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2. Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus — CDC Guidance, United States, 2020

Author

Moorman, Anne C, de Perio, Marie A, Goldschmidt, Ronald, Chu, Carolyn, Kuhar, David, Henderson, David K, Naggie, Susanna, Kamili, Saleem, Spradling, Philip R, Gordon, Stuart C, Russi, Mark B, and Teshale, Eyasu H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Services, Chronic Liver Disease and Cirrhosis, Hepatitis, Hepatitis - C, Emerging Infectious Diseases, Infectious Diseases, Digestive Diseases, Clinical Research, HIV/AIDS, Liver Disease, Infection, Good Health and Well Being, Centers for Disease Control and Prevention, U.S., Health Personnel, Hepacivirus, Hepatitis C, Humans, Infectious Disease Transmission, Patient-to-Professional, Occupational Exposure, Post-Exposure Prophylaxis, Practice Guidelines as Topic, RNA, Viral, United States, United States Public Health Service
Abstract

Exposure to hepatitis viruses is a recognized occupational risk for health care personnel (HCP). This report establishes new CDC guidance that includes recommendations for a testing algorithm and clinical management for HCP with potential occupational exposure to hepatitis C virus (HCV). Baseline testing of the source patient and HCP should be performed as soon as possible (preferably within 48 hours) after the exposure. A source patient refers to any person receiving health care services whose blood or other potentially infectious material is the source of the HCP's exposure. Two options are recommended for testing the source patient. The first option is to test the source patient with a nucleic acid test (NAT) for HCV RNA. This option is preferred, particularly if the source patient is known or suspected to have recent behaviors that increase risk for HCV acquisition (e.g., injection drug use within the previous 4 months) or if risk cannot be reliably assessed. The second option is to test the source patient for antibodies to hepatitis C virus (anti-HCV), then if positive, test for HCV RNA. For HCP, baseline testing for anti-HCV with reflex to a NAT for HCV RNA if positive should be conducted as soon as possible (preferably within 48 hours) after the exposure and may be simultaneous with source-patient testing. If follow-up testing is recommended based on the source patient's status (e.g., HCV RNA positive or anti-HCV positive with unavailable HCV RNA or if the HCV infection status is unknown), HCP should be tested with a NAT for HCV RNA at 3-6 weeks postexposure. If HCV RNA is negative at 3-6 weeks postexposure, a final test for anti-HCV at 4-6 months postexposure is recommended. A source patient or HCP found to be positive for HCV RNA should be referred to care. Postexposure prophylaxis of hepatitis C is not recommended for HCP who have occupational exposure to blood and other body fluids. This guidance was developed based on expert opinion (CDC. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recommend Rep 2001;50[No. RR-11]; Supplementary Figure, https://stacks.cdc.gov/view/cdc/90288) and reflects updated guidance from professional organizations that recommend treatment for acute HCV infection. Health care providers can use this guidance to update their procedures for postexposure testing and clinical management of HCP potentially exposed to hepatitis C virus.

Published
2020

3. Regional Differences in Hepatitis C–Related Hospitalization Rates, United States, 2012-2019.

Author

Hofmeister, Megan G., Zhong, Yuna, Moorman, Anne C., Teshale, Eyasu H., Samuel, Christina R., and Spradling, Philip R.

Subjects
HEPATITIS C prevention, SECONDARY analysis, HOSPITAL care, CENSUS, POPULATION geography, DESCRIPTIVE statistics, HEPATITIS C, SOCIODEMOGRAPHIC factors, MEDICAID, COMORBIDITY, DISEASE complications, SYMPTOMS
Abstract

Objectives: In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)–related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination. Methods: We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease–related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions. Results: During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region. Conclusions: HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission. [ABSTRACT FROM AUTHOR]

Published
2025
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4. Evolving Characteristics of Decedents With Hepatitis A Listed as a Cause of Death, United States, 2011–2021.

Author

Hofmeister, Megan G., Ly, Kathleen N., Yin, Shaoman, and Spradling, Philip R.

Subjects
HEPATITIS A virus, HEPATITIS A, HEPATITIS A vaccines, VACCINATION coverage, VIRUS diseases
Abstract

Hepatitis A is a vaccine‐preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person‐to‐person transmission have been widespread in the United States since 2016. We used public‐use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A‐listed deaths during non‐outbreak (2011–2015) and outbreak (2017–2021) periods and assessed the median age at death among decedents with and without hepatitis A‐listed deaths during the outbreak period. From the non‐outbreak period to the outbreak period, hepatitis A‐listed deaths more than doubled (from 369 to 801), while the hepatitis A‐listed age‐adjusted mortality rate increased 150% (p < 0.001). When compared with the non‐outbreak period, hepatitis A‐listed decedents during the outbreak period were more frequently male, aged 18–49 years, non‐Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A‐listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non‐outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A‐listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017–2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Progress in Testing for and Treatment of Hepatitis C Virus Infection Among Persons Who Inject Drugs — Georgia, 2018

Author

Stvilia, Ketevan, Spradling, Philip R., Asatiani, Alexander, Gogia, Maka, Kutateladze, Khatuna, Butsashvili, Maia, Zarkua, Jaba, Tsertsvadze, Tengiz, Sharvadze, Lali, Japaridze, Maia, Kuchuloria, Tinatin, Gvinjilia, Lia, Tskhomelidze, Irinka, Gamkrelidze, Amiran, Khonelidze, Irma, Sergeenko, David, Shadaker, Shaun, Averhoff, Francisco, and Nasrullah, Muazzam

Published
2019

13. Comparison of ICD-9 Codes for Depression and Alcohol Misuse to Survey Instruments Suggests These Codes Should Be Used with Caution

Author

Boscarino, Joseph A., Moorman, Anne C., Rupp, Loralee B., Zhou, Yueren, Lu, Mei, Teshale, Eyasu H., Gordon, Stuart C., Spradling, Philip R., Schmidt, Mark A., Trinacty, Connie Mah, Zhong, Yuna, Holmberg, Scott D., Holtzman, Deborah, Holmberg, Scott D., Teshale, Eyasu H., Spradling, Philip R., Moorman, Anne C., Xing, Jim, Zhong, Yuna, Gordon, Stuart C., Nerenz, David R., Lu, Mei, Lamerato, Lois, Li, Jia, Rupp, Loralee B., Akkerman, Nonna, Oja-Tebbe, Nancy, Zhang, Talan, Trudeau, Sheri, Zhou, Yueren, Boscarino, Joseph A., Daar, Zahra S., Smith, Robert E., Daida, Yihe G., Trinacty, Connie M., Wong, Carmen P., Schmidt, Mark A., Donald, Judy L., Keast, Erin M., and For the Chronic Hepatitis Cohort Study (CheCS) Investigators

Published
2017
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22. sj-docx-1-phr-10.1177_00333549231175548 – Supplemental material for Progress and Unfinished Business: Hepatitis B in the United States, 1980-2019

Author

Bixler, Danae, Roberts, Henry, Panagiotakopoulos, Lakshmi, Nelson, Noele P., Spradling, Philip R., and Teshale, Eyasu H.

Subjects
111799 Public Health and Health Services not elsewhere classified, FOS: Health sciences
Abstract

Supplemental material, sj-docx-1-phr-10.1177_00333549231175548 for Progress and Unfinished Business: Hepatitis B in the United States, 1980-2019 by Danae Bixler, Henry Roberts, Lakshmi Panagiotakopoulos, Noele P. Nelson, Philip R. Spradling and Eyasu H. Teshale in Public Health Reports

Published
2023
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33. Hepatitis C treatment failure is associated with increased risk of hepatocellular carcinoma

Author

Lu, Mei, Li, Jia, Rupp, Loralee B., Holmberg, Scott D., Moorman, Anne C., Spradling, Philip R., Teshale, Eyasu H., Zhou, Yueren, Boscarino, Joseph A., Schmidt, Mark A., Lamerato, Lois E., Trinacty, Connie, Trudeau, Sheri, Gordon, Stuart C., Xing, Jim, Tong, Cindy, Nerenz, David R., Akkerman, Nonna, Oja-Tebbe, Nancy, Zhang, Talan, Daar, Zahra S., Smith, Robert E., Parker, John V., Donald, Judy L., and Keast, Erin M.

Published
2016
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36. Prevalence and Types of Drugs Used Among Hepatitis A Patients During Outbreaks Associated with Person-to-Person Transmission, Kentucky, Michigan, and West Virginia, 2016-2019

Author

Hofmeister, Megan G., Asher, Alice, Jones, Christopher M., Augustine, Ryan J., Burkholder, Cole, Collins, Jim, Foster, Monique A., McBee, Shannon, Thomasson, Erica D., Thoroughman, Doug, Weng, Mark K., and Spradling, Philip R.

Subjects
FOS: Medical and health sciences
Abstract

Background: People who use drugs are at increased risk for hepatitis A virus infection. Since 1996, the Advisory Committee on Immunization Practices has recommended hepatitis A vaccination for people who use drugs. Since 2016, the U.S. has experienced widespread hepatitis A outbreaks associated with person-to-person transmission. Purpose: To describe the prevalence of drug use, route of use, and drugs used among hepatitis A outbreak-associated patients. Methods: State outbreak and medical records were reviewed to describe the prevalence, type, and route of drug use among a random sample of 812 adult outbreak-associated hepatitis A patients from Kentucky, Michigan, and West Virginia during 2016���2019. Differences in drug-use status were analyzed by demographic and risk-factor characteristics using the ��2 test. Results: Among all patients, residents of Kentucky (55.6%), Michigan (51.1%), and West Virginia (60.1%) reported any drug use, respectively. Among patients that reported any drug use, methamphetamine was the most frequently reported drug used in Kentucky (42.3%) and West Virginia (42.1%); however, opioids were the most frequently reported drug used in Michigan (46.8%). Hepatitis A patients with documented drug use were more likely (p

Published
2022

43. Hepatitis A Hospitalization Costs, United States, 2017

Author

Hofmeister, Megan G., Yin, Shaoman, Aslam, Maria V., Teshale, Eyasu H., and Spradling, Philip R.

Subjects
United States. Centers for Disease Control and Prevention, Hepatitis A -- Prevention, Hepatitis A vaccines, Health care costs, Epidemiology, Vaccines, Hospital patients, Medical economics, Homelessness, Diseases, Investments, Health
Abstract

The introduction of hepatitis A vaccine has dramatically changed the epidemiology of hepatitis A in the United States. After vaccine licensure in 1995, hepatitis A incidence declined substantially; 3,366 hepatitis [...]

Published
2020
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