Background
Viral Hepatitis continues to be a pressing health concern in Virginia. In 2024, reportable viral hepatitis cases were surpassed only by chlamydia and gonorrhea cases. As frontline providers, you can greatly influence the prevalence of viral hepatitis infections in Virginia by ensuring patients receive screening, vaccinations, and treatment per the most recent Center for Disease Control (CDC) recommendations.
Clinical Recommendations Summary
Virginia Department of Health encourages all providers to implement the following recommendations into their daily practice to prevent and control viral hepatitis in Virginia:
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- Screen all adults 18 and older for hepatitis B and C
- Test all pregnant women for hepatitis B and C early in each pregnancy
- Vaccinate all eligible patients against hepatitis A and B
- Educate all patients on the risk of viral hepatitis
- Treat all patients, regardless of substance use, for hepatitis C
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One-Pager
Access clinical resources and recommendations in a convenient one-pager. Also includes results from a health systems and laboratory needs assessment survey.
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Clinician Resources
Find resources for your practice and your clients
Hepatitis A
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- The Centers for Disease Control and Prevention (CDC) recommend routine HAV vaccination of children aged 12-23 months, as well as catch-up vaccination for individuals aged 2-18 years that were not previously vaccinated.
- Adults at risk of HAV or requesting protection against HAV, regardless of risk, are recommended to receive a HAV vaccination
Hepatitis B
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- The CDC recommends universal HBV testing for all adults aged 18 or older, regardless of disclosure of risk
- The CDC recommends vaccination for all adults aged 19-59 against HBV, including pregnant persons, regardless of risk
- CDC screening recommendations now include triple-panel laboratory tests:
- Hepatitis B surface antigen (HBsAg)
- Antibody to HBsAg
- Total antibody to HBcAg (total anti-HBc)
- Virginia code 12.VAC5-90-130. Prenatal Testing requires HBV testing of all pregnant persons throughout the duration of the pregnancy.
Hepatitis C
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- The CDC recommends universal screening for HCV for all patients over 18, including routine periodic testing if on-going risk factors are present (such as injection drug use or maintenance hemodialysis)
- Pregnant persons should be routinely screened for hepatitis during each pregnancy
- Virginia Medicaid does not require prior authorization, fibrosis restrictions, substance use restrictions, prescriber restrictions, or retreatment restrictions.
- The CDC now recommends a two-step testing sequence for the diagnosis of an HCV infection, with automatic reflex to an RNA test:
- HCV antibody (anti-HCV)
- HCV RNA
- HCV treatment can now be managed by general practitioners. This allows for HCV treatment to be accessible within a primary care setting, with no infectious disease specialist required.
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Hepatitis Data
Find data and reports for viral hepatitis in Virginia
Additional Resources
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- Virginia is rated A+ for HCV Medicaid Access after many barriers/restrictions to treatment were lifted.
- Virginia HEPC offers a variety of resources for both providers and patients:
- For local in-person resources, Virginia HEPC’s treatment access map can help provide vetted treatment providers
- Providers can refer to telehealth treatment through Virginia HEPC
- VA HEPC offers in-person and virtual training for primary care teams to learn to treat HCV independently
- Once an organization's clinician and staff have completed training, they are able to request consultations with an Infectious Disease provider whenever treatment-related questions arise
- VA HEPC offers a monthly virtual Community of Practice for clinicians and care teams to stay connected, build knowledge, and learn from peers across the state
- Virginia Hepatitis Coalition hosts monthly meetings to discuss strategies and progress towards eliminating viral hepatitis in the Commonwealth.
- View the Virginia Viral Hepatitis Elimination Plan
- Comprehensive Harm Reduction in Virginia
- VDH: HCV/HIV Co-Infected Treatment Assistant Program
Get Involved
Interested in getting involved with other viral hepatitis providers? Hearing directly from patients receiving hepatitis services? The Virginia Hepatitis Elimination Workgroup and the Virginia Hepatitis Coalition are looking for providers. Let your voice be heard!
Contact us
For any questions or needs regarding viral hepatitis, please contact Colin Dwyer, Viral Hepatitis Coordinator. Colin can be reached at colin.dwyer@vdh.virginia.gov or 804-613-8228.