The “Hepatitis C – It’s About More Than Liver Disease” project of the National Viral Hepatitis Roundtable (NVHR) aims to increase awareness among the healthcare and patient communities about the extrahepatic manifestations (EHMs) associated with chronic Hepatitis C virus (HCV) infection. Through the provision of educational materials and opportunities to engage in discussion, the project promotes the recognition of HCV infection as a systemic disease that requires a comprehensive approach to care in order to improve patient health outcomes.
By Amy Orciari Herman
Use of sofosbuvir-velpatasvir to treat hepatitis C virus (HCV) infection in injection drug users usually leads to a sustained virologic response at 12 weeks, according to an industry-supported study in the Lancet Gastroenterology & Hepatology.
Some 103 patients with chronic HCV infection (types 1–4) who reported injection drug use in the prior 6 months received sofosbuvir-velpatasvir once daily for 12 weeks. At baseline, three-quarters had injected drugs in the past month. Roughly 60% of participants were receiving opioid substitution therapy during the study.
Of 100 participants who completed treatment, 99 had an end-of-treatment response. The primary outcome — sustained virologic response 12 weeks later — occurred in 94% of all participants. Of the three participants who completed treatment but didn’t achieve the primary outcome, two were lost to follow-up and one had HCV reinfection.
Commentators note that although guidelines recommend HCV treatment for drug users, “stigma … has resulted in insurance restrictions and reluctance from providers to offer appropriate medical therapy.” They conclude that HCV-infected injection drug users “can and should be treated with direct-acting antivirals.”
Follow-up of this cohort is ongoing.
by Kenneth Bender
A best practice advisory (BPA) displayed in the electronic health record (EHR) of baby boomer patients in a multi-site healthcare system prompted a 5-fold increase of screening for hepatitis C virus (HCV) in the population that, according to the Centers for Disease Control and Prevention (CDC), has a 5-fold higher prevalence of HCV than other age groups.
Low screening rates for baby boomers in clinical practice have been noted in multiple studies, in spite of the CDC’s and US Preventive Services Task Force’s recommendation years ago, Monica Konerman, MD, Gastroenterologist and Clinical Lecturer, University of Michigan Hospitals and Health Centers, Ann Arbor, MI, told MD Magazine.
The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) launched the Hepatitis C: The State of Medicaid Access project.
This project includes a report that details hepatitis C treatment access restrictions in Medicaid programs in all states, the District of Columbia and Puerto Rico, including traditional fee-for-service as well as managed care. The report focuses on three of the most significant restrictions to treatment: liver damage, sobriety, and prescriber limitations. It is the most comprehensive public listing of these restrictions to date.
NVHR also issued report cards for each state Medicaid program. These report cards grade each state based on its restrictions and include recommendations for improving access to hepatitis C treatment. Colorado received a C+.
These materials are available for download at www.stateofhepc.org. The website also has a petition for advocates to sign calling for open access and will have media articles, resources and other materials.
By Robert Preidt, HealthDay Reporter
FRIDAY, Oct. 20, 2017 (HealthDay News) — Opioid abuse therapy may be more effective if patients are screened for hepatitis C as part of the program, a new Canadian study says.
The research found a sharp drop in opioid abuse among patients after they were told they tested positive for the hepatitis C virus (HCV). Hepatitis C causes liver disease that can lead to cirrhosis (scarring of the liver), liver cancer and liver failure, the researchers said.
“Our study showed awareness of HCV infection among this particular population may motivate them to reduce their consumption and hopefully high-risk behavior,” said lead investigator Dr. Hooman Farhang Zangneh, a postdoctoral research fellow at the Toronto Centre for Liver Disease at Toronto General Hospital.
By Amy Orciari Herman
A New York State law requiring healthcare providers to offer hepatitis C virus (HCV) antibody testing to patients born between 1945 and 1965 led to rapid increases in HCV testing and linkage to HCV care. The findings appear in MMWR.
The law, enacted in 2014, mandated that clinicians in primary care or inpatient settings offer HCV screening to age-appropriate patients who hadn’t been offered screening previously. (Since 2012, the CDC has recommended one-time HCV testing for this population.)
Laboratory data showed a 51% increase in the number of specimens collected for HCV testing in this age group during the first year of the law’s implementation, compared with the prior year. A similar increase was seen among Medicaid patients alone. In addition, the percentage of patients with newly diagnosed HCV infection who were linked to care increased by 40% (from 24% to 34%) between the two periods.
- People who use drugs can adhere to treatment
- Risk of re-infection among PWID is minimal
- Offering HCV curative treatment reduces the amount of transmissible disease within communities most affected
- Treatment of HCV among PWID is cost-effective and demonstrates the need for accessible, equitable insurance for all