Cross-posted from the Hepatitis blog

Viral hepatitis, an “Aggravated Organizm” affecting Alaskan communities as depicted by carver, Drew Michael, and painted by Elizabeth Ellis. Viral hepatitis, an “Aggravated Organizm” affecting Alaskan communities as depicted by carver, Drew Michael, and painted by Elizabeth Ellis.

American Indian and Alaska Native (AI/AN) communities are disproportionately affected by hepatitis C virus (HCV). The most recent national data show AI/AN people as the racial/ethnic group with the highest rates of both acute HCV infection as well as HCV-related deaths. Responding to these health disparities and building on the previous success of hepatitis A and B elimination and linkage of AN persons with chronic HBV to care and liver cancer screening, the Alaska Native Health Tribal Consortium (ANTHC) is committed to hepatitis C elimination. To date ANTHC has treated and cured over 900 persons with HCV and is expanding screening statewide. There is a lot to learn from programs and strategies being undertaken by partners across the nation that can be useful when adapted to other counties and localities…

What is the Alaska Native Health Tribal Consortium (ANTHC)?

The ANTHC Liver Disease and Hepatitis Program aims to improve the health of Alaska Native (AN) and American Indian persons who either have or are at risk of getting viral hepatitis or other liver diseases.

Some of ANTHC’s services include:

  • Medical screening of liver disease patients to diagnose liver disease and detect liver cancer at an early stage, to determine the appropriate treatment plan, and increase rates of cure for HCV
  • Consultation services for health care providers across statewide Tribal Health Organizations to assist in the management of viral hepatitis and other liver diseases
  • Provider education and resources to help primary care providers manage and treat liver diseases, including a step-by-step approach to treating hepatitis C, available at exit disclaimer icon website
  • Patient education and resources to promote knowledge, understanding and prevention of viral hepatitis and other liver diseases, available on the website above.
  • Research on the effectiveness of hepatitis vaccines and the natural history, prevention, and treatment of viral hepatitis and other liver diseases and the early detection of hepatocellular carcinoma

How is ANTHC working towards hepatitis elimination?

ANTHC has been at the forefront of hepatitis elimination in Alaska, starting with hepatitis B in the 1980s and hepatitis A in the 1990s, and has been actively treating AN/AI people with hepatitis C for the past 25 years, including all oral direct acting antivirals since 2014. We have a comprehensive education program which includes 2 videoteleconference programs, LiverConnect, a didactic-style continuing education program on liver disease, and AK HCV Echo, an interactive Project Echo style program which provides case-based learning to help increase the knowledge and comfort level of those treating hepatitis C, as well as our website which includes liver disease information for providers and patients. ANTHC is part of the Alaska Hepatitis Advisory Working Group (HAWG), which is actively pursuing strategies to provide linkage to care and wrap around services to help bring Alaska closer to HCV elimination. The HAWG’s plan for a state HCV elimination program calls for community wide participation, and includes:

  • Screening and linkage to care for:
    • Baby Boomers and at-risk adults, now expanding to all adults over 18
    • Pregnant females
    • Prison populations
  • Drug treatment programs
  • Needle exchange programs
  • Emergency departments

As the HAWG continues to develop plans that support hepatitis elimination in Alaska, there is a strong focus on training primary care providers to manage and treat hepatitis. The HAWG has developed a training curriculum and hosted four half-day trainings to enable primary care providers to diagnose, estimate the level of liver fibrosis, treat HCV, and do appropriate follow up of those with advanced liver disease.

To learn more about elimination efforts in Alaska, visit the webpage:

To learn more about elimination efforts across the United States, visit Mapping Hepatitis Elimination in Action.