LATINOS rally for Hepatitis Day @ May 19 Get Tested!

During May’s observance of Hepatitis Awareness Month, we also mark National Hispanic Hepatitis Awareness Day (NHHAD). Both of these events highlight the importance of strengthening efforts to address hepatitis C virus (HCV) infection among Latinos.

NHHAD is a national community mobilization and social marketing campaign that unites the Hispanic/Latino community in efforts to raise awareness about viral hepatitis; promote hepatitis C testing, prevention and education; and bring attention to other related critical health issues such as HIV co-infection and alcohol use.

Hepatitis C in the U.S.: Key Facts

Viral hepatitis is a silent epidemic in the United States and more than 3 million Americans are living with chronic hepatitis C, according to the CDC. Over time, chronic hepatitis C can lead to serious liver problems including liver damage, cirrhosis, liver failure, or liver cancer. Every year, thousands of Americans die from liver disease associated with viral hepatitis. Despite these statistics, viral hepatitis is not well known. In fact, as many as 75 percent of people with chronic viral hepatitis do not know that they are infected. Without knowing they are infected, these individuals cannot take steps to stay healthy or access lifesaving care and treatment. Read more about viral hepatitis from CDC’s Division of Viral Hepatitis.

Latinos and Hepatitis C

As one of the fastest growing ethnic groups in the U.S., the health concerns of Latinos are the health concerns of the nation. Several studies suggest that hepatitis C is one of those key concerns.

Latinos experience some of the highest rates of hepatitis C infection in the U.S., with an estimated overall prevalence rate of 2.6%, and incidence appears to be growing.1 2 3

• Hepatitis C rates among Latinos have been associated with injection drug use, blood transfusion prior to 1992, and tattooing.4
• Latinos are less likely to be tested than individuals of other races/ethnicities even in the presence of a known risk factor.5
• Latinos with hepatitis C also are more likely to be coinfected with HIV or HBV.6 7

Historically, Latinos infected with HCV have experienced more rapid disease progression, as evidenced by the higher liver enzyme levels, more portal inflammation, and higher rates of hepatic steatosis (fatty liver), cirrhosis, and fibrosis progression.8 9 10 11 More aggressive hepatitis C infection among Latinos has been associated with a higher weight and body-mass index,10 12 13 insulin resistance and diabetes mellitus,14 and more frequent use of alcohol.15
Latinos often experience significant barriers to accessing HCV screening and treatment, including language and communication, cultural attitudes related to illness, medical provider biases, and lack of adequate health insurance.15 16
Latinos are less likely to be offered HCV treatment even though they are more likely to meet the criteria for antiviral therapy.6 17
Latinos experience rates of hepatocellular carcinoma (HCC) – the most common type of liver cancer – that are second only to those found within Asian and Pacific Islander communities.18 These high rates of HCC result in an age-adjusted mortality rate that is higher in Latinos than in non-Hispanic Blacks or Whites.19

Let’s Talk About Hepatitis

An essential first step to addressing the impact of hepatitis C in the Latino community is raising awareness – talking about what hepatitis C is, how it is transmitted, how it can be prevented, why screening is important, and what treatments are available. So this year’s NHHAD theme is “Let’s Talk About Hepatitis” or “Hablemos sobre la Hepatitis”.

NHHAD’s organizers – The Latino Commission on AIDS and its local, regional and national partners – want to leverage this theme to support capacity building among Hispanic-serving community-based organizations, faith-based communities, and local health departments to provide hepatitis C testing, awareness, prevention and education services.

Ways to Participate

Everyone can play a role in NHHAD; indeed, we need everyone to help raise awareness of the impact of hepatitis C in the Latino community and educate others about what can be done. Here are some ideas of ways you could join us in this observance:

1. Take this 5-minute online hepatitis risk assessment developed by the CDC and get a personalized report on hepatitis testing and vaccination recommendations that you can discuss with a healthcare provider.
2. Highlight NHHAD in your organization by sending an email to all stakeholders educating them about this issue or holding a short information session.
3. Join other partners in your community in organizing a health fair focusing on overall health wellness and educate people about hepatitis C. Invite a local health care provider to speak about hepatitis C screening and where people in your community can access it.
4. Simply share this information with a friend or colleague…talk about hepatitis C.

The observance of NHHAD is among the important steps being taking by governmental and non-governmental partners across the nation to achieve the goals of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis.

This month’s observances of Hepatitis Awareness Month and National Hispanic Hepatitis Awareness Day—along with Hepatitis Testing Day on May 19 – are making important contributions to the Action Plan’s priority of educating healthcare providers and communities to reduce viral hepatitis-related health disparities and to raising awareness about hepatitis C among Latinos across the nation.

[1] Altekruse, S., McGlynn, K. & Reichman, M. (2009). Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005. Journal of Clinical Oncology, 27, 1485-1491.

[2] Blessman, D. (2008). Chronic Hepatitis C in the Hispanic/Latino Population Living in the United States. Gastroenterology Nursing, 31(1), 17-25.

[3] IOM (Institute of Medicine). 2010. Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. Washington, DC: The National Academies Press.

[4] Hand, W. & Vazquez, Y. (2005). Risk Factors for Hepatitis C on the Texas–Mexico Border. American Journal of Gastroenterology, 100, 2180-2185.

[5] Trooskin S., Navarro V., Winn R., Axelrod, D., McNeal, A., Velez, M., et al. (2007). Hepatitis C risk assessment, testing and referral for treatment in urban primary care: role of race and ethnicity. World Journal of Gastroenterology, 13, 1074-1078.

[6] Cheung, R., Currie, S., Shen, H., Ho, S., Bini, E., Anand, B., et al. (2005). Chronic Hepatitis C in Latinos: Natural History, Treatment Eligibility, Acceptance, and Outcomes. American Journal of Gastroenterology, 100, 2186-2193.

[7] Fisher, D., Reynolds, G., Jaffe, A. & Perez, M. (2006). Hepatitis and Human Immunodeficiency Virus Co-Infection Among Injection Drug Users in Los Angeles County, California. Journal of Addictive Diseases, 25(2), 25-32.

[8] Balart, L., Lisker-Melman, M., Hamzeh, F., Kwok, A., Lentz, E. & Rodriguez-Torres, M. (2010). Peginterferon α -2a Plus Ribavirin in Latino and Non-Latino Whites With HCV Genotype 1: Histologic Outcomes and Tolerability From the LATINO Study. American Journal of Gastroenterology, 105, 2177-2185.

[9] Bonacini, M., Groshen, S., Yu, M., Govindarajan, S. & Lindsay, K. (2001). Chronic Hepatitis C in Ethnic Minority Patients Evaluated in Los Angeles County. American Journal of Gastroenterology, 96(8), 2438-2441.

[10] Kallwitz, E., Layden-Allmer, J., Dhamija, M., Berkes, J., Guzman, G., Lepe, R., et al. (2010). Ethnicity and Body Mass Index Are Associated With Hepatitis C Presentation and Progression. Clinical Gastroenterology and Hepatology, 8, 72-78.

[11] Lepe, R., Layden-Almer, J., Layden, T. & Cotler, S. (2006). Ethnic differences in the presentation of chronic hepatitis C. Journal of Viral Hepatitis, 13, 116-120.

[12] Rodriguez-Torres, M., Jeffers, L., Sheikh, M., Rossaro, L., Ankoma-Sey, V., Hamzeh, F. & Martin, P. (2009). Peginterferon Alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C. New England Journal of Medicine, 360, 257-267.

[13] Rodriguez-Torres, M., Rios-Bedoya, C., Ortiz-Lasanta, G., Purcell-Arevalo, D., Marxuach-Cuetara, A. & Jimenez-Rivera, J. (2008). Weight Affect Relapse Rates in Latinos With Genotype 2/3 Chronic Hepatitis C (CHC) Treated With Peg IFN Alfa-2a (Pegasys) 180 mcg/Week and 800 mg Daily of Ribavirin for 24 Weeks. Journal of Medical Virology, 80, 1576-1580.

[14] Verma, S., Bonacini, M., Govindarajan, S., Kanel, G., Lindsay, K. & Redeker, A. (2006). More Advanced Hepatic Fibrosis in Hispanics with Chronic Hepatitis C Infection: Role of Patient Demographics, Hepatic Necroinflammation, and Steatosis. American Journal of Gastroenterology, 101, 1817-1823.

[15] Rodriguez-Torres, M. (2008). Latinos and Chronic Hepatitis C: A Singular Population. Clinical Gastroenterology and Hepatology, 6, 484-490.

[16] Stevenson, L., Faucher, Y., Hewlett, S., Klemm, K. & Nelson, D. (2004) Chronic Hepatitis C Virus and the Hispanic Community: Cultural Factors Impacting Care. Gastroenterology Nursing, 27(5), 230–238.

[17] Schackman, B., Teixeira, P. & Beeder, A. (2007). Offers of Hepatitis C Care Do Not Lead to Treatment. Journal of Urban Health, 84(3), 455-458.

[18] El-Serag, H., Lau, M., Eschbach, K., Davila, J. & Goodwin, J. (2007). Epidemiology of Hepatocellular Carcinoma in Hispanics in the United States. Archives of Internal Medicine, 167(18), 1983-1989.

[19] Kochanek, K., Xu, J.,

Murphy, S., Miniño, A. & Kung, H. Deaths: Final Data for 2009. National Vital Statistics Reports, 60(3). Hyattsville, MD: National Center for Health Statistics. 2012.

Hepatitis Testing Day – May 19

May 19th has been designated as a national Hepatitis Testing Day in the United States. CDC uses Hepatitis Testing Day as an opportunity to remind health care providers and the public who should be tested for chronic viral hepatitis. Millions of Americans have chronic viral hepatitis; most of them do not know they are infected.

NPIN Testing Event Page: The NPIN-sponsored Hepatitis Testing Day Event page is back! If you are hosting an event, please register it on the site. Once events are registered people can search for testing events in their area by entering their zip code. You can promote the event page by featuring a button on your site, so that your constituents can find testing events near them.

Hepatitis Risk Assessment: The online assessment is designed to determine an individual’s risk for viral hepatitis and asks questions based upon CDC’s guidelines for testing and vaccination. The Hepatitis Risk Assessment allows individuals to answer questions privately and print their recommendations to discuss with their doctor.

Twitter. Follow CDC’s Division of Viral Hepatitis @CDChep. Share information on Twitter about how you’re taking action for Hepatitis Testing Day with the hashtag #HTD.

SAVE THE DATE: Join us on May 30th at 2 PM EDT for a Twitter chat on Hepatitis C testing with CDC’s Director, Dr. Frieden. Follow @DrFriedenCDC and use #CDCchat to ask questions and participate in the conversation.