As Debate on Health Care Continues in Washington, Health Department Releases Data on Hepatitis B and C in New York City

Newly reported cases of chronic hepatitis B increased by 9.4 percent from 2015 to 2016, possibly related to new screening guidelines; newly reported cases of chronic hepatitis C declined slightly

If Congress cuts billions in Medicaid, thousands of New Yorkers living with hepatitis would be deprived of care

July 28, 2017 – In recognition of World Hepatitis Day, the Health Department today released new preliminary data on hepatitis B and C in New York City. From 2015 to 2016, there was a 9.4 percent increase in newly reported hepatitis B cases; the rise is likely due to screenings targeted at New Yorkers who were born in countries with a high prevalence of the virus. Newly reported chronic hepatitis C cases, meanwhile, declined slightly, from 4,171 in 2015 to 3,781 in 2016. The Health Department has a number of programs devoted to the prevention and treatment of hepatitis. The Project INSPIRE hepatitis C comprehensive care coordination program closed enrollment in February 2017, and was found to improve health care and lower costs for the 2,775 patients served. In January, the agency also started a program to connect pregnant women with hepatitis B to affordable care after the birth of their child.

The repeal of the Affordable Care Act would have severe and negative impacts on the communities benefiting from these essential programs. Proposals under consideration include deep cuts to Medicaid funding and the removal of vital insurance protections, including health insurance for people with pre-existing conditions and coverage for essential health benefits. 

“Although we have made progress in expanding screenings and treatment for hepatitis B and C, we will not be satisfied until we see an end to hepatitis in New York City,” said Health Commissioner Dr. Mary T. Bassett. “We will continue to work with our community partners to expand access to treatment and reach communities that have been disproportionately affected by this disease. It is now easier than ever to get tested, and all New Yorkers should know their status.”   

Preliminary data highlights:

  • In 2016, 8,439 people were newly reported with chronic hepatitis B, an increase from 7,719 in 2015.
  • The highest rate of chronic hepatitis B continues to be seen in Sunset Park, Brooklyn at 755.7 per 100,000 people. Other neighborhoods with high rates of chronic hepatitis B were Borough Park and Bensonhurst/Bay Ridge (Brooklyn), Flushing and West Queens (Queens), Greenwich Village/SoHo and Union Square/Lower East Side (Manhattan).
  • 43 percent of those diagnosed with chronic hepatitis C were born between 1945 and 1965.
  • 14.8 percent of patients diagnosed with chronic hepatitis C were under 30 years of age, slightly higher than in 2015 (12.4 percent).
  • Neighborhoods with the highest hepatitis C rates were Chelsea-Clinton, East and Central Harlem (Manhattan), Coney Island (Brooklyn), and Hunts Point-Mott Haven (Bronx), similar to 2015.

“In this era of highly effective, short-course and well-tolerated therapy for hepatitis C, patients should be identified by complete diagnostic testing,” said Dr. Demetre Daskalakis, Deputy Commissioner for the Division of Disease Control. “The best way to test for hepatitis C is to conduct the antibody with reflex to RNA to confirm infection in one step. Positive individuals should be offered curative therapy to reduce their risk of long term liver complications.”

“We want all New Yorkers, especially those born in countries with high rates of hepatitis B, to get tested and receive appropriate medical evaluation, and ongoing monitoring and treatment for hepatitis B to prevent serious liver disease and cancer. In addition, testing New Yorkers with current or past risk factors for hepatitis C, including baby boomers and people who use drugs, is critical,” said Dr. Ann Winters, Medical Director of the Health Department’s Viral Hepatitis Program.

“I applaud the Department of Health for working to raise awareness of hepatitis in New York City and I am proud to be leading the effort on the federal level, “ said U.S. Rep. Grace Meng (D-Queens), Co-Chair of the Congressional Hepatitis Caucus. “It is critical that we continue to educate the public about hepatitis and do all we can to expand screening and treatment for the virus. I am proud to have introduced a resolution in Congress expressing support for World Hepatitis Day, and to have requested in appropriations legislation that the National Institute of Health intensify its current effort to find a cure. We will not rest until we end hepatitis once and for all.” 

"New York City is a leader in hepatitis screening and care," said Assembly Health Committee Chair Richard N. Gottfried.  "We must continue expanding outreach, particularly in underserved communities, so that all New Yorkers know their status and can access treatment without financial barriers." 

“The City offers vital services geared toward preventing and treating hepatitis B and C in communities across New York City. Potential cuts to the Affordable Care Act could trickle down and have considerable harm to the people benefiting from these program and their ability to pay for essential health services,” said Council Member Jumaane D. Williams.
 
The City has expanded services for hepatitis screening and treatment in the last two years, including:

Project INSPIRE is a comprehensive hepatitis C care coordination program at Mount Sinai in Upper Manhattan and Montefiore Medical Centers in the Bronx. At the close of enrollment in February 2017, 2,775 people chronically infected with hepatitis C were enrolled to receive support through medical evaluation, treatment to cure infection and management of co-morbid conditions. The project makes a case for health insurance to cover care coordination services to reduce high cost medical care and hospitalization due to unmanaged chronic hepatitis C. 

The New York City Council “Viral Hepatitis Initiative” was first funded in 2014, which allowed the Health Department to develop a citywide hepatitis B and hepatitis C patient and peer navigation program, as well as a clinical provider training program. In FY2018, this initiative will provide over $2 million to community health organizations serving high-risk populations. As of last month, this program has trained and supported 31 community health organizations to:

  • Enroll and educate 8,128 residents at risk for or living with hepatitis B or C.
  • Link 3,126 patients to hepatitis medical care.
  • Assist 1,794 patients in completing a comprehensive medical evaluation necessary for treatment.
  • Train over 800 clinical providers in hepatitis screening, management and treatment.

The Hep B Moms Linkage to Care program launched in January to link pregnant women with hepatitis B to affordable hepatitis B care after the birth of their child. The majority of patients are foreign born, have limited English proficiency, and many only have access to health insurance during pregnancy. Through this project, bilingual health care access specialists at the Health Department provide intensive telephone-based linkage to care services. The program will serve at least 400 patients over two years.

Project SUCCEED (Scaling up Co-Infection Care & Eliminating Ethnic Disparities) launched last September when the Health Department was awarded a three year Health and Human Resources (HRSA) Ryan White Special Projects of National Significance (SPNS) grant. The goal of Project SUCCEED is to increase hepatitis C screening, linkage to care, treatment and cure rates among persons living with HIV in New York City, the majority of whom are people of color. As of December 2016, over 11,000 persons living with diagnosed HIV have screened hepatitis C antibody positive, and nearly 4,000 have confirmed current hepatitis C infection. Project SUCCEED will use Health Department surveillance data to target interventions which include training and technical assistance for HIV clinical and non-clinical providers, as well as direct to patient outreach and linkage to hepatitis care services. The project includes a strong evaluation component in the hopes that many of the elements of the intervention will be able to be used in other jurisdictions.

Many people living with hepatitis B or C are unaware of their infection and not receiving medical care, yet are at risk for developing liver cirrhosis and cancer. Chronic hepatitis C infection can be treated and cured. Hepatitis B can be prevented through vaccination, and chronic hepatitis B infection can be treated to slow the progression of disease.
 
The Health Department urges all New Yorkers to:

  • Learn your risk for hepatitis B and C. Visit nyc.gov/health/hepatitis or text the word “LIVER” to 877877.
  • Get tested if you are at risk. Ask your doctor for the test, or find a hepatitis B or C testing and treatment site near you using the Health Department’s NYC Health Map.
  • Protect yourself and your loved ones from hepatitis B. Ask your doctor for the hepatitis B vaccine.
  • If you are living with hepatitis B and/or C, learn more about how to stay healthy. Visit nyc.gov/health/hepatitis or download the NYC Liver Health app.

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