What tools are needed to eliminate the hepatitis C epidemic?

Paul Basilio, MDLinx | June 19, 2017

A new report from O’Neill Institute for National and Global Health Law at Georgetown University highlights a key element that is needed to achieve complete elimination of hepatitis C (HCV).

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Relatively modest investments can have a big impact toward eliminating HCV.

Adequate surveillance and monitoring were the focus of the report, which detailed how modest investments could improve lives and decreases costs.

An estimated 3.5 million patients in the US currently have HCV infection, according to the CDC. New infection rates have increased nearly 2.9-fold between 2010 and 2015.

The report states that effective medicines are available to treat and often cure hepatitis C, but information is lacking to know where to “deploy critical public health and health care resources to prevent new infections, screen and diagnose cases, and treat all of those who are infected with the virus,” write the authors.

The study was written by Institute Associate Sonia L. Canzater, JD, MPH, and Jeffrey S. Crowley, MPH, Program Director of Infectious Disease Initiatives and Distinguished Scholar at the O’Neill Institute. It was developed following an expert consultation with diverse stakeholders, including hepatitis C medical and non-medical providers, patient advocates, epidemiologists, and federal hepatitis C policy and program staff.

 Crowley and Canzater identify five critical actions that should be priorities for monitoring HCV:

  • Expand and standardize reporting to the CDC
  • Utilize electronic medical records to collect data on HCV cases and the cure cascade
  • Fund epidemiologic research using clinical data sets
  • Integrate improved monitoring of HCV with responses to the opioid epidemic
  • Establish and monitor HCV elimination plans across major US health systems.

“Even with a constrained federal budget, more resources are needed for HCV surveillance and monitoring,” Mr. Crowley said. “Relatively modest investments, however, can have a big impact toward eliminating HCV.”

Dr. Canzater added that most of the newly infected HCV cases are among injection opioid drug users. “[However,] we often do not have even basic information to adequately monitor where and how the HCV epidemic is unfolding in the US and we are not using the clinical data that is already collected.”

Both Dr. Canzater and Mr. Crowley say eliminating HCV would lead to a plummet in liver cancer rates, as HCV was responsible for half of the nearly 23,000 liver cancer deaths in 2010. Almost $300 million a year in health care costs could be saved by avoiding the liver transplant surgeries caused by HCV.  

“Unlike some pressing problems where the scope of need is so large it can be immobilizing, modest new investments can have a significant impact,” the authors write. “Boosting the capacity to monitor the HCV epidemic can move the nation toward eliminating HCV as a public health threat in the United States.”

The report is available for free on the O’Neill Institute website.

This project is supported by funding from Gilead Sciences, Inc. Gilead had no editorial control over the content of the report. Mr. Crowley received an honorarium from Gilead for a speaking engagement unrelated to this report. Dr. Canzater reports no recent personal financial interests related to the report.

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