A, B, and C. These are the three most common hepatitis viruses. The first two are preventable by vaccines. The third is curable.
These facts come from the latest Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination 2021-2025 (January 2021), which states in its Executive Summary: " the nation faces unprecedented hepatitis A outbreaks, progress on preventing hepatitis B has stalled, and hepatitis C rates nearly tripled from 2011 to 2018."
Hepatitis C co-infection among persons with HIV is of particular concern as the disease progresses more rapidly and is more prevalent. From 15 to 30% of people with HIV are also infected with Hepatitis C, as cited in the Hepatitis C Coinfection chapter of the National HIV Curriculum. Coinfection rates are much higher among injection drug users who have HIV, according to CDC.
Fortunately, effective treatments for hepatitis C are available.
Hepatitis C Treatment
Hepatitis C treatments called Direct-Acting Antivirals (DAAs) became available in recent years They are more effective than earlier interferon-based regimens. For the first time, persons infected with hepatitis C can be cured, with all-oral, once-daily treatment regimens that last 8-24 weeks. Efficacy rates for these medications are high (above 90%) for both hepatitis C monoinfected and HIV/hepatitis C coinfected people. Side effects or contraindications of these medications are minimal.
Moreover, studies have shown that hepatitis C treatment is effective for individuals with substance abuse disorders. See the AETC on Myths about Treating Substance Users with Hepatitis C Virus.
HRSA's HIV/AIDS Bureau has developed provider resources on hepatitis screening and treatment of patients with HIV. These and other tools are summarized on the AETC National Coordinating Resource Center's (NCRC) viral hepatitis confection topic page, including the HIV/HCV Coinfection: An AETC National Curriculum (and its HIV/HCV Co-infection Resources page).
HCV/HIV Care Delivery
HRSA's focus on HCV/HIV coinfection care includes development of innovations in care delivery and performance and data monitoring by Ryan White HIV/AIDS Program (RWHAP) agencies to measure their efforts to deliver and improve services to coinfected individuals. Below are highlights from our Hepatitis topic page:
- Hepatitis C Prescriber Toolkit, a directory of state-specific resources (prescribing restrictions, ADAP coverage, Medicare coverage) and contact information for all state programs.
- Curing Hepatitis C among People of Color Living with HIV.This SPNS initiative (2017-2020) focused on expanding a full array of services for HCV/HIV coinfected individuals, in collaboration with SAMHSA-funded substance abuse agencies.
- Jurisdictional Approach to Curing Hepatitis C among HIV/HCV Coinfected People of Color. This HRSA HCV SPNS initiative (2016-2019) focused on improving HCV services among HIV/HCV-coinfected people of color.
- Performance Measurement. The HRSA HIV/AIDS Bureau has a framework of resources to support RWHAP programs in monitoring the delivery of HIV care, inclusive of hepatitis. HAB's Performance Measures are comprised of multiple sets, with an adolescent/adult set of measures that includes specific measures addressing hepatitis B screening and vaccination and hepatitis C screening.
- Data Monitoring. HRSA's Ryan White Services Report, the RSR client-level data system, is used by RWHAP recipients and subrecipients to collect performance measure data on hepatitis B screening and vaccination as well as hepatitis C screening.