CN Hepatitis C Elimination Program featured for high cure rate

Cherokee Nation’s innovative Hepatitis C Virus Elimination Program was recently featured in a Centers for Disease Control report touting its high cure rate of Cherokee citizens.

The article evaluated the program’s efforts after five years of implementation.

In that five-year span, Cherokee Nation Health Services diagnosed 1,423 patients with the virus and 86% of those patients were evaluated for treatment. Among those, 61% received medication for treatment and 99% of the individuals who completed their HCV treatment were cured.

“In Indian Country, we know that American Indian and Alaska Natives are disproportionately affected by the hepatitis C virus and that the Cherokee Nation continues making every effort to eliminate this virus within the reservation by providing effective treatment and cures and better health outcomes for our Cherokee families,” Cherokee Nation Principal Chief Chuck Hoskin Jr. said.

According to the report, 2.4 million people in the United States have hepatitis C with 66,700 acute cases. American Indian or Alaska Natives are disproportionately affected and experienced the highest rates of acute infections.

Cherokee Nation Health Services implemented the Hepatitis C Virus Elimination Program in 2015, which includes universal HCV screening, primary care HCV workforce expansion, and harm reduction services.

Part of the program’s efforts includes primary care providers and pharmacists presenting hepatitis C patient cases to the infectious diseases team for recommendations and treatment, so patients would not have to travel from their home clinic to see a specialist, making it more accessible.

“Many patients do not know that they are infected with HCV, but with fast evaluation and proper treatment, HCV is curable,” said Cherokee Nation Health Services Director of Infectious Diseases Dr. Jorge Mera, who oversees the program. “The main barrier for treatment is the lack of access to medications that cure HCV infection at the time of evaluation. When discussing plans for the program moving forward, it is important for all health care providers to be involved in screening, evaluation and treatment for HCV elimination to occur. Physician assistants, nurse practitioners, pharmacists and primary care physicians saw the majority of the patients who were evaluated for HCV in the Cherokee Nation, and we will continue to work together here to achieve our goals.”

The tribe’s Hepatitis C Virus Elimination Program garnered national attention on Hepatitis Testing Day from the White House in 2016. The recent CDC report noted that the program in Cherokee Nation is a model for other health systems, especially those serving Native American patients.

“I’m proud of the difference this program is making in the lives of our citizens and, as noted in the CDC report, I know that community participation is also essential for complete elimination of this virus within the reservation and even better outcomes in the days ahead,” Cherokee Nation Deputy Principal Chief Bryan Warner said. “The exceptional work of our infectious disease experts, Dr. Jorge Mera and Whitney Essex, and health team is making true change.”

Cherokee Nation has also identified ways to make the program even stronger: working to close the gaps in HCV care, starting with same-day treatment, ensuring that HCV medications are on site at each health facility, and eliminating prior authorizations for medications for increased access.

Cherokee Nation and Cherokee Nation Health Services officials also recently hosted a visit from Gilead Sciences and the Oklahoma State Department of Health to discuss further strategies for evaluation, testing and treatment.

To read the full CDC article, visit https://www.cdc.gov/mmwr/volumes/72/wr/mm7222a2.htm?s_ cid=mm7222a2_w. To learn more about HCV, HIV and Behavioral Health Harm Reduction services, visit https://health.cherokee.org/services-andprograms/