Thursday, July 10, 2014

Vermont - Number of Hepatitis C cases second only to Lyme disease in 2013

Number of Hepatitis C cases second only to Lyme disease in 2013  

More than 600 Vermonters have chronic hepatitis C. The disease was the second most commonly tracked by public health officials last year, according to data from the Vermont Department of Health.

The Health Department began monitoring hepatitis C data in the past three months, to look for trends and see if doctors are performing duplicate tests for the virus.

Meanwhile, taxpayer-funded health insurance programs for poor and older Vermonters, who are more likely to have hepatitis C, cover the new treatment drug Sovaldi. That drug is controversial because it costs $84,000 for 12 weeks of treatment but is known to eliminate the disease, which is thought to be virtually incurable.

In 2013, there were 638 reported cases of chronic hepatitis C, according to state health data. Only Lyme disease had more reported cases last year (887). There have been 294 cases reported this year, which is on track with health officials’ expectations.

Hepatitis C is considered the most common blood-borne infection in the United States. Nationwide, about 3.2 million people have the chronic form of the virus, according to the Centers for Disease Control.

The number of hepatitis C cases in Vermont is high but not abnormal compared to the rest of the country, said Patsy Kelso, state epidemiologist.

“Ultimately what we’re trying to do is use the surveillance data to help us guide prevention,” she said.

There were 806 cases of hepatitis C in 2007 then the number slowly fell to 539 by 2010. In 2011 cases rose to 621 then 671 in 2012, then dipped back to 638 last year.

The Vermont data is collected by the health department from labs that process tests for doctors who are testing their patients. Each year there is also a much smaller number of acute cases of the disease, which sometimes turn into the chronic form of the illness.

The health department does not collect data for the number of people who test negative.

Hepatitis C is a liver disease caused by a virus that can be acute or chronic and last a few weeks or a lifetime. Many people who have it don’t know they do because they don’t look or feel sick.

An especially high number of baby boomers are infected, Kelso said. People born between 1945 and 1965 should be tested, she said. Boomers’ children are more susceptible as well.

It is a blood-borne virus and the most common modes of infection are through unsafe needle use, being born to a mother with the virus or, less commonly, through sexual contact with an infected person.

The disease can be silent for decades but if not treated, can cause liver scarring and liver cancer.

A small percentage of people are able to cure the infection on their own and don’t need treatment, she said. But once cured, it’s possible to contract it again.

It is hard to calculate the national number of cases of hepatitis C because many states do not track cases, Kelso said. Vermont not only collects the data but follows up with patients to learn more.

Many people infected are in prison, have low incomes or are baby boomers, and the cost for treating hepatitis C often falls on taxpayers, who fund health insurance programs for poor and aging citizens.

Although hepatitis C drugs are not the most expensive on the market, it would cost $268 billion to treat all Americans with $1,000-per-pill Sovaldi, experts have calculated.

Sovaldi’s manufacturer, Gilead Sciences, reported $2.3 billion in sales of the drug during the first quarter of 2014.

Another treatment drug, Olysio, costs about $66,000 for a 12-week treatment but is approved for fewer types of patients and other drugs must be used along with these drugs, according to Kaiser Health News.

So far Vermont health officials have approved 31 prescriptions for the medicine to be prescribed to people on Medicare or Medicaid, government-funded health care programs for poor or elderly people, according to Scott Strenio, the medical director at the Department for Vermont Health Access.

In the past few months the state hired a hepatitis C prevention coordinator to analyze the data, a position funded by the CDC that was vacant.

Kelso said it’s important not to read too much into the numbers of cases because data is sometimes dependent on the number of staff the department has to follow up on cases.


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