effort is needed to get patients plugged into care so they beat their addictions and avoid becoming reinfected with hepatitis C.
Yet there have been several studies performed on rates of reinfection among IV drug users and they range from about 10% to 20%, said Chung. The results are not yet “water-tight,” said Chung, but reinfection rates can be viewed from another angle: “Success can be had — and durable success can be had — in most of these patients.”

National Hepatitis Testing Day








National Hepatitis C Testing  Day on May 19th

America’s 6th annual National Hepatitis Testing Day is an opportunity for people at-risk to be tested all throughout Colorado. Free blood screening tests will be offered and providers will have the opportunity to educate patients about chronic viral hepatitis and treatments.

Hepatitis C is a serious liver disease that results from infection with the Hepatitis C virus. Hepatitis C has been called a silent epidemic because most people with Hepatitis C do not know they are infected.

A wide variety of organizations will be making a collaborative effort to participate in the free testing from the Boulder County AIDS Project, the Western Colorado Health Network in Grand Junction to Denver Indian Health and Family Services.


Listed Below is the entire list of groups offering testing in Colorado.

Northern Colorado Aids Project

400 Remington St., #100 Fort Collins, Co

9:00 a.m. to 4:30 p.m.



6260 East Colfax Avenue, Denver

Testing will be on a walk-in basis.


1720 Pearl Street Denver

10:00 a.m. to 5:00 p.m. 

Jefferson County Public Health

654 Parfet Street, Lakewood

8:00 a.m. to 4:00 p.m.


Boulder County AIDS Project

2118 14th Street, Boulder

10:00 a.m to 5:00 p.m.


Ecumenical Social Ministries (SCAP)

201 North Weber Street, Colorado Springs

9:00 a.m. to 11:30  May 18th

Call 719-578-9092 for more information


Southern Colorado Health Network

1301 South 8th Street, Ste 200, Colorado Springs

9:00 a.m. to 4:00 p.m.  May 18th and 19th

Appointment only-719-578-9092


Southern Colorado Health Network

807 North Greenwood Street, Ste 200, Pueblo

9:00 a.m. to 12 p.m. and 1:30 p.m. to 4:00 p.m.  May 16th, 17th, 18 and 19th

Call 719-621-1105 to make appointment


Western Colorado Health Network (WCAP)

2352 North 7th Street, Ste A1, Grand Junction

9:00 a.m. to 5:00 p.m.


Denver Indian Health and Family Service

1633 Fillmore Street, Denver

8:30 a.m. to 4:30 p.m.


Liver Health Connection

Wellington Webb Building, Main Floor

201 W Colfax Ave, Denver

9:00 a.m. to 3:00 p.m.

Liver Health Connection en La Habana, Cuba

In early April, Liver Health Connection board member Dr. Marcelo Kugelmas organized a delegation of U.S. hepatologists to educate and learn from hepatologists and gastroenterologists in Cuba.  Pictured below are some of the attendees of the Hepatology and Liver Transplant Symposium in Havana, Cuba including doctors from the United States, Cuba and Spain as well as Liver Health Connection’s Executive Director Nancy Steinfurth.


The U.S. hepatologists shared their expertise in liver transplantation, hepatitis C treatment, liver cancer and non-alcoholic fatty liver disease among other topics.  Dr. Zobair Younossi from Inova Fairfax Hospital in Virgina is shown here sharing an overview of hepatitis C treatment in the United States.


The Cuban doctors shared on their highly successful efforts to eradicate hepatitis B in the country.  More than 99% of newborn are vaccinated for hep B and in 2016 the whole Cuban population under 36 years of age was covered by the vaccination program. Part of the success in HBV elimination is a the extensive medical care that women receive during pregnancy – pictured here is an old bank converted into clinic for pregnant women who receive daily monitoring during the final weeks of pregnancy.


As for hepatitis C prevention and treatment, the U.S. delegation was surprised to learn: 1) injection drug use is practically nonexistent in Cuba; and 2) pegelated interferon (which they produce in Cuba) is still the standard treatment for hep C on the island.  Based on these two facts alone, it’s obvious the both countries can benefit from ongoing communication with each other about viral hepatitis.

The trip of course was not all shop talk.  The delegation had the opportunity to see the country such as the Univeridad de Habana pictured here . . .Cuba4

. . . and the Habor de Habana seen here.


How the Affordable Care Act Helps People with Hepatitis B and C


How the Affordable Care Act (ACA) Helps People with Hepatitis B and C

Preventive services
Under the ACA, all new health plans and Medicaid expansion programs must offer free preventive services, including hepatitis B vaccination and hepatitis B and C testing. These services are essential to prevent new infections and link individuals to lifesaving care and treatment. The ACA also created the Prevention and Public Health Fund, which has improved access to the hepatitis B vaccine.
Expanded coverage for communities disproportionately affected by hepatitis C
African Americans have higher rates of hepatitis C than other ethnic groups. Since the ACA’s enactment, the uninsured rate has declined 59% for African Americans. The uninsured rate for veterans, who also have higher rates of hepatitis C, has dropped 42%. Because the ACA permanently authorized funds for the Indian Health Care Improvement Act, more Native Americans have gained coverage. The ACA has also expanded health coverage for an estimated 4.2 million Latino adults and 676,000 Latino children. Expanded coverage for these populations is crucial to eliminating hepatitis C.
Pre-existing conditions
The ACA prohibits private insurers from discriminating against people with pre-existing conditions. Before the ACA, people with pre-existing conditions like hepatitis B or C were often automatically denied coverage. The ACA’s protection of people with pre-existing conditions ensures that people with hepatitis B or C can be tested and treated.

No annual or lifetime limits
The ACA’s elimination of lifetime or annual limits on the amount of insurance available has enabled persons with viral hepatitis to successfully treat and manage their disease, saving lives and helping to stop new infections.

Expanded Medicaid eligibility
The ACA allows states to expand Medicaid to cover people with incomes at or below 138 percent of the federal poverty level, including single adults without children. In states with the Medicaid expansion, viral hepatitis prevention and care are now more accessible to low-income persons.

More affordable coverage
Under the ACA, the federal government provides financial assistance to many low-income people who obtain coverage through their state’s marketplace. Low-income people with hepatitis B or C need this assistance to receive core services.
Equal coverage for substance use disorders
The ACA requires insurers to offer equal coverage for substance use treatment. People who contracted viral hepatitis from opioid overuse can get treatment for their addiction as they would for any other medical condition.