In the U.S., millions of the individuals live with viral hepatitis.
Viral hepatitis is an infection that causes inflammation in the liver, the most common infections being hepatitis A, B and C. While hepatitis A is typically a short-term infection caused by contaminated food or water, hepatitis B and C are spread through contact with blood and can be a short-term infection or a chronic infection.
A key difference between these viral infections is that unlike hepatitis A and B, there is no vaccine for hepatitis C. And in the U.S., hepatitis C is the leading blood-borne illness as well as the leading cause of liver failure, transplantation and cancer — but only half of people who have it are aware of their condition.
To help combat this, Governor Inslee addressed providers at the Harborview Hepatitis and Liver Clinic in 2018 and announced the Hepatitis C Free Washington plan, a coordinated, statewide effort to eliminate hepatitis C by 2030.
Today, UW Medicine experts are working to not only make that 2030 hepatitis C goal a reality but also to rid the world of viral hepatitis altogether.
Providing educational resources
The first step to eliminating viral hepatitis is making sure that healthcare providers across the state are trained in the best practices for screening, evaluation and treatment.
To help educate providers, the University of Washington Infectious Diseases Education and Assessment (IDEA) program created two hepatitis educational curriculums: Hepatitis B Online and Hepatitis C Online.
“The materials are designed and geared for healthcare professionals, including clinicians in various stages of training,” says David Spach, MD, the executive director of the IDEA program.
The free online courses are updated regularly with the latest techniques and recommendations for detecting and treating hepatitis, allowing physicians from across the state to access training, continuing medical education (CME) credits and certified nurse educator (CNE) contact hours.
For UW Medicine providers, this means access to updated hepatitis B and hepatitis C recommendations.
“The awareness of the available viral hepatitis prevention and treatment tools — including knowledge of up-to-date recommendations for viral hepatitis — plays a very important role in the public health goal of protecting the population from hepatitis viruses,” Spach says.
Collaborating with physicians across the state
Another way UW Medicine is working to expand hepatitis care is through a mentorship program called Project ECHO HCV, which connects clinicians in underserved or rural areas with UW Medicine infectious disease specialists.
“We’re really trying to push hepatitis C treatment into the community,” says John Scott, MD, a physician at Harborview’s Hepatitis and Liver Clinic and the leader of Project ECHO. “Project ECHO is one way to equip primary care doctors to evaluate and treat their own patients.”
In the program, clinicians receive peer-to-peer training through weekly video conferences where they discuss evidence-based practices and various hepatitis C cases.
To Geoff Jones, MD, the UW School of Medicine assistant clinical dean for Central and Eastern Washington and a physician at Newport Community Hospital, the program helps rural doctors integrate new ideas into their practices, fight burnout and ultimately treat more patients.
“Without ECHO, there would have been no doctors in northeast Washington treating folks with hepatitis C with Medicaid,” Jones says. “These days, if we have a hepatitis C patient who is a candidate for treatment, we are able to cure them 99% of the time.”
Since the program’s conception, more than 30 clinics have participated and more than 1,000 cases have been presented — and Scott notes 2019 was one of the busiest years yet.
“We are learning as a community; it’s not one-way communication,” Scott says. “When you’re outside of the city, resources aren’t always available. Those colleagues who have dealt with challenges and have been creative sometimes have the best ideas on the call.”
Hope for a hepatitis-free future
Earlier this year, the Centers for Disease Control and Prevention (CDC) and the U.S. Preventative Services Task Force both announced new hepatitis C screening recommendations, stating all adults should be screened for hepatitis C at least once and all pregnant individuals should be screened for hepatitis C during each pregnancy.
“These landmark recommendations will be a game changer in the fight against hepatitis C,” Spach says. “It is my hope that will see similar recommendations for routine hepatitis B screening in the near future.”
With these policies in place, providers will be able to catch hepatitis C virus cases earlier, treat patients sooner, and prevent more people from developing hepatitis C and experiencing major organ damage and cirrhosis.
For Spach, the combination of these new hepatitis policies, advanced treatments and education programs all adds up to a promising future.
“With all the prevention and treatment tools now available, one could envision a day, somewhere in the not-too-distant future, where viral hepatitis could be nearly eliminated as a major healthcare problem,” Spach says.