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Adult Viral Hepatitis Update

Learn about common determinants leading to HIV, VH, and STD transmission. Find out about Hepatitis A and B impact, vaccine recommendations, and strategies. Discover why collaboration across HIV, VH, and STD prevention is crucial for public health.

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Adult Viral Hepatitis Update

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  1. Adult Viral HepatitisUpdate Roxanne Ereth, MPH, BS Hepatitis C Program Manager Adult Viral Hepatitis Prevention Coordinator

  2. There are common determinants that lead to transmission of HIV, VH and STD. Unprotected sex Injection drug use (and non-injection!!) Interactions between health concerns increase potential for negative health outcomes. Untreated STD increase risk of HIV infection. HIV infection increases the infectiousness of STD (and VH!). Common strategies can help prevent HIV, VH and STD infection. Abstinence Condoms Clean needles / syringes Health Education (Vaccination!!!) Why are collaboration and integration across HIV, VH and STD prevention important?* *original slide from 2008 National STD Prevention Conference by NASTAD (blue inserts are my comments)

  3. Inflammation of the liver Causes Viruses Toxins Genetic Disorders Bacteria Parasites Unknown causes What is Hepatitis?

  4. Virus found in feces ~30% of US population have been infected (32,000 new cases in 2006) Transmitted Contaminated food and/or water Direct contact with infected persons feces Resolves-does not become chronic Can lead to fulminant hepatitis with chronic liver disease Hepatitis A Virus

  5. Infection typically is symptomatic in adults, with jaundice occurring in >70% of patients. Signs and symptoms typically last <2 months Relapses possible for 6 months (15%) Virus shed for 1 – 3 weeks Most likely 1 -2 weeks before onset Minimal 1 week after Hepatitis A Impact

  6. 11%--22% of persons with hepatitis A are hospitalized. The average duration of work loss estimated at 15.5 days for nonhospitalized patients and 33.2 days for hospitalized patients. Estimates of the annual direct and indirect costs of hepatitis A in the United States have ranged from $300 million to $488.8 million in 1997 dollars. Hepatitis A Impact

  7. Travelers to countries with high or intermediate endemicity of hepatitis A virus infection Men who have sex with men Users of injection and non-injection illegal drugs Persons with clotting factor disorders Persons working with nonhuman primates susceptible to hepatitis A virus Hepatitis A InfectionPersons at Increased Risk infection

  8. MSM Users of injection and noninjection drugs Occupational risk Clotting factor disorders Chronic liver disease Close personal contact Hepatitis A Vaccine Recommendations

  9. Blood, semen, vaginal and other body fluids Transmission Sexual Perinatal Percutaneous Transfusions, organ transplants or blood products prior to 1992 Hepatitis B Virus

  10. Estimated 1.25 million Americans have chronic hepatitis B: major cause of liver cancer In 2006, an estimated 46,000 persons were newly infected. Rates are highest among adults, particularly males aged 25–44 years. 4,000-5,000 deaths annually $658 million in medical costs and lost wages each year Up to 10% with HIV infected with HBV Hepatitis B virus is 100 times more infectious than HIV Hepatitis B Impact

  11. Persons with multiple sex partners or diagnosis of a sexually transmitted disease Men who have sex with men Sex contacts of infected persons Injection-drug users Persons at Increased Risk of Hepatitis B Infection

  12. Household contacts of chronically infected persons Infants born to infected mothers Health-care and public safety workers with exposure to blood Hemodialysis patients Persons at Increased Risk of Hepatitis B Infection

  13. Universal vaccination of adults who receive care in: Sexually transmitted disease treatment facilities HIV testing and treatment facilities Facilities providing drug-abuse treatment and prevention services Health-care settings targeting services to injection-drug users Correctional facilities Health-care settings targeting services to men who have sex with men Chronic hemodialysis facilities and end-stage renal disease programs Institutions and nonresidential day care facilities for developmentally disabled persons Hepatitis B Vaccine Recommendations

  14. Regardless of insurance status Hepatitis B Vaccine: All who present at STD clinic Twinrix: Illicit drug use Chronic liver disease HIV and/or HCV infected Adult Hepatitis B Vaccine Initiative

  15. To participate Contact Immunization Coordinator Complete VFA Program Enrollment Agreement Complete 2008 Adult Provider Profile Complete Program Provider/ASIIS Information Forward forms to Roxanne Adult Hepatitis B Vaccine Initiative

  16. Roxanne Ereth, MPH Adult Viral Hepatitis Prevention Coordinator Hepatitis C Program Manager 602-364-3655 erethr@azdhs.gov Questions?

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