NEMS offers comprehensive hepatitis B and C care services at the comfort and convenience of your medical home.
Hepatitis B and C are the leading causes of liver cancer worldwide caused by infection with the hepatitis B virus (HBV) and hepatitis C virus (HCV). It is estimated that 1 in 12 Asian Americans are chronically infected with HBV, but most are unaware. Hepatitis B can be prevented through vaccination. While there is no vaccine to prevent hepatitis C, HCV infection is curable through treatment!
NEMS’ Hepatitis B and C Elimination Program aims to eliminate HBV and HCV for current and future generations through universal screening and vaccination, perinatal prevention, monitoring, and treatment.
Screening and Vaccination
At NEMS, we recommend universal HBV and HCV screenings for all adults. HBV and HCV screenings are covered by most insurances. We also offer free HBV and HCV testing for all community members and persons without insurance who want to get HBV and/or HCV testing.
The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends universal HBV vaccination for all persons younger than age 60 who do not have evidence of prior HBV infection or immunity upon screening. NEMS offers the 2-dose Heplisav-B vaccine for adults that can be completed over 1 month and the 3-dose HBV vaccine for pregnant women and children that can be completed over 6 months.
There is no vaccine for HCV.
Perinatal Prevention
NEMS screens for HBV and HCV in all pregnancies.
NEMS’ Hep B Moms care management program ensures mothers with HBV and their infants receive recommended treatment, monitoring, and vaccination during the perinatal period, when there is an increased risk for mother-to-child transmission.
Monitoring and Treatment
NEMS ensures all persons identified with chronic hepatitis B and C are linked to care with a primary care provider or specialist who can evaluate, monitor, and treat their condition.
It is important for people living with hepatitis B to get routine lab monitoring and liver ultrasounds to stay up to date on their hepatitis B care management and liver health.
People living with chronic HBV should complete the below lab tests every six (6) months to stay up to date with their HBV care management:
- ALT to check if their liver is inflamed
- HBV DNA to check the virus count in the blood
Patients identified with HCV may receive their lab evaluation at NEMS.
NEMS offers routine liver ultrasounds for people with chronic HBV and HCV at multiple sites.
People with a history of HBV or HCV cirrhosis should get a liver ultrasound done every 6 months.
Additionally, people with HBV without cirrhosis who belong to one of the below categories have increased risk for developing liver cancer and should get a liver ultrasound done every 6 months:
- Men over the age of 40 years old
- Women over the age of 50 years old
- People with hepatitis delta infection
- People with family history of liver cancer
All people living with HBV or HCV should have fibrosis staging done at least once in their lifetime. One of the best ways to complete fibrosis staging is through FibroScan, a point-of-care device that measures liver stiffness and fatty liver changes. NEMS offers FibroScan at multiple sites.
Patients with HBV may or may not need treatment, depending on their HBV status, so please discuss with your provider if you have any questions. NEMS providers and pharmacists can help identify affordable HBV antiviral medication options for patients without insurance or with high co-pays.
Patients identified with HCV may receive treatment at NEMS or be referred to a specialist. NEMS providers and pharmacists can also assist with prior authorizations needed to obtain HCV treatment.
Hepatitis B Management Guidance for the Primary Care Provider
Co-authored by NEMS Director of Immigrant Health, Dr. Amy Tang, this resource provides simplified guidance for primary care medical providers to manage HBV care in the primary care setting:
Advocacy
For more than a decade, NEMS has been a leader in promoting awareness of HBV within the Asian American community, as Asians are disproportionately impacted by HBV infection. NEMS also has a long history of partnering with local organizations, such as San Francisco Hep B Free–Bay Area, and national advocacy groups, like Hep B United and Hepatitis B Foundation, to advocate for more HBV support and resources so future generations are HBV free.
See below for a publication on HBV elimination co-authored by NEMS Director of Immigrant Health, Dr. Amy Tang:
- “What will it take to eliminate hepatitis B as a public health threat in the United States and Canada?”
- “Hepatitis B Virus Elimination in the U.S.: Time to Dismantle Barriers and Implement Solutions”
