Hepatitis is new focus of public health efforts

By CELESTE BOTT
Capital News Service
LANSING – The state will use a new $1.6 million federal grant to better determine barriers to hepatitis screening, testing and treatment.
The grant was awarded by the Centers for Disease Control and Prevention.
James K. Haveman, director of the Department of Community Health, said that it was the first time the state received federal funding for the surveillance of this prevalent disease.

“Hepatitis affects millions of Americans, and opportunities such as this are critical to detecting and treating those cases,” Haveman said.
Hepatitis, a disease that causes inflammation of the liver and eventual liver cirrhosis, requires extensive statewide awareness because according to the department, up to 75 percent of infected people aren’t aware they have it.
Angela Minicuci, public information officer for the department, said that there are already some plans for the federal funding.
“We want to reduce the burden of paper reporting by focusing on the enhancement of electronic laboratory reporting of hepatitis,” she said. “We also want to establish guidelines to prioritize public health follow-up in hepatitis cases.”
Most cases of Hepatitis B and C are not reported until there are symptoms of advanced disease such as chronic liver disease or a type of liver cancer, according to the department.
While this doesn’t make it impossible to cure or treat, it does mean it is more likely the infection has spread.
Hepatitis B infection is caused by coming into contact with the blood or bodily fluids of an infected person. Newborns can get it if their mothers have the disease during pregnancy. Hepatitis C is blood-borne, with infections typically caused by infected needles or syringes.
In 2011, the department received reports of more than 7,000 confirmed cases of Hepatitis C.
Many cases can be prevented with immunizations, but screenings can prevent infected individuals from unknowingly spreading the disease by means such as unprotected sex.
The department will receive the grant over the course of three years. While their plans haven’t reached the local level yet, Minicuci said that they will be working with health centers and community care facilities extensively during that time.
“We want to improve the coordination of internal hepatitis programs,” she said. “We also want to coordinate with other agencies, substance abuse and law enforcement to educate youth on hepatitis risk and drug use.”
The first priority, according to Minicuci, will be using the funding to conduct a needs assessment with community health clinics to study the exposure, diagnosis, treatment and education of hepatitis.
In the meantime, steps are being taken statewide to find better treatments or even cures for the disease.
Anna Lok, a professor at the University of Michigan’s department of Internal Medicine, has worked with a team developing a more effective drug for Hepatitis C without the harsh side effects of the current treatment.
“There is a necessity for new combination regimens that can increase response rates in that population,” Lok said.
The new drug, which combines two direct-acting anti-viral agents, is currently undergoing a second phase of research.
David Rueda, a former Wayne State University researcher, has studied how the partnering of enzymes and RNA protein, a cell molecule that acts like a DNA messenger, helps shape the genetic mechanism underlying infections such as Hepatitis C.
“A lot of those kinds of diseases are associated with RNA machines not working properly,” Rueda said. “By understanding the steps by which RNA folds into their functional structure, we may discover how to cure some very devastating diseases.”
Even in the medical community, there is a push for hepatitis awareness in addition to treatment improvements.
For example, in November, Hepatitis Foundation International, based in Maryland, held a viral hepatitis summit in Grand Rapids.
Topics of discussion at the summit included assessment risk behaviors, screening, protocol, treatment monitoring, side effects of treatments and the challenges and outcomes of working with hepatitis patients.