Sounding the Alarm on a Silent Epidemic: Federal HIV/STD Advisory Group Adopts Viral Hepatitis as Priority

February 12, 2013 • 0 comments • By Antigone Dempsey, M.Ed., Co-Chair, CDC-HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment

Antigone Dempsey, M.Ed.

In support of enhanced cross-government efforts to address the prevention, care and treatment of viral hepatitis, a federal advisory body on HIV and STDs recently expanded its scope and title to include viral hepatitis. Now known as the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment (CHAC), the body advises the Secretary of Health and Human Services, Director of the Centers for Disease Control and Prevention (CDC), and Administrator of the Health Resources and Services Administration (HRSA) on objectives, strategies, policies and priorities for HIV, viral hepatitis and STD prevention and treatment efforts. The CHAC also supports the agencies’ responses to the prevention and health service delivery needs of affected communities, and the needs of individuals living with or at risk for HIV, viral hepatitis and other STDs.
Members of the CHAC are appointed by the Secretary and are a diverse group of experts, including people living with HIV/AIDS, from backgrounds such as public health, migrant health, community-based organizations, clinical care, and national organizations. The CHAC meets twice yearly and accomplishes additional work between meetings through several workgroups.
Aware that viral hepatitis affects over 4 million Americans and is the leading cause of both liver cancer and transplantation, the CHAC was prompted to engage more actively in addressing this issue primarily by three things, according to CHAC’s Co-chair, Dr. Jeanne Marrazzo, Professor of Medicine at the University of Washington. “The implementation of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis has really sharpened the focus of federal agencies on viral hepatitis and galvanized cross-agency collaborations. The unfolding of those efforts to increase testing, vaccinations, and access to care and treatment as well as improve education for providers and patients highlighted a natural opportunity for the CHAC to engage and lend our advice and support.” A second main impetus was learning from CDC analysis last spring that mortality related to hepatitis C has now outpaced AIDS related deaths. Finally, the CHAC understood that HIV and hepatitis coinfection is a serious issue for providers and people living with HIV/AIDS. One-third of people living with HIV are co-infected with hepatitis B (HBV) or hepatitis C (HCV) and viral hepatitis progresses at a faster rate among persons with HIV. People living with HIV/AIDS and hepatitis experience greater liver-related health problems than non-HIV infected persons. Indeed, liver disease—much of which is related to hepatitis C and hepatitis B infection— has become a leading cause of death among people living with HIV/AIDS in the United States.
In an effort to effectively integrate viral hepatitis into its work, the CHAC first unanimously voted to change the name of the committee to include “viral hepatitis”. In addition, CHAC’s charter was officially changed to integrate activities related to viral hepatitis and we have recommended to the Secretary that upcoming vacancies on the CHAC be filled by persons with experience and expertise in viral hepatitis.
As we have worked to integrate viral hepatitis into the work of the CHAC over the past nine months, these are some of the highlights:

The CHAC established a Viral Hepatitis Workgroup to further the ongoing efforts of the committee to address this epidemic.
The CHAC is working closely with federal and community partners to address the priorities of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis and other federal efforts, focusing on addressing patient and provider education, surveillance, testing, linkages to care, and research.
The CHAC also recently endorsed CDC’s recommendation for one-time HCV screening for persons born between1945-1965.

With heightened awareness and new and more effective life-saving treatments available, now is the time to take important policy, research, program and service delivery actions that can positively impact the lives of people living with hepatitis B and C. The CHAC welcomes the opportunity to contribute to this national effort and invites others to join us in prioritizing efforts to better prevent and diagnose viral hepatitis and improve the care and treatment for those living with the disease. Our meetings are open to the public and always include time for public comment; the CHAC welcomes and invites community members to share their thoughts and concerns on these issues. Our meeting times and locations are published in the Federal Register.
Ms. Dempsey is the Area of Expertise Lead for HIV/AIDS at Altarum Institute