Rising to the challenge of Hep B and chronic infectious disease

I began my term of service as a patient assistance program advocate with the Philadelphia Department of Public Health expecting to learn about the different treatments available for chronic diseases like hypertension, diabetes, and asthma. Encountering patients who needed help accessing medication for hepatitis B virus (HBV)  surprised me because I did not know that hepatitis B, a transmissible infection, is also a chronic disease that can be controlled with continuous treatment. Doctors at my host site helped me understand the disease progression, prevalence, and treatment options for chronic HBV, and I’ve observed the roles of advocacy and education outside of the health center where I serve. Helping people obtain treatment for chronic HBV infection during my term of service has challenged me to expand my understanding of “chronic” and “infectious” diseases.

Hepatitis B is a liver infection caused by HBV, which, if persistent, can lead to liver disease and liver cancer overtime. While HBV is a vaccine-preventable infection, it can be transmitted to unvaccinated people through direct contact with infected blood, which can occur through using shared needles or through blood transfusions. Additionally, HBV can be transmitted through unprotected sex and from an infected mother to a newborn during delivery.
As a patient assistance program advocate, I help patients obtain certain antiviral medications that can slow down the development of liver disease and can also reduce the incidence of liver cancer, prolonging life expectancy. Because the patients referred to my office for these antiviral medications have persistent, chronic HBV, my role is not to prevent the transmission of hepatitis B but rather to contribute to continuity of care by ensuring regular access to antiviral medications.

In addition to learning about the treatments available for HBV, I’ve learned about demographics of chronic hepatitis B infection. China and countries in Southeast Asia have the highest prevalence of chronic HBV. Because of a lack of education regarding the transmission of HBV and the stigma of being infected with HBV, many people are unaware that they are at-risk for, or may be infected with HBV. As a result, it is possible that an infected mother may unknowingly transmit HBV to her child during birth, causing the high prevalence of HBV among people from these regions to persist throughout generations.

My host site is located in South Philadelphia, where there are large Vietnamese, Indonesian, and Chinese communities. Serving within this part of Philadelphia, I’ve gained an understanding of the different roles prevention, screening, education, and treatment play in preventing the transmission of an infectious disease and managing chronic HBV infections. While I’ve helped patients acquire treatment, I’ve also helped screen members of Philadelphia’s Vietnamese community for hepatitis B at a health fair in South Philadelphia. Along with other Philadelphia Health Corps members, I attended a Hepatitis C Allies of Philadelphia (HepCAP) meeting to learn about the roles of advocacy and education in preventing and treating hepatitis B and hepatitis C infection in Philadelphia.

Through my multiple roles as a patient advocate, as a community coalition member, and as a volunteer with organizations dedicated to tackling hepatitis B, I’ve encountered interventions that target HBV infection at the biological, interpersonal, and societal levels. Antiviral medications slow the development of liver disease and cancer caused by chronic HBV infection, while screenings and education events encourage early detection and raise awareness about how to prevent the transmission of HBV. Advocacy groups bring together different groups including policy makers, healthcare providers, pharmaceutical companies, health insurance companies, and community organizations to cultivate broad collaborations that make society more conducive to the prevention and treatment of HBV infection. During my time serving people and communities impacted by HBV, I’ve gained an appreciation of multi-pronged approaches that aim to prevent the spread of infectious disease while ensuring continuous care for people living with chronic viral infections.

This post was written by PHC member Hannah Stone.
Hannah serves at the Philadelphia Department of Public Health - Health Center #2 as a Patient Assistance Program Advocate.