Though cardiovascular disease, diabetes, Alzheimer’s, and others have remained among the greater drivers of mortality, other conditions have spread like wildfire in just less than 3 decades. Among them, opioid use disorder (OUD) mortality has raised by 447.3%, and liver disease due to hepatitis C by 75.4%.
With the rise of these conditions also came the fall of previously-feared epidemics: HIV/AIDS, a public health crisis and the 13th-leading cause of death in 1990, killed fewer Americans in 2016 than 50 other conditions. Access to highly-efficacious antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and a growing understanding of how and when to test at-risk patient populations have made HIV a good example of clinical response to a growing disease.
Bold move from leadership will reduce deaths from hepatitis C in Oregon
OREGON CITY, OR, November 30, 2018 – Caring Ambassadors Program applauds the bold leadership shown by Governor Brown and the Oregon Health Authority (OHA) this week. On Wednesday, the Governor introduced her budget which includes funding for hepatitis C treatment and a forward-looking statement that brings our state into alignment with the World Health Organization’s goal of hepatitis C elimination by 2030.
From Governor Brown’s budget “• Ending Hepatitis C – New treatments exist to cure individuals living with Hepatitis C. An investment in the 2017-19 biennium enabled OHA to expand treatment to Oregon Health Plan patients with later stages of the disease. The Governor’s Budget increases this investment with an additional $10 million General Fund to ensure treatment is available to Oregon Health Plan members with any stage of the disease and puts the state on track to eradicate the cascading effects of Hepatitis C infections.” [2019-2021 Governor’s Budget, State of Oregon]
The second bold move critical to hepatitis C elimination was the vote on Thursday by the Pharmacy and Therapeutics committee to remove all restrictions on access to the curative treatments.
Currently, Oregon has the highest hepatitis C mortality rate in the country. These aggressive moves by leadership can change that unfortunate statistic and save future lives and precious healthcare resources for all Oregonians.
“We look forward to working with the legislature to ensure the funding remains in the budget and with OHA and the community to develop Oregon’s elimination strategy,” said Lorren Sandt, Executive Director of Caring Ambassadors Program. “We have all the tools now to make elimination a reality, thanks to the support of our leadership.”
About Caring Ambassadors Program
The Caring Ambassadors supports individuals in gaining control of their healthcare, regardless of the illness they face.
We provide information, tools, and resources to help those with any long-term disease not only manage their health care after a diagnosis but improve their quality of life and capacity for healing. As an advocacy organization, we both fight for patient rights and work to build a new generation of patient and healthcare champions. Our disease-specific programs for Hepatitis C and Lung Cancer have been helping people obtain the support, assistance, and information they need for over 20 years.
Hepatitis C virus (HCV) coinfection increases the risk of preterm birth in women with HIV four-fold to those with lone HIV, according to a new study.
Justyna Kowalska, MD, PhD, of the Hospital for Infectious Diseases and the Medical University of Warsaw, told MD Magazine® the study aimed to give greater clarity to the roles of HCV and HIV in the pregnancies of coinfected women.
“It is well recognized in [the] mono-HCV infected population that HCV replication affects intrauterine fetus growth and can also lead to preterm delivery,” she said.
It’s hard to believe that the end of the year is near and the HCV Advocate newsletter is entering its 21st year of publication. This month we have devoted the entire issue to coverage of The Liver Meeting recently held in San Francisco, CA. Lucinda Porter, RN and I are reporting on our favorite posters presented at the meeting. Listed below are the abstracts that we have covered.
#584 Early Treatment with Direct-Acting Antivirals (DAAs) Saves Medical Costs in Non-Cirrhotic Patients with Chronic Hepatitis C (CHC) Virus Infection in the United States (US)- Patrice Cacoub, et. al.
Summary: In this review, the authors discuss the challenges in the development of a fully protective vaccine against the hepatitis C virus (HCV). The obstacles include overcoming how quickly the HCV mutates or changes its genetic make-up, the limited animal models available to test an HCV protective vaccine and our limited understanding of the HCV immune response. The authors conclude that these obstacles will need to be overcome to develop an effective protective vaccine in order to effectively eliminate HCV. It is unlikely that a protective vaccine will be developed in the very near future but progress is being made.
Title: Australia on track to achieve WHO HCV elimination targets following rapid initial DAA treatment uptake: a modeling study—J.A. Kwon, et. al.
Summary: This study evaluated the likelihood that Australia would reach their target goal to eliminate HCV by 2030. Using a mathematical model to simulate the epidemiology and death rates in Australia over the period 2016-2030. Australia had a very fast rate of people who initiated direct-acting antiviral therapy (DAA) in 2016 with 32,600 people treated. It should be noted that the Australian government subsidizes the cost of HCV medications.
In their analysis, Australia should meet the WHO target of HCV elimination of 10 to 15 years. However, the authors noted that due to the number of people who already had HCV disease progression prior to the beginning of the approval of DAA therapies, it would be difficult to achieve the WHO target mortality or deaths.
Title: Eight-week hepatitis C treatment with new direct-acting antivirals has a better safety profile while being effective in the treatment-naïve geriatric population without liver cirrhosis and hepatitis C virus-RNA < 6 Million IU/mL—B. Yanny, et. al.
Study Aims and Results: Currently, eight weeks of Harvoni (ledipasvir plus sofosbuvir) is the recommended treatment period for people with hepatitis C (HCV) genotype 1, treatment naïve, without cirrhosis and who have an HCV viral load less than 6 million. The goal of the study was to find out if the recommended eight-week treatment duration can be applied to people over 65 years old.
A total of 454 patients were enrolled in the study—82 patients were treated for eight weeks, and 272 patients were treated for 12 weeks. The two groups were evenly matched for sex and age. All of the people were over 65 years old.
The cure rate in the 8-week group was 93% vs. 95% in the 12-week group. Eight-weeks of Harvoni was found to be safe, better tolerated and as effective compared to the 12-week Harvoni treatment group. As expected, the costs and treatment-related side effects in the 8-week treatment group were lower compared to the 12-week treatment group.
Conclusion: Treating people over 65 years old for eight weeks using the same patient characteristics as people treated for 12 weeks is as effective, produced fewer side effects, and is cost-effective.
Editorial Comments: This study showed that people over 65 years old could reap the benefits of an eight-week treatment of Harvoni.
A shorter treatment period will help to reduce side effects and increase medical insurance approval. Since people over 65 years old are more likely to take more medications, I would like to understand what benefit this would have for these persons.