Hepatitis epidemic hits Hawaii harder than other states

HONOLULU (KHON2) — Viral hepatitis C is curable. Hepatitis B is treatable. Both are preventable — so, why does one U.S. state have such high rates of it?

Did you know that Hawaii has higher liver cancer mortality due to hepatitis B and C than the continental United States?

“When we look at hepatitis B, and hepatitis C specifically, we also see higher death rates of both of those compared to the continental U.S.,” says Hawaii Department of Health’s Viral Hepatitis Prevention Coordinator Thaddeus Pham. “People who die from hepatitis in Hawaii — hepatitis C specifically — can die up to 20 years earlier than residents in the rest of the state.”

That’s right. There’s a 20-year difference in life expectancy between those who contract the curable hepatitis C and those who don’t have it.

Pham and the DOH are in the middle of developing a surveillance infrastructure as part of the HepFree by 2030 campaign, which will track the spread of viral hepatitis and hopefully begin pinpointing specifics on who is contracting hepatitis and how.

Now, don’t let the word surveillance scare you. It’s not what you may think. This is a system that will allow the DOH to help those who have contracted viral hepatitis in order to get them link to care and help develop prevention strategies.

There are three types of hepatitis.

Hepatitis A

Hepatitis A is contracted when a person comes into contact with contaminated fecal matter in their mouth. This has been seen with foods that have been the conduit that spreads hepatitis. These foods are oftentimes imported into the United States.

It is preventable with a vaccine, but some people will develop a natural immunity to it. However, if you do contract it through contaminated food, then it is important to know the source. This is one of the ways where the surveillance system that Pham is working on comes into play.

Hepatitis B

Hepatitis B is spread in much the same way as HIV. So, from mother to child, through sexual transmission or by coming into contact with blood that is contaminated. There is no cure for hepatitis B. Pham said that is can be controlled through simple and safe medication.

So, if you get chronic hepatitis B, then you are going to take treatment to keep the virus down. But you will always have it. However, you can prevent contraction by getting vaccinated.

Hepatitis C

Hepatitis C is spread from blood to blood. Typically, this is the hepatitis that comes along with sharing drug paraphernalia, things like needles. Although hepatitis C is curable through short, safe treatment, there is no immunity or vaccine.

The numbers

Pham provided KHON2.com with some statistics on how hepatitis is impacting Hawaii. He pointed out that because the surveillance system is still being developed, there is still much to learn from collecting data and observation.

• Hepatitis B mortality rates – DOH report.
  • Hawaii has higher rates than U.S. from 2000 to 2020.
    • Hawaii rate was 3 times higher than U.S. in 2019.
  • Within Hawaii, higher rates among Asian and Pacific Islander (1.2 to 1.4 times) residents, compared to state average.
• Liver cancer mortality rates – DOH report.
  • Hawaii has higher rates than U.S. from 2000 to 2020.
  • Hawaii rates increased from 2000 to 2020 with 7.96 per 100,000 to 9.41 per 100,000.
  • Rates partially driven by disparities among Asian and Pacific Islander residents.
  • Note: HBV and HCV are leading causes of liver cancer in Hawaii, per journal article.
• HCV mortality rates – Journal article and CDC data.
  • HCV is associated with up to 20 year lower life expectancy compared to the rest of the state.
  • Hawaii is the state with highest proportion of NHAPI decedents among HCV-listed deaths (2016-17).

The spread of hepatitis C is why things like syringe exchanges are so important for prevention. You can visit HepFree2030 for information and resources.

Pham said that the Centers for Disease Control and Prevention recommends that all adults, regardless of your perceived risk, be tested at least one time for both hepatitis B and C.