Kentucky Is Making Progress on Ending the Epidemic at the 2018 Viral Hepatitis Conference

Between 2010 and 2016 new hepatitis C (HCV) infections increased by 350% in the United States. The opioid crisis, increasing drug use and injection of drugs, and incomplete viral hepatitis prevention efforts are fueling new hepatitis A (HAV), hepatitis B (HBV), and HCV infections. The state of Kentucky has been hit particularly hard by the opioid crisis resulting in high rates of new HCV infections at nearly double the national target for 2020, HBV infections at more than triple the national target, steep increases in the number of pregnant women with HCV, and a growing HAV outbreak among people who use drugs and homeless individuals. Despite these challenges, Kentucky has set a goal of eliminating viral hepatitis.

In July, I had the pleasure of speaking at the 2018 Kentucky Viral Hepatitis Conference entitled, Ending the Epidemic: The Role of Professionals in Hepatitis Education. Organized by the Kentucky Rural Health Association, the Kentucky Department for Public Health’s Adult Viral Hepatitis Prevention Program, and the Kentucky Immunization Program, it was a unique forum that brought together approximately 300 participants from across the state. Discussions included the challenges faced, potential strategies and solutions, lessons shared by expert presenters and among participants, and concrete actions that could improve health outcomes for people at risk for and living with viral hepatitis in Kentucky.

Despite being one of the hardest-hit states in terms of new viral hepatitis infections, leaders in Kentucky shared their commitment to eliminating viral hepatitis through implementing a variety of unique solutions including:

• Changing state Medicaid guidelines to reduce hepatitis treatment barriers. This includes collaborating with managed care plans to develop strategies to improve access to providers, services, and hepatitis treatment and implementing provider training and programs to address challenges with access to treatment and care.
• Passing the first-ever state legislation making HCV testing mandatory for all pregnant women, and recommending HCV screening for all babies born to mothers who test positive for HCV.
• Partnering across public health, local organizations, industry and universities to offer free HCV screenings throughout the state.
• Expanding HAV vaccination efforts in collaboration with local health department and social services organizations to prevent the spread of new infections and help bring an end the outbreak.

Recognizing that expansion of HCV treatment is required in order to reach their goal of hepatitis elimination, the Kentucky Rural Health Association and Kentucky Department for Public Health launched the Kentucky Hepatitis Academic Mentorship Program (KHAMP) on August 1^st in conjunction with the conference. KHAMP brought primary health care providers from across the state together to learn how to manage and treat HCV with today’s newer curative treatments that can usually be effectively administered by non-specialist providers. The addition of trained primary care providers will expand access to HCV treatment in many rural communities across the state where there were previously no providers treating HCV. Following the program, the newly trained providers will return to their offices and, with support from a newly developed HCV teleconsultation program, begin treating and curing Kentuckians in the communities where they live.

We all have a role to play in reaching our state and national viral hepatitis goals and achieving the vision of elimination. Kentucky is a great example of multidisciplinary collaborative strategic planning leading to tailored solutions to meet state-specific challenges. Convening stakeholders at forums like the Kentucky Viral Hepatitis Conference provides a forum to share information about trends, strategies, and tools to implement solutions and is an important way to expand utilization of the strategies and services that best meet the needs of our communities. State by state, county by county, and organization by organization, working together we can win the fight against viral hepatitis!  Join us in working toward our shared goals with strategies and recommended actions in the National Viral Hepatitis Action Plan: https://www.hhs.gov/hepatitis/action-plan/national-viral-hepatitis-action-plan-overview/index.html