CDC Integrated Viral Hepatitis Cooperative Agreement – National Call (February 22, 2022)
TLDRThe video script details a comprehensive discussion on advancing automatic HCV (Hepatitis C Virus) reflex testing among laboratory partners, as part of the integrated viral hepatitis cooperative agreement national call. The meeting, led by Chris Sang from the CDC's Division of Viral Hepatitis, includes presentations from Dr. Nicola Thompson on surveillance updates, Dr. Saleem Kamili on CDC's efforts to promote reflex testing, and Dr. Anne Gaynor from APHL discussing public health lab testing practices. The session also features insights from Dr. Ann Thomas and Heather Linardos on their respective state's laboratory surveys to assess and enhance HCV testing capacity. The discussion emphasizes the importance of reflex testing for timely diagnosis and care, addresses potential challenges such as contamination and reimbursement issues, and highlights the role of public health labs in providing cost-effective testing alternatives.
Takeaways
- 📋 The meeting focused on advancing automatic HCV reflex testing among lab partners, emphasizing the importance of this approach for timely diagnosis and treatment of hepatitis C.
- 👤 Chris Sang, the health department support lead, introduced the session and outlined the agenda, highlighting the packed schedule with several important updates and presentations.
- 🔍 The CDC is actively engaging with commercial and clinical labs to promote automatic reflex testing for HCV RNA, which is crucial for identifying current infections and linking patients to care.
- 🧪 High-performing nucleic acid testing (NAT) assays for HCV RNA detection are available, and their use supports the case for reflex testing when an anti-HCV test is positive.
- 🚀 Dr. Nicola Thompson provided updates on surveillance activities, including new personnel and the progress on the annual performance reports, emphasizing the importance of accurate data for public health strategies.
- 📉 The COVID-19 pandemic has impacted hepatitis C testing volumes, with lab closures and staffing challenges leading to decreased testing and increased turnaround times.
- 📈 Despite the pandemic, there has been a recovery in HCV testing volumes, indicating a resilience in public health surveillance systems and the potential for rebound post-pandemic.
- 💡 The Association of Public Health Laboratories (APHL) conducts regular surveys to assess testing practices and capacity, with the latest data revealing room for growth in HCV RNA testing.
- 🌐 The CDC and APHL are working to improve the integration of testing algorithms and promote the adoption of efficient testing practices, such as automatic reflex testing for HCV RNA when an antibody test is positive.
- 📝 Jurisdictional health departments, like those in Oregon and Connecticut, are conducting lab surveys to assess current practices and identify areas for improvement in hepatitis C testing and reporting.
- 💌 The NPIN Integrated Viral Hepatitis Community is a valuable resource for sharing information, tools, and best practices related to hepatitis testing and surveillance, encouraging collaboration among health departments.
Q & A
What is the main topic of today's talk?
-The main topic of today's talk is advancing automatic HCV (Hepatitis C Virus) reflex testing among lab partners.
Who is leading the health department support for this cooperative agreement?
-Chris Sang is the health department support lead for this cooperative agreement.
What is the purpose of the Q&A box during the meeting?
-The Q&A box is used for participants to submit their questions, including their name, organization, and the presenter they have a specific question for. Time permitting, questions will be addressed after all presentations.
What is the role of Dr. Nicola Thompson in the CDC?
-Dr. Nicola Thompson is the surveillance team lead in the division of viral hepatitis at the CDC.
What is the significance of the new viral hepatitis message mapping guide?
-The new viral hepatitis message mapping guide is expected to help streamline and improve communication regarding viral hepatitis cases, and it will be piloted, potentially starting in spring of the current year.
What is the goal of the NPIN viral hepatitis community?
-The goal of the NPIN viral hepatitis community is to share tools, resources, surveillance data summaries, annual reports, and outbreak response plans to aid in case investigation activities and connect with other health departments.
What is the current status of the 2020 annual surveillance report?
-The 2020 annual surveillance report, which includes mortality data for 2020, is in the process of being analyzed by the surveillance team. There has been a delay in the case reconciliation and closeout of the 2020 data, but the report is expected to be released sometime during the year.
What is the role of the Association of Public Health Laboratories (APHL) in the context of this meeting?
-APHL represents state and local governmental public health laboratories and works to improve public health laboratory systems and practices. They conduct surveys on testing practices and capacities, and in this context, they are providing an update on HCV diagnostics in U.S. public health laboratories.
What are the challenges faced by public health labs in relation to HCV RNA testing?
-The challenges include the cost of HCV RNA testing, with some labs struggling to afford it. Additionally, there can be issues with staffing, sample contamination, and the need for additional samples for HCV RNA testing in some cases.
How does the CDC plan to engage with commercial and clinical labs to promote automatic reflex testing for HCV RNA?
-The CDC is actively engaging with representatives from major commercial and clinical labs, as well as with diagnostic industry partners, to promote automatic reflex testing for HCV RNA. They are also exploring the introduction of additional diagnostic tools like HCV core antigen and point-of-care HCV RNA tests into the U.S. market.
What is the current state of HCV testing in public health labs according to the APHL survey?
-According to the APHL survey, a majority of public health labs are performing HCV antibody testing, and there has been an increase in the number of labs performing HCV RNA testing. However, there is still room for growth, as not all labs are performing automatic reflex testing from HCV antibody to HCV RNA.
What steps is the CDC taking to improve HCV diagnostics and promote reflex testing?
-The CDC has updated its HCV testing guidelines, held diagnostic conferences, established a work group on viral hepatitis diagnostics, and is engaging with commercial labs and diagnostic industry partners. They are also planning to initiate a survey to gather information on current reflex testing practices and future plans for incorporating new assays.
Outlines
😀 Introduction to the Viral Hepatitis Cooperative Agreement and Agenda
Chris Sang, the health department support lead for the integrated viral hepatitis cooperative agreement, opens the national call for 2103 recipients. He introduces the topic of advancing automatic HCV reflex testing among lab partners and notes the invitation extended to public health lab partners. The agenda is packed, and housekeeping items include muting participants upon entry, submitting questions through the Q&A box, and addressing potential technical issues with Dionne. Upcoming events and CDC updates are also mentioned, with a focus on surveillance team updates and the introduction of a new surveillance officer, Karen Lewis.
📋 Updates on Surveillance, Quality Assurance, and Viral Hepatitis Messaging
Dr. Nicola Thompson provides updates on the surveillance team, including the analysis of the 2020 annual surveillance report and the impact of missing data on epidemiologic analyses. She also discusses the submission of year one annual performance reports and the verification process for certain responses. Quality assurance reports are highlighted, with a focus on data completeness and timeliness. An upcoming viral hepatitis message mapping guide and a pilot led by CSELS are announced. The importance of sharing tools, resources, and data summaries within the NPIN viral hepatitis community is emphasized.
📈 HCV Diagnostics and Promoting Reflex Testing in Laboratories
Dr. Saleem Kamili discusses the importance of HCV RNA testing in diagnosing current HCV infection and the benefits of automatic reflex testing. He outlines the steps taken by the CDC to promote reflex testing, including the publication of guidelines, holding diagnostic conferences, and engaging with commercial and clinical labs. The potential challenges of contamination are addressed, along with the CDC's efforts to explore additional diagnostic tools and revise the current diagnostic algorithm.
🧪 Technical and Logistical Considerations for HCV Reflex Testing
The paragraph delves into the technical aspects of HCV reflex testing, addressing concerns such as contamination and the use of disposable sample probes. It outlines the steps taken by the CDC to promote reflex testing for HCV RNA, including the establishment of a work group focused on viral hepatitis diagnostics. The paragraph also mentions the exploration of new diagnostic tools and the potential down-classification of HCV diagnostics by the FDA, which could facilitate the development of additional tools.
🔬 APHL's Role in Expanding HCV RNA Testing and Surveying Public Health Laboratories
Anne Gaynor from APHL provides an overview of the organization and its mission. She discusses the survey conducted on HCV testing capacity and algorithms, highlighting the impact of COVID-19 on testing volumes and practices. The survey results indicate a stable number of labs performing HCV testing, with room for growth. Challenges such as staff turnover, shortages of testing supplies, and the need for batching due to decreased specimens are also covered. The potential for increasing HCV testing within the public health lab system is emphasized.
🏥 Oregon's Laboratory Survey on HCV Reflex Testing Practices
Dr. Ann Thomas details Oregon's efforts to survey laboratories on their HCV reflex testing practices. The goal is to identify all labs conducting hepatitis testing and determine their policies on reflex testing. The survey also aims to understand the barriers to reflex testing and reporting methods. Dr. Thomas discusses the process of contacting known labs, sending out surveys, and following up with non-respondents. The response rate and findings from the survey are shared, along with plans for future engagement with large health systems and insurance companies.
📝 Connecticut's Clinical Lab Survey and HIV Surveillance Integration
Heather Linardos describes Connecticut's approach to integrating hepatitis C surveillance with HIV surveillance efforts. She outlines the organization's structure, the allocation of resources, and the importance of understanding relationships between primary and reference laboratories. The impact of the COVID-19 pandemic on testing volumes is discussed, along with the use of SurveyMonkey for conducting the HTB add-on survey. The survey results and next steps, including feedback to labs and potential inclusion in the elimination plan, are also covered.
🤝 Collaboration and Resource Sharing in Viral Hepatitis Surveillance
The final paragraph emphasizes the importance of utilizing the NPIN Integrated Viral Hepatitis Community for resource sharing and collaboration. It highlights the availability of jurisdictional resources, including lab surveys and health systems assessments. The paragraph also addresses questions from participants regarding the updating of guidelines to reduce contamination, the scope of DVH's survey on clinical labs, and the challenges of working with insurance companies on reimbursement issues. The potential for public health laboratories to offer more cost-effective testing is mentioned, and the policy of APHL on data sharing is clarified.
Mindmap
Keywords
💡HCV Reflex Testing
💡CDC
💡Public Health Laboratories
💡HCV RNA
💡Contamination
💡APHL
💡Surveillance Officer
💡
💡Annual Performance Reports (APR)
💡Quality Assurance (QA) Reports
💡Viral Hepatitis Message Mapping Guide
💡Hepatitis B and C Testing Capacity
Highlights
Chris Sang introduces the integrated viral hepatitis cooperative agreement national call for 2103 recipients, emphasizing the importance of advancing automatic HCV reflex testing among lab partners.
Dr. Nicola Thompson provides updates on CDC surveillance activities, including a new surveillance officer for region C and the review process for year one annual performance reports.
The CDC is preparing the 2020 annual surveillance report, which includes finalized mortality data and NNDSS data, despite delays due to case reconciliation challenges.
Dr. Saleem Kamili discusses the benefits of automatic reflex testing for HCV RNA, emphasizing the need for a single-step testing approach to expedite the elimination of hepatitis C.
Dr. Kamili also addresses technical challenges and strategies for promoting reflex testing, including engaging with commercial labs and the diagnostic industry.
Kari Sapsis, Communication Team Lead, updates participants on the release of the 2022 adult immunization schedule featuring new hepatitis B adult vaccine recommendations.
Anne Gaynor from APHL presents insights from the 2021 public health lab viral hepatitis survey, highlighting the impact of COVID-19 on testing volumes and practices.
Dr. Ann Thomas shares Oregon's experience with conducting a lab survey to assess hepatitis testing practices and the implementation of automatic HCV reflex testing.
Heather Linardos discusses Connecticut's approach to clinical lab surveys and the integration of hepatitis C testing into existing HIV surveillance efforts.
The meeting emphasizes the use of the NPIN Integrated Viral Hepatitis Community as a resource for sharing information and best practices among jurisdictions.
Dr. Kamili clarifies that the CDC's survey on reflex testing is limited to major labs and not aimed at all clinical labs, to avoid overlaps with health department efforts.
Discussion on the challenges of reimbursement for HCV RNA testing, especially when considered diagnostic rather than screening, and its impact on underinsured individuals.
APHL's data sharing policy is mentioned, with a commitment to sharing data in aggregate form but not at the jurisdictional level.
The importance of working with insurance companies to address reimbursement issues for HCV testing is acknowledged as a critical next step.
Dr. Gaynor emphasizes the potential cost-effectiveness of public health laboratories for HCV testing and encourages jurisdictions to explore this option.
The session concludes with thanks to the speakers and a reminder for participants to utilize available resources and communities for further collaboration and support.
Transcripts
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