Hepatitis C Tennessee Caring Ambassadors, Senate Briefing May 18, 2018

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Presentation transcript:

Hepatitis C Tennessee Caring Ambassadors, Senate Briefing May 18, 2018 Carolyn Wester, MD, MPH / Medical Director HIV/STDs/Viral Hepatitis

U.S. Opioid Prescribing Rates per 100 U.S. Residents by State (2016) (https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html)

The Syndemic of Acute HCV and Opioid Abuse (< 30 year olds in 4 Appalachian States) (MMWR, May 2015)

Intersection of Epidemics Opioid Abuse Hepatitis C HIV

HIV Risk Vulnerability Assessment, Tennessee Profile, County Level

Increasing HCV Surveillance, Testing, and Navigation to Care Outbreak Planning, Detection and Response Chronic HCV Perinatal HCV Testing Health Department STD Clinics Community Based Partners Navigation to Care Treatment (MH, SUD, HCV, HIV) Prevention (SSPs, OD, Vaccinations, Family Planning)

Reported Cases of Acute HCV in Tennessee 2011 2012 2013 2014 2015 2016 US case rate 0.4 0.6 0.7 0.8 1.0 cases 1,229 1,778 2,138 2,194 2,436 2,967 TN 1.3 2.0 1.5 1.9 2.6 2.3 83 129 98 123 173 150 rank 4th 6th 5th (https://www.cdc.gov/hepatitis/statistics/2016surveillance/index.htm)

Surveillance for Chronic HCV in Tennessee Case Classification 2013 2014 2015* 2016 2017 Confirmed 1,782 (44%) 3,385 (50%) 7,394 (59%) 10,442 11,018 Probable 2,234 3,421 5,244 10,496 10,992 Total (C + P) 4,016 6,806 12,628 20,938 22,010 *TDH Central office chronic HCV surveillance efforts augmented beginning 7/1/15. (TDH NEDSS Based System, NBS)

Confirmed & Probable Cases of Chronic HCV in TN by Age (7/1/15 – 12/31/17, n = 50,267) (TDH NEDSS Based System, NBS)

HCV Perinatal Exposures per Live Birth (TN, 2013 – 2016) Ab(+) Only RNA(+) RNA(-) HCV-Exposed Infants Total % Births 2013 306 392 55 698 0.9% 2014 305 570 102 875 1.1% 2015 350 686 149 1036 1.3% 2016 472 835 227 1307 1.6% 1433 2483 533 3916 1.2% (TDH NEDSS Based System (NBS), TDH Birth Statistical Files)

HCV Prevalence Among Women with Live Births (2014, TN by county) (Patrick S et al, MMWR 2017)

HCV Testing in HD STD Clinics in TN (4/1/17 – 3/31/18) 27,261 people tested 12.5% Ab (+) 69.8% RNA (+) Risk Factor Total n (%) N = 27,261 HCV Ab (+) N = 3,407 HCV Ab (-) N = 23,854 Injection Drug Use 3,495 (12.8) 2,188 (62.6) 1,307 (37.4) Intranasal Drug Use 6,032 (22.1) 2,123 (35.2) 3,909 (64.8) Incarceration 7,781 (28.5) 2,206 (28.4) 5,575 (71.7) Non-Professional Tattoo 6,804 (25.0) 1,542 (22.7) 5,262 (77.3) Baby Boomers 2,949 (10.8) 768 (26.0) 2,181 (74.0) No Risk Factors Reported 13,019 (47.7) 321 (2.5) 12,698 (97.5) Note: Risk factors are not mutually exclusive; and total %’s are by column, whereas HCV Ab+ and Ab- %’s are by row. (TDH PTBMIS, Knox County Electronic Health Records)

Increasing HCV Surveillance, Testing, and Navigation to Care Outbreak Planning, Detection and Response Chronic HCV Perinatal HCV Testing Health Department STD Clinics Community Based Partners Navigation to Care Treatment (MH, SUD, HCV, HIV) Prevention (SSPs, OD, Vaccinations, Family Planning)

Thank You!