HCV: The Silent Epidemic An Educational Intervention

Author: Charles Howsare, Suzanna Masartis Sarjita Naik, Pharm D

Theme: Epidemiology & Public Health Research Year: 2017

Background: In Pennsylvania, the number of newly reported HCV infections among
individuals ages 15 to 34 more than tripled from 2003 to 2016 representing a 36% per
capita rate increase with over 6000 reported cases in this age group in 2016 alone. The
emerging bimodal distribution of cases is being driven by HCV transmission in young
people who inject drugs (PWIDs), primarily opiates. The Pennsylvania Department of
Health, the Community Liver Alliance, and members of the medical community formed a
partnership to raise awareness to the intersection of opiate use disorder, overdose and
infectious disease epidemics in young adults. We describe a yearlong initiative of
holding educational seminars throughout the six health districts of Pennsylvania.
Methods: We selected 6 venues, one each in the 6 state community health districts.
Sessions specifically targeted health care providers, counselors, and nurses and
included topics on HCV screening, treatment, harm reduction and HCV/HIV antibody
testing certification. The goals were to raise awareness to the epidemics, to provide an
opportunity for medical providers, drug and alcohol counselors, community and public
health workers, harm reduction workers, and patient advocacy groups to network, to
form informal care networks, to improve drug user healthcare, and to prevent overdose
and infectious disease transmission in PWID. The current epidemiological data for
HCV across the state was described. Officials from the CDC and state officials reported
on the rising epidemic of new HCV infections among persons who inject drugs. Local
officials spoke on the current opioid epidemic and strategies to address the problem.
1. 759 participants attended from the 6 separate Community health districts
2. 356 participants were certified in HCV/HIV rapid antibody testing and taught
overdose prevention.
3. The number of harm reduction programs operating across the state tripled during
the period from 3 to 9, despite syringe exchange being illegal in Pennsylvania.
4. The total number of electronic lab reported positive HCV screening tests in
Pennsylvania more than doubled during the period from an average of 10,000
new cases per year from 2003 to 2014, to 15,000 new cases in 2015, and 23,500
new cases in 2016.
5. The total number of electronic lab reported positive HCV screening tests in
Pennsylvania in young adults (risk based screening) increased from an average
of 2500 cases from 2003-20014 to 4000 cases in 2015, and 6000 cases in 2016.
Conclusion: Raising awareness to the concurrent entwined epidemics to a variety of
stakeholders is the first step to addressing the epidemics. Risk based HCV screening of
current and former PWIDs can be improved by knowledgeable collaborative networks of
health departments/public health workers, drug and alcohol treatment providers, primary
care providers, and harm reduction workers.

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