Adult Viral Hepatitis Update. Roxanne Ereth, MPH, BS Hepatitis C Program Manager Adult Viral Hepatitis Prevention Coordinator. There are common determinants that lead to transmission of HIV, VH and STD. Unprotected sex Injection drug use (and non-injection!!)
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Adult Viral HepatitisUpdate
Roxanne Ereth, MPH, BS
Hepatitis C Program Manager
Adult Viral Hepatitis Prevention Coordinator
There are common determinants that lead to transmission of HIV, VH and STD.
Injection drug use (and non-injection!!)
Interactions between health concerns increase potential for negative health outcomes.
Untreated STD increase risk of HIV infection.
HIV infection increases the infectiousness of STD (and VH!).
Common strategies can help prevent HIV, VH and STD infection.
Clean needles / syringes Health Education
(Vaccination!!!)Why are collaboration and integration across HIV, VH and STD prevention important?*
*original slide from 2008 National STD Prevention Conference by NASTAD (blue inserts are my comments)
Inflammation of the liver HIV, VH and STD.
Unknown causesWhat is Hepatitis?
Virus found in feces HIV, VH and STD.
~30% of US population have been infected (32,000 new cases in 2006)
Contaminated food and/or water
Direct contact with infected persons feces
Resolves-does not become chronic
Can lead to fulminant hepatitis with chronic liver diseaseHepatitis A Virus
Infection typically is symptomatic in adults, with jaundice occurring in >70% of patients.
Signs and symptoms typically last <2 months
Relapses possible for 6 months (15%)
Virus shed for 1 – 3 weeks
Most likely 1 -2 weeks before onset
Minimal 1 week afterHepatitis A Impact
11%--22% of persons with hepatitis A are hospitalized. occurring in >70% of patients.
The average duration of work loss estimated at 15.5 days for nonhospitalized patients and 33.2 days for hospitalized patients.
Estimates of the annual direct and indirect costs of hepatitis A in the United States have ranged from $300 million to $488.8 million in 1997 dollars.Hepatitis A Impact
Travelers to countries with high or intermediate endemicity of hepatitis A virus infection
Men who have sex with men
Users of injection and non-injection illegal drugs
Persons with clotting factor disorders
Persons working with nonhuman primates susceptible to hepatitis A virusHepatitis A InfectionPersons at Increased Risk
MSM of hepatitis A virus infection
Users of injection and noninjection drugs
Clotting factor disorders
Chronic liver disease
Close personal contactHepatitis A Vaccine Recommendations
Blood, semen, vaginal and other body fluids of hepatitis A virus infection
Transfusions, organ transplants or blood products prior to 1992Hepatitis B Virus
Estimated 1.25 million Americans have chronic hepatitis B: major cause of liver cancer
In 2006, an estimated 46,000 persons were newly infected.
Rates are highest among adults, particularly males aged 25–44 years.
4,000-5,000 deaths annually
$658 million in medical costs and lost wages each year
Up to 10% with HIV infected with HBV
Hepatitis B virus is 100 times more infectious than HIVHepatitis B Impact
Persons with multiple sex partners or diagnosis of a sexually transmitted disease
Men who have sex with men
Sex contacts of infected persons
Injection-drug usersPersons at Increased Risk of Hepatitis B Infection
Household contacts of chronically infected persons sexually transmitted disease
Infants born to infected mothers
Health-care and public safety workers with exposure to blood
Hemodialysis patientsPersons at Increased Risk of Hepatitis B Infection
Universal vaccination of adults who receive care in: sexually transmitted disease
Sexually transmitted disease treatment facilities
HIV testing and treatment facilities
Facilities providing drug-abuse treatment and prevention services
Health-care settings targeting services to injection-drug users
Health-care settings targeting services to men who have sex with men
Chronic hemodialysis facilities and end-stage renal disease programs
Institutions and nonresidential day care facilities for developmentally disabled personsHepatitis B Vaccine Recommendations
Regardless of insurance status sexually transmitted disease
Hepatitis B Vaccine:
All who present at STD clinic
Illicit drug use
Chronic liver disease
HIV and/or HCV infectedAdult Hepatitis B Vaccine Initiative
To participate sexually transmitted disease
Contact Immunization Coordinator
Complete VFA Program Enrollment Agreement
Complete 2008 Adult Provider Profile
Complete Program Provider/ASIIS Information
Forward forms to RoxanneAdult Hepatitis B Vaccine Initiative