Jules Levin From NATAP/Video - Hepatitis C Aging Population

Jules Levin lives with HIV and was co-infected with Hepatitis C for 30 years prior to being successfully treated and cured of Hepatitis C. Mr. Levin is the founder of NATAP, an internet resource for global HIV & hepatitis conference coverage & scientific information. He has been a leader in the in NYC, NY state and federal HIV and viral hepatitis advocacy communities since the early 90s, with numerous achievements that have changed the course of hepatitis-related policy and service delivery across the nation.

From Natap

Age-Based vs Risk Based HCV Screening

Histological diagnosis (markers) of early hepatocellular carcinoma - Editorial 

Surveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is recommended but 17% received regular testing for HCC(liver cancer)

EASL: Increasing & Peaking Cirrhosis, Decompensated Cirrhosis & HCC(liver cancer) in UK Projected

HCV Standard of Care Controversy: report from FDA Hearing; what can new era of HCV antivirals offer by Ira Jacobson; Key Treatment Outcomes for Boceprevir & Telaprevir, Essentially Doubling SVR Rates -



HCV Advocate April Newsletter

Article: Use of Surveillance for Hepatocellular Carcinoma among Patients with Cirrhosis in the United States—
Jessica Davila, Robert Morgan, Peter Richardson, Xianglin Du, Katherine McGlynn, Hashem El-Serag

Source: Hepatology July 2010; Volume 52, Issue I, Pages 132-141

People with alcoholic liver disease, hepatitis B or late-stage hepatitis C are at risk for liver cancer, specifically hepatocellular carcinoma (HCC). HCC rates have doubled in the past two decades and are expected to triple in the next two decades.  Late stage HCC has a poor prognosis, but is often treatable with early detection. Clinical practice guidelines were developed to help identify those at risk for HCC.
In this population-based study of Medicare-enrolled patients of 65 and older, 1873 patients with HCC were enrolled; all had a prior diagnosis of cirrhosis during 1994-2002. Researchers learned that adequate HCC screening (ultrasound and AFP testing) occurred in 17% of those at risk. Inadequate screening was performed on 38% of those at risk (only ultrasound or AFP testing). Patients with higher incomes or living in urban areas were more likely to be adequately screened for HCC. Patients who received medical care from a gastroenterologist or hepatologist were 4.5 times more likely to be screened for HCC compared to those seen by primary care physicians. Other patients who were more likely to be screened were younger, Asian, women, or diagnosed in recent years. Those receiving health care from providers associated with medical schools were more likely to be screened.

The Bottom Line: Screening for liver cancer is inadequately performed in the U.S.

Editorial Comment: If you have any risk factors for HCC, such as hepatitis B, alcoholic liver disease, cirrhosis or even stage 3 fibrosis, you should be screened every 6 months for liver cancer. These simple tests are covered by insurance.