National American Indian and Alaska Native Heritage Month

• recommending routine vaccination of children against hepatitis A and hepatitis B;
• consulting with the Indian Health Service to integrate viral hepatitis prevention messages into existing HIV and sexually transmitted disease prevention programs;
• developing programs to identify American Indian and Alaska Natives with viral hepatitis;
  helping to improve access to medical care and treatment options;
• funding education and prevention projects;
• examining risk factors and co-factors for viral hepatitis; and
• assisting in calculating the numbers of people with viral hepatitis and chronic liver disease in American Indian and Alaska Native communities.
  
  
  

Hepatitis A: Not as common as it used to be

Until recently, epidemics of hepatitis A, caused by hepatitis A virus (HAV), occurred every 5 - 10 years in most American Indian and Alaska Native communities. In 1996, the Advisory Committee on Immunization Practices recommended routine hepatitis A vaccination for all American Indian and Alaska Native preschool children beginning at age two years and catch-up vaccination for school-age children. Following these recommendations, American Indian and Alaska Native communities implemented widespread hepatitis A vaccination programs. Since these communities began widespread vaccination programs, the number of people infected with HAV has decreased dramatically. Today, hepatitis A is less common in American Indian and Alaska Native communities than in the rest of the nation.

Hepatitis B: Vaccine prevents HBV infections, saves lives

Hepatitis B, caused by hepatitis B virus (HBV), was quite common in Alaska Natives before the early 1980s. In some Alaska villages, greater than 80% of the population had been infected with HBV. Alaska Natives had the highest rates (about 8%) of chronic (long-term) HBV infection and the highest rates of liver cancer of all racial/ethnic groups in the United States.

However, when hepatitis B vaccine became available in the early 1980's, a program was started to vaccinate all newborn Alaska Natives and to also vaccinate as many older children as possible. Since that time, few Alaska Natives have gotten infected with HBV. A generation of Alaska Native children has grown up without worrying about HBV infection and its consequences.

Recently, outbreaks of hepatitis B among American Indians have occurred in the lower 48 states. These outbreaks have primarily occurred among illegal injection drug users and highlight the continued need for vaccination of adults who practice such high-risk behaviors.

Hepatitis C: Prevention Strategy

Hepatitis C, caused by the hepatitis C virus (HCV) occurs among persons of all ages, but more new cases of hepatitis C are found among persons aged 20 - 39 years and among males. Very little is known about how common acute or chronic HCV infection is among American Indian and Alaska Natives. However, infection with HCV can lead to chronic liver disease and chronic liver disease is the 5th leading cause of death among American Indian and Alaska Natives compared to the 9th leading cause in the general United States population.

Native American and Alaska Native community leaders are working with CDC to prevent HCV infections and progression to HCV-related chronic liver disease in their communities. Some of the prevention activities include

• screening national blood, tissue, and organ supplies;
• finding, testing, and counseling those at risk for HCV infection;
• providing proper medical management to those who are chronically infected;
• implementing practices in health-care settings that reduce risks for HCV infection;
  counseling people about how to reduce their risk for HCV infection;
• educating health professionals and community members; and
• tracking and recording numbers of new cases of hepatitis C to evaluate the effectiveness of prevention activities.

For more information

Contact the Epidemiology Program of the Indian Health Service to find out more about preventing viral hepatitis in American Indian and Alaska Native communities.

Indian Health Service
National Epidemiology Program
5300 Homestead Road NE
Albuquerque, NM 87110
505-248-4226
505-248-4393 FAX

American Indian and Alaska Native Health Care Web Sites

• Area Offices and Facilities
  List of Native American and Alaska Native health care centers by geographic location

• Health Care Information
  Health care resources such as Medicare/Medicaid, and clinical practice guidelines

• American Association of Indian Physicians (AAIP)
  Health and Information Services

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This page last reviewed October 1, 2004

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