TRENTON – Coinciding with National Hepatitis Awareness Month (May), the New Jersey Department of Health and Senior Services (DHSS) released the state’s first Strategic Plan for Hepatitis C Prevention and Control today.  The plan contains key recommendations from the New Jersey Hepatitis C Advisory Board and addresses the issues of education, risk factors, prevention, testing and access to care. The hepatitis C virus (HCV) is the cause of over 40 percent of chronic liver disease and affects a growing number of New Jerseyans every year.

Chronic liver disease will, in turn, lead to a high number of individuals with cirrhosis, end-stage liver disease, and hepatocellular carcinoma.  Without proper preventive measures, those currently infected will continue to transmit the disease. Compounding this challenge is the fact that HCV disproportionately affects the medically underserved.

"The burden of illness due to hepatitis C underscores the importance of education, prevention and treatment," said DHSS Commissioner Fred M. Jacobs, M.D., J.D.  "This plan provides a strategic blueprint to eliminate disparities among our most vulnerable residents and reduce infection rates."

In 2001, New Jersey Hepatitis C Advisory Board was created through legislation to help address the challenges associated with HCV and the board began meeting in the fall of 2003.  The strategic plan is the result of a comprehensive process and represents the consensus statement of the board.

The purpose of the New Jersey plan is to outline a comprehensive and integrated approach to prevent the spread of HCV among the state’s most at-risk populations, reduce complications from the disease, and improve health outcomes.  These recommendations will provide a basis for development of a broader strategic plan to address HCV as part of a statewide agenda, beyond the programs of the DHSS.

The major goals of the Strategic Plan for Hepatitis C Prevention and Control include:

• Expand educational outreach to increase knowledge of HCV among health care providers and the general public.
• Improve primary prevention and harm reduction activities to decrease transmission of HCV.
• Improve HCV surveillance in NJ.
• Improve access to HCV testing and care for uninsured and underinsured residents.
• Develop funding mechanisms to implement interventions for all stated goals.
• Foster partnerships with healthcare providers, community organizations, and other state and local agencies to promote these goals.

Helping to facilitate these goals will be the state’s Hepatitis C Coordinator, who was hired by DHSS’ Communicable Disease Service in June 2003 through federal funding for the Centers for Disease Control and Prevention (CDC). The coordinator’s role is to oversee HCV awareness, prevention and surveillance activities, and enhance statewide hepatitis activities by collaborating with community groups and other state agencies.                  

HCV is an infection of the liver that affects people from all walks of life, regardless of age, race, gender, or sexual orientation.  The CDC estimates that 1.8 percent of Americans are infected with HCV, the most common blood-borne infection in the United States today. In New Jersey, that number translates to roughly 155,000 people infected with the virus.

HCV has been a reportable disease in New Jersey since 1998.  The number of newly diagnosed cases has increased annually, although many of these cases are not believed to be newly acquired, but rather newly diagnosed. In 2002 there were 2,200 newly diagnosed cases reported in New Jersey.  In 2003, the number of newly diagnosed cases increased to 3,300.

However, it is estimated that New Jersey’s true incidence of HCV is under reported and under diagnosed. Information on race, risk factor, ethnicity, co-morbidity and treatment data are lacking for many reported cases.  New Jersey’s state plan will provide a road map for addressing these issues and compiling comprehensive data on the virus to better address prevailing risk factors.

HCV is found in the blood and body fluids of an infected person and is primarily passed from person to person through direct blood-to-blood contact, including mucous membranes or broken skin. HCV can also be spread through sexual contact; however, sexual transmission is responsible for a relatively small number of infections. The majority of current transmissions are due to injection drug use.

Since the implementation of screening tests for HCV, transmission due to blood transfusions and organ donations has declined dramatically. HCV is not spread by casual contact or by contaminated food or water.

HCV can be prevented through the following:

• Avoid sharing toothbrushes, razors, needles and other personal care items
• Cover cuts and open sores
• While a relatively small number of cases are transmitted through sexual contact, latex condoms should be used to lower the risk of transmission.  
• An individual who uses or injects street drugs should stop. If he or she cannot stop, he or she should not reuse or share syringes, water, or drug works.

Symptoms caused by the initial infection with HCV usually occur 6 to 9 weeks after exposure but may be delayed for up to 6 months. These symptoms include fatigue, poor appetite, fever and vomiting. A small number of individuals may develop dark colored urine and jaundice. However, oftentimes these symptoms may be very non-specific, causing many individuals to delay seeking medical treatment for years.

Symptoms caused by chronic HCV infection may appear many years after the initial infection. Available information suggests that as many as 60% to 70% of people infected with HCV will develop chronic infection, and 10% to 20% of those may develop cirrhosis, within 20 years of their initial infection. There also appears to be an increase in the risk of developing liver cancer.

For additional information on HCV and full details of the plan, visit the department’s website at: http://nj.gov/health/cd/f_hepac.htm .  For information about HCV testing and referrals, individuals may contact: (609) 588-7500.

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