The viral hepatitis epidemiology, prevention, and intervention (HEPI) project comprises two components, each with its own purpose and outcomes, which, when implemented, will complement each other to develop and implement a framework for 1) viral hepatitis outbreak detection and response, and 2) viral hepatitis elimination. The purpose Component 1 is to expand jurisdictional surveillance for acute hepatitis A, acute hepatitis B, and acute hepatitis C; perinatal hepatitis C; and chronic hepatitis B and chronic hepatitis C through rapid detection and response to outbreaks and systematic collection, analysis, interpretation, and dissemination of data to inform and evaluate evidence-based interventions. The purpose Component 2 is to create a framework for jurisdictional viral hepatitis elimination. Together, these project activities will increase the proportion of people living with chronic viral hepatitis infection who are aware of their status and linked to care, and prevent new infections among those at highest risk, with an emphasis on people who inject drugs (PWID) and the programs in which they are best served.
Project outcomes for Component 1 will include having: 1) An integrated jurisdictional framework for viral hepatitis cluster and outbreak response in a priority population; 2) Assessed the feasibility of and piloted the collection of negative hepatitis C virus (HCV) ribonucleic acid (RNA) test results, which are needed to identify people who have cleared or been successfully cured of their infection RNA from at least one 1 large commercial laboratory; 3) Improved monitoring of disease burden and trends in acute (HAV, HBV, HCV) and chronic (HBV, HCV) viral hepatitis through the development of a dynamic data dashboard, open data portal, and/or integrated viral hepatitis surveillance report; and 4) Assessed the feasibility of and piloted reporting of chronic hepatitis B and chronic hepatitis C cases to the U.S. Centers for Disease Control and Prevention (CDC) using a national surveillance system; and 5) Improved monitoring of the chronic hepatitis C (and, if funded, chronic hepatitis B) continuum of care to identify gaps in care and where focused outreach is needed. This information will ensure California’s disease burden is reflected in national estimates and be used to inform the activities in Component 2.
Project outcomes for component 2 will include having: 1) Increased stakeholder engagement with local health jurisdictions (LHJs), community-based organizations (CBOs), people with lived experience, and community partners to develop a framework for viral hepatitis elimination; 2) Increased the proportion of people with an HCV antibody positive test who receive HCV RNA testing by 5% by promoting HCV RNA reflex testing policies (where a screening test is automatically followed by a diagnostic test); 3) Increased the number of primary care providers in California trained to treat chronic hepatitis C infection in a primary care setting by =50; 4) Increased hepatitis C testing, linkages to care, and/or treatment among PWID in 2-3 high-impact settings; and 5) Increased utilization of syringe services programs (SSPs) by PWID by 10%.
These outcomes will be accomplished by collecting and analyzing data from public health surveillance and other data sources; convening community partners to share, interpret, and use data to inform public health action; and partnerships with laboratories, health care providers, health systems, academic medical centers; and CDC to increase viral hepatitis testing and care. If additional funding is allocated for the contingent components of this application, these outcomes will also be accomplished through partnerships with LHJs, CBOs, and settings serving PWID, such as jails, SSPs, and drug treatment programs, where services are most effectively delivered.