NYC Health Department Releases 2023 Annual Report On Hepatitis A, B, C

 The New York City Health Department today released its 2023 Hepatitis A, B, and C Annual Report highlighting surveillance data and programming for New York City.

It includes updates on progress toward meeting the goals in the Plan to Eliminate Viral Hepatitis as a Major Public Health Threat in New York City by 2030. The number of people newly reported with chronic hepatitis C in 2023 in New York City decreased by 11% from 2022 and 67% from 2014, showing steady gains towards eliminating this preventable and treatable illness. However, there were increases in the numbers of people newly reported with chronic hepatitis B and people with hepatitis A in New York City compared with 2022. Inequities by gender, race and ethnicity, age, and neighborhood poverty level persist among people reported with hepatitis A and people newly reported with chronic hepatitis B and C in New York City.

In 2023, there were 2,375 people newly reported with chronic hepatitis C in New York City:

• 63% were male, 42% were ages 30 to 49 years, and 17% were white, 15% were Black, and 14% were Latino/a.
• The highest rates of newly reported hepatitis C cases were in the Bronx and Brooklyn, and in neighborhoods of very high poverty.
• Injection drug use was the most frequently reported risk factor among a group of people newly reported with hepatitis C interviewed by the Health Department.

Over the last 10 years, the rate of people newly reported with hepatitis C decreased most steeply for people ages 50 to 69 years compared with other age groups, and while rates decreased for most race and ethnicity groups, Black people consistently had the highest rate.

In 2023, there were 6,947 people newly reported with chronic hepatitis B in New York City, up 26% from 2022 but down 6% from 2014. The 2023 number surpassed the number seen in 2019 prior to the COVID-19 pandemic.

Among people newly reported with chronic hepatitis B in 2023:

• 61% were male, 26% were ages 30 to 39 years, and 19% were Asian or Pacific Islander.
• The highest rates of newly reported hepatitis B cases were in Queens and Brooklyn, and in neighborhoods of high or very high poverty.
• Despite steep declines, the rate of Asian or Pacific Islander people newly reported with hepatitis B was persistently higher compared with other race and ethnicity groups over the last 10 years.
• People ages 30 to 59 had the highest rates compared with other age groups.

In 2023, there were 61 people reported with hepatitis A in New York City, up 30% from 2022. International travel was the most frequently reported transmission category.

“While we continue to make progress toward our overall hepatitis C elimination goals, 2022 saw increases in chronic hepatitis B and hepatitis A, and inequities by a range of sociodemographic factors among people newly reported with chronic hepatitis B and C persisted,” said Acting Health Commissioner Dr. Michelle Morse. “Without investment commensurate with the scope and scale of the local epidemic, we will continue to fall short of the goals set forth in the City’s viral hepatitis elimination plan. With the appropriate resources, equitable progress toward eliminating viral hepatitis as a major public health threat in New York City by 2030 is possible.”

The Health Department administers the New York City Council-funded Viral Hepatitis Initiative, which supports dozens of organizations working to improve access to hepatitis B and C testing, care, and treatment, and to build provider capacity to deliver these services. From July 1, 2022, to June 30, 2023:

• Check Hep B patient navigators provided education and linkage to care services in 10 languages to 961 people with chronic hepatitis B, and Check Hep B organizations screened 1,026 people and vaccinated 250 people for hepatitis B.
• Check Hep C patient navigators provided education and linkage to care services to 723 people with chronic hepatitis C.
• Hep C Navigation in Syringe Service Programs peer and patient navigators provided education, prevention, and linkage to care services to 1,814 people at risk for hepatitis C.
• Empire Liver Foundation trained 911 clinical providers in hepatitis B and C prevention, testing, linkage to care, evaluation, and treatment.

In June 2024, the New York City Council announced continued funding to support the Viral Hepatitis Initiative.

“The Health Department and Hep Free NYC are national leaders in engaging stakeholders, including community advocates, public health workers, and clinicians,” said Dr. Matthew Akiyama, Associate Professor of Medicine at Montefiore Medical Center. “The 2023 Hepatitis A, B, and C Annual Report provides critical information outlining surveillance data and programmatic developments to inform future planning as we strive for viral hepatitis elimination in New York City.”

“In New York City, hepatitis B and hepatitis C continue to impact thousands, often going undiagnosed and untreated,” said Shifra Baum, Physician Assistant at NYC Health + Hospitals/Elmhurst. “Many face language barriers, limited access to health care, and other social determinants that can make it challenging to get the help they need. Through our partnership with the Health Department’s hepatitis patient navigation program at NYC H + H/Elmhurst, we play a vital role in helping New Yorkers overcome barriers to viral hepatitis care by connecting them to affordable, low-cost comprehensive primary and specialty care and ensuring they receive the necessary care and treatment to lead healthier lives. We hope this work is expanded to support viral hepatitis elimination in New York City.”

“We know that hepatitis B disproportionately affects Asian Americans, many of whom don’t know they have it, and if left untreated can lead to serious liver problems, including liver cancer,” said Emily Li, Project Coordinator at Public Health Research Center, Korean Community Services of Metropolitan New York, Inc. “As a proud partner of the Hep Free NYC coalition, Korean Community Services continues to provide free hepatitis B screenings to our Asian community members to identify new infections and provide follow-up care with our pro bono doctors as we continue to raise awareness about hepatitis B and liver cancer. Our screenings and education help us to address common misconceptions of hepatitis B and reduce the stigma against it within the Asian American community.”

In 2023, the Health Department continued its work to address the syndemic of hepatitis C and substance use disorder. Through a four-year partnership with Addiction Care Interventions, the Health Department facilitated access to hepatitis C and substance use services for 13,653 people at risk for overdose. The Health Department continued to partner with Mount Sinai REACH to offer hepatitis C treatment via telemedicine to people receiving care in two inpatient substance use treatment programs experienced in treating opioid use disorder. The programs admitted a total of 7,551 people, 96% of whom were screened for hepatitis C. The Health Department funds 14 syringe service programs across New York City which provide access to hepatitis C and HIV testing and counseling; free and sterile syringes and other safer use equipment to prevent transmission of hepatitis B and C, HIV, and other infections; overdose prevention and harm reduction education; fentanyl and xylazine test strips and naloxone; wound care; buprenorphine treatment and other onsite medical care; and referrals to other services.

“We strongly believe that co-location of hepatitis C treatment in opioid treatment programs (OTPs) is crucial in ultimately eliminating hepatitis C,” said Dr. Jesi Ramone, Medical Director of HIV/HCV Services at BMS Family Health Center. “Through our Health Department-supported Hepatitis C Patient Navigation Program, BMS Family Health Center has made a significant impact towards hepatitis C elimination in our community’s OTPs. However, there are still many untreated patients with multiple medical and socioeconomic challenges, highlighting the need for additional Health Department/OTP partnerships to ensure hepatitis C treatment is co-located and consistently available in OTPs.”

Since 2004, the Health Department has worked with community partners to convene Hep Free NYC, a citywide network of stakeholders working together to prevent, manage, and treat hepatitis B and C in New York City.

For more information, visit hepfree.nyc or email hep@health.nyc.gov.

For information on hepatitis A, B, or C, including how to find low- to no-cost services, visit nyc.gov/health/hepa, nyc.gov/health/hepb, or nyc.gov/health/hepc, or call 311.

Photo credit: Sietu Oronde.

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