Wednesday, May 25, 2011

Hepatitis C Perspective: Test and treat this silent killer

Today an editorial written by Brian R. Edlin was published online at Nature addressing the lack of funding by the U.S. government  for research, prevention, and treatment of hepatitis C. Mr. Edlin points out that five times as many people are infected with Hepatitis C then HIV.

The author writes;
The US government has all but ignored the threat of HCV and is underfunding prevention, treatment and research into the disease (see nature for  'US Response to the HIV and viral hepatitis epidemics'). The Action Plan to Prevent, Care and Treat Viral Hepatitis, which was released in May 2011 by the US Department of Health and Human Services in response to the IOM report, does not include an intention to increase funding for viral hepatitis.

Control of any epidemic starts with an accurate understanding of the magnitude of the problem, but the scope of the HCV epidemic in the United States is poorly understood. For example, the Centers for Disease Control and Prevention (CDC) estimate of the prevalence of HCV infection in the United States is four million people (ref. 3). But this relies on data from a national household survey that has long been known to suffer from non-responder bias and to exclude high-risk populations such as homeless people and prisoners. This survey underestimated4 the prevalence of HIV infection in the United States by a factor of 1.4 to 2.0. If the HCV estimate is similarly biased, then 6–8 million Americans are likely to have been infected with HCV.

Also discussed in the editorial is the need for recommended HCV testing; as mentioned below funding and policy are not in place like it is for HIV.  
About half of all HCV infections can be cured with a single 6–12-month course of therapy, and new drug regimens are likely to be more effective. But the resources to provide testing and deliver care are missing. US government policy recommends that all adults be screened for HIV, and there has been significant progress towards that goal: 83 million people have been tested, and CDC grants provide funding for another 1.4 million tests each year. But no such policy or funding supports HCV testing — even though more than ten times as many Americans have undiagnosed HCV as have undiagnosed HIV infection, and half or more of them could be cured with a single 6–12 month course of therapy. Moreover, public-health programmes stop at the doors of most correctional facilities, abandoning the infected and those at risk at the moment when providing prevention and treatment services would be most practical

Read the full editorial here.
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