Hepatitis B and Hepatitis C in Caldwell County

CALDWELL COUNTY, NC (November 9, 2017)…Caldwell County Health Department is encouraging Caldwell County Citizen to help stop the spread of hepatitis B and hepatitis C by being tested, receiving vaccination (HBV only) and observing safe injection practices.

Hepatitis B, a vaccine preventable disease, that can be spread by exposure to infected bodily fluids. In addition to exposure to infected blood, hepatitis B can be spread through sexual contact or exposure to bodily fluids. In adults, of those who are infected with hepatitis B, approximately 95% of individuals will clear the infection. However, for those who are chronically infected, there is no cure.

Since 2008, only 36 cases of acute Hepatitis B Virus (HBV) have been reported from Caldwell County. In 2016, 18 cases of acute HBV were reported to the State, representing 50% of reported HBV cases in Caldwell County in the last 9 years. Statewide, 151 cases of acute HBV were reported in 2016. This is an increase of 62% over a five-year reporting period. Caldwell’s reported hepatitis B cases represent 12% of the total reported cases in 2016, while its population is only representative of less than one percent of the State. This is an indicator that Caldwell County was disproportionately affected by acute HBV in 2016. Of the reported cases in 2016, 44.4% of cases self-reported injection drug use as their risk, while 66.7% claimed non-injection drug use as a risk. Over 50% of acute HBV reported cases were also co-infected with Hepatitis C Virus (HCV). In addition, reported acute HCV numbers have remained consistent since 2014.

Hepatitis C is most frequently transmitted through injection drug use. Hepatitis C is spread through prolonged or repeated blood to blood contact and can be prevented by limiting exposure to infected blood. Approximately 75% of individuals who are infected with HCV will go on to develop chronic disease. However, curative treatment now exists for HCV.

In addition, Baby Boomers (born between 1945-1965) are at a higher risk for testing positive for hepatitis C. This population is likely at an increased risk due to an exposure that may have happened prior to discovery of a commercial method to test for hepatitis C.

Amongst people who use drugs, harm reduction is an evidenced based method to decrease risk of transmission from person to person. In addition to sharing of needles and syringes, both HBV and HCV can be spread through use of contaminated injection or drug use equipment (cotton filters, cookers, tourniquets, water, drugs, blood fingers, crack/meth pipes, nasal straws).

In fall of 2017, in partnership with the State Lab of Public Health (SLPH), and the NC Communicable Disease Branch, high risk hepatitis B testing was made available to the western portion of North Carolina for uninsured individuals. This region was chosen in response to the elevated rates of reported acute HBV that were observed in 2016. This is in conjunction with the high risk testing already available for hepatitis C (statewide).

Individuals are eligible for HBV testing at Caldwell County Health Department if they are:

• Uninsured and claim on of the following risk factors:

• Drug use (or history of drug use) not as prescribed

• Sexual contact with a Drug user

• Men who have sex with men

• HIV+

Individuals are eligible for HCV testing at Caldwell County Health Department if they are:

• Uninsured and claim on of the following risk factors:

• Current injection drug use, or history of injection drug use

• Born between 1945 and 1965

• HIV+

“I am very concerned about the observed increase in transmission and diagnosis of viral hepatitis in Caldwell County. However, it is important to note that hepatitis B and C are preventable,” Health Director Joshua Swift, MPH. Both can be prevented through harm reduction practices, safer sex practices, and for HBV: vaccination. The best ways to prevent viral hepatitis is to continue to spread these prevention messages, screening high risk individuals to notify them of disease status and link them to care, and increasing vaccine coverage. While risk does increase in the community through injection and non-injection drug use, there are evidence based methods to help bend the curve of viral hepatitis transmission.

For more information regarding Hepatitis B and C, contact 426-8506.