Chronic Viral Hepatitis Registry

Objectives of the Registry

• To obtain risk factor and demographic information about persons with chronic hepatitis B or C viral infection (HBV or HCV) in San Francisco
• To inform persons with chronic hepatitis B (HBV) or hepatitis C (HCV) about how to prevent transmission of the disease to others

Funding

Funding is provided by the U.S. Centers for Disease Control & Prevention (CDC), Division of Viral Hepatitis.

Registry Data

• Knowledge of Hepatitis B Risk Factors and Prevention Practices among Individuals Chronically Infected with Hepatitis B in San Francisco, California. This article appears in the Journal of Community Health and presents findings from chronic hepatitis B enhanced surveillance activities to assess risk factor knowledge and prevention practices in a random sample of persons with chronic hepatitis B infection who were reported to SFDPH between October 2007 and July 2009. The final publication is available at www.springerlink.com. Nishimura A, Shiono P, Stier D, Shallow S, Sanchez M, Huang S. Knowledge of hepatitis B risk factors and prevention practices among individuals chronically infected with hepatitis B in San Francisco California. Journal of Community Health 2011. DOI: 10.007/s10900-011-9430-2.
• Registry Match: Chronic Hepatitis B, Hepatitis C Infection and HIV 2010 San Francisco, California. This report summarizes findings from a collaboration between the SFDPH Chronic Viral Hepatitis Registry Project and the SFDPH HIV Epidemiology Section to link their respective databases in 2010.
• Chronic Hepatitis B and Hepatitis C Infection Surveillance Report 2009, San Francisco. This report provides overviews of hepatitis B and hepatitis C infection, a description of the SFDPH Chronic Viral Hepatitis Registry, findings of chronic hepatitis B and past or present hepatitis C infection core surveillance and findings of chronic hepatitis B enhanced surveillance activities collected from January 1, 2009 through December 31, 2009.
• Evaluation of the Impact of Electronic Reporting on the Completeness of Data, May 1, 2008 - June 30, 2009, San Francisco. This report provides an initial assessment of the impact of automated electronic laboratory reporting of positive laboratory results for chronic hepatitis B and hepatitis C on the completeness of data in the SFDPH Chronic Viral Hepatitis Registry for the period from May 1, 2008 through June 30, 2009.
• Chronic Hepatitis B Surveillance Report, 2007-2008, San Francisco. This report provides an overview of hepatitis B infection, a description of the SFDPH Chronic Viral Hepatitis Registry, and findings of both core and enhanced surveillance activities on data collected from January 1, 2007 through December 31, 2008.
• MMWR 2007; 56(18):446-448.  Characteristics of Persons with Chronic Hepatitis B --- San Francisco, California, 2006.
• Reprinted in JAMA 2007; 298(2):167-68. Characteristics of Persons with Chronic Hepatitis B --- San Francisco, California, 2006.

Case Definitions

• Current Hepatitis B virus (chronic) case definition (2007) and the prior case definition (2003)
• Current hepatitis C virus infection case definition (2005)

Data Sources- Role of Clinical Laboratories

Regulations making certain positive HCV tests laboratory-reportable to the local health department were enacted in June, 2007.  Laboratories are now required by the CA Code of Regulations, Title 17 Section 2505 to report positive results of both HBV and HCV tests to the San Francisco Department of Public Health. In addition to test results, labs are required to report patient identifiers (e.g. name, DOB, gender, medical record no.) and provider identifiers (e.g. name, facility).

The San Francisco Department of Public Health reviews the test reports, organizes them by person in an electronic database, and removes duplicates.  CDC criteria are applied to test results used to identify persons with chronic viral hepatitis.

Data Sources- Role of San Francisco Health Care Providers

When San Francisco residents meet CDC criteria for chronic HBV or HCV, the San Francisco Department of Public Health contacts the provider for information unavailable from laboratory reports alone. 

A simple, one-page data collection form is sent to the health care provider who ordered the most recent positive HBV or HCV test.  The data collection form asks about hepatitis risk factors, demographics, and other patient attributes. Providers complete the form and return it by fax to (415) 554-2878 at the SF Dept Public Health.  SFDPH maintains the confidentiality of all patient data.

Providers are required by the CA Code of Regulations, Title 17 Section 2500 to report cases of viral hepatitis, including chronic HBV and HCV, to SFDPH.  See instructions for reporting.

Data Sources- Role of San Francisco Residents

From 2007-2009 SFDPH completed telephone interviews with SF residents with chronic hepatitis B identified via the registry database.  Information was gathered about household and intimate contacts at risk for HBV acquisition and about practices used to prevent disease transmission.  Interviewers provided educational information to patients about preventing HBV spread and about monitoring for liver disease and liver cancer.  Written materials were mailed to interviewees at the close of the interview to reinforce the preventive care messages.  Interviews of SF residents with chronic hepatitis C will begin in 2010.

Project Team

• Melissa Sanchez, PhD MA - Project Director
• Sue Shallow, MPH - Lead Project Epidemiologist
• Sandra Huang, MD - Director, Communicable Disease Control Unit
• Amy Nishimura, MPH - Project Coordinator
• Martina Li - Surveillance Assistant
• Rachel Arrington - Surveillance Assistant
• David Stier, MD - Medical Epidemiologist

For More Information

• Frequently Asked Questions
• Contact Melissa Sanchez, PhD MA, Project Director.  Tel: (415) 554-2830 Email: melissa.sanchez@sfdph.org
• Project Fax Line (415) 554-2878