Hepatitis C Update and Expanding the Role of Primary Care
Primary care physicians (PCPs) are increasing their role in the fight against the Hepatitis C Virus (HCV). Approximately 3.5 million Americans currently live with chronic HCV with rising incidence among young persons, especially those affected by the opioid epidemic. Online guidelines and drug interaction checkers streamline treatment and increase accessibility for both patients and providers. Although treatment with new Direct Acting Antiviral agents ensure cure rates that routinely exceed 95%, as well as cause fewer adverse effects than previously available interferon-based regimens, some states still restrict access to HCV treatment, including by mandating which providers can prescribe and treat HCV. This special communication reviews HCV treatment resources, discusses data demonstrating similar cure rates between PCPs and specialists, and argues that capacity-building among PCPs will be necessary to control the HCV epidemic.
The Indian Health Service (IHS) has awarded $2.4 million to nine Tribal Epidemiology Centers to support the reduction of HIV, hepatitis C, and sexually transmitted infections in American Indian and Alaska Native communities. The Tribal Epidemiology Centers plan to implement a national strategy to diagnose, treat, prevent, and respond to HIV, with the goal of ending the epidemic by 2030.
Authors: Li M, Zhuang H, Wei L Abstract Introduction: Hepatitis C virus (HCV) infection is a major global health concern on the rise, prompting unprecedented efforts by the World Health Organization (WHO) to eliminate this epidemic by 2030. Being the country with the largest HCV-infected population in the world, China has been faced with a general lack of awareness for HCV, low treatment uptake and subpar collaborations among healthcare providers and stakeholders. Areas covered: This review discusses the epidemiological situations of HCV infection and the challenges in HCV management in China. This review also expl...
With one in every 20 Pakistanis already infected, Pakistan has the second largest number of hepatitis C virus (HCV) infections globally. The aim of this study was to present a quantitative and analytical chara...
An unprecedented number of heart transplants were performed in the United States during 2016,1 yet 15% of patients on the waitlist either died or became too sick for transplant.2 Wait times remain unacceptably high for heart transplant candidates. As a result, there has been growing interest in the development of innovative strategies to mitigate the donor organ shortage. During the past decade, the opioid epidemic in the United States has led to a dramatic increase in the number of organ donors who died as a result of drug intoxication.
Source: Centers for Disease Control and Prevention (CDC). Published: 8/14/2019. The intertwined epidemics of prescription opioid, heroin, and methamphetamine use in Southern Appalachia, including western North Carolina, are driving a new wave of hepatitis C virus (HCV) infections. This one-hour, 17-minute presentation discusses the Southern Appalachia Test Link Care (SA-TLC) project, a coalition of public health and healthcare partners working to strengthen regional health and service infrastructures that are addressing the injection drug use epidemic in western North Carolina. (Video or Multimedia)
In the past, donors with hepatitis C (HCV) viremia were rarely accepted for orthotopic heart transplantation (HT) due to post-transplantation risks. A successful cure, the opiate epidemic and the shortage of available donors have led to a paradigm shift with increasing HT from HCV donors. We sought to examine the temporal and regional trends utilizing a national database.
PCPs knowledgable in HCV treatment and management are needed to help control the epidemic. Find resources here.Journal of the American Board of Family Medicine
Authors: Tang Q, Zhang X, Lu H Abstract Acquired immune deficiency syndrome (AIDS), hepatitis B virus (HBV), hepatitis C virus (HCV), gonorrhea and syphilis are the major sexually transmitted diseases (STDs) in the world, which are the focus of epidemic prevention and control in China. The epidemiological trend analysis of STDs in Shanghai could reflect the epidemic situation of these diseases in high-income areas of China, providing a reference for how to control their epidemic. Although the overall incidence rate of infectious diseases levelled off after 2009, Shanghai still faces many new obstacles in the fight ...
CONCLUSIONS: Increased-risk donor organs provided high levels of utility in liver transplant recipients who were anti-HCV positive, showing optimal graft and patient survival. Increased-risk donors were younger and preferably transplanted in hepatitis C virus RNA-positive recipients with lower Model for End-Stage Liver Disease score. Posttransplant direct-acting antiviral therapy was highly efficacious irrespective of pretransplant recipient and donor virologic status. PMID: 31324136 [PubMed - as supplied by publisher]
ConclusionsRates of ODD utilization in lung transplantation have increased in accordance with the opioid epidemic, but there remains a significant pool of ODD pulmonary allografts with favorable characteristics that are discarded. With no significant difference in survival between ODD and non-ODD recipients, further expansion of this donor pool may be appropriate and pulmonary allografts should not be discarded based solely on ODD status.