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TATOOS LINKED TO HEPATITIS C RISK

1/27/2013

2 Comments

 
By Kathryn Doyle, Reuters Health

NEW YORK (Reuters Health) - Researchers are hoping that people will do some
research about where to get a tattoo, after a study found a link between body
art and hepatitis C.

The new study found that people with the virus were
almost four times more likely to report having a tattoo, even when other major
risk factors were taken into account, co-author Dr. Fritz Francois of New York
University Langone Medical Center told Reuters Health.

Although the study
could not prove a direct cause and effect, "Tattooing in and of itself may pose
a risk for this disease that can lay dormant for many, many years," Francois
said.

About 3.2 million people in the U.S. have hepatitis C, and many
don't know because they don't feel ill, according to the Centers for Disease
Control and Prevention (CDC). 

Hepatitis C is the leading cause of liver cancer and most common reason for
liver transplants in the U.S. Some 70 percent of people infected will develop
chronic liver disease, and up to 5 percent will die from cirrhosis or liver
cancer.

For the current study, researchers asked almost 2,000 people
about their tattoos and hepatitis status, among other questions, at outpatient
clinics at three New York area hospitals between 2004 and
2006.

Researchers found that 34 percent of people with hepatitis C had a
tattoo, compared to 12 percent of people without the infection.

The most common routes of contracting hepatitis C, a blood-borne disease, are through a
blood transfusion before 1992 or a history of injected drug use. Injected drug
use accounts for 60 percent of new hepatitis cases every year, but 20 percent of
cases have no history of injected drug use or other exposure, according to the
CDC.

Francois and his colleagues only included people with hepatitis C
who did not contract it from these two other common sources.

After accounting for other risk factors, the difference between people with and
without hepatitis was even greater, with four times as many tattoos in the
infected group than for uninfected people, according to results published in the
journal Hepatology.   

" This is not a big surprise to me," Dr. John Levey, clinical chief of
gastroenterology at the University of Massachusetts Medical School in Worcester,
told Reuters Health. Earlier studies had found a link, but they were small and
had not taken other risk factors into account as well as this new one
did.

"This was one of the stragglers, and now we finally have some
numbers for it," said Levey, who was not involved in the study.

Still, the CDC's Dr. Scott Holmberg said the link may not be quite as strong as the
findings suggest, because some people who had used illegal drugs probably would
not admit it, even on an anonymous questionnaire. And the researchers didn't
rule out people who contracted hepatitis before getting their
tattoo.

WHAT TO LOOK FOR IN A TATTOO PARLOR

Holmberg, of the CDC's
viral hepatitis division, recommends people only have tattoos or piercings done
by trained professionals.

"In the U.S., there have been no reports of
hepatitis C outbreaks linked to professional tattoo parlors," told Reuters
Health by email.

In 2012, one in five people reported having at least one
tattoo, according to a Harris poll.

"There are very reputable places that
use appropriate standards," said Francois. Tattoo parlors are not federally
regulated, and standards vary by state and region, so it's up to the consumer to
do their homework, he said.

The Alliance for Professional Tattooists
recommend finding a tattoo artist who wears disposable gloves, a clean work
space without blood spatters and single-use disposable needle kits.

Levey
said he wouldn't prevent his two adult daughters from getting tattoos, but he
would make sure they were aware of the hepatitis C risk first.   Continued...
"A lot of their friends have tattoos, it's the cool thing to do," he said.
"They're adults, they can make their own decisions. But I'd mention this to
them, because the long-term consequences of hepatitis C are so
serious."

2 Comments

HEPATITIS C/CO-INFECTION SUPPORT GROUPS ARE NOW MANDATORY!

1/22/2013

9 Comments

 
Patient support groups are important for
patients with many diseases and conditions.  Hepatitis C /Co Infection
support groups have been shown to help patients deal with their diagnoses,
manage care and treatment more effectively than they would on their
own.  Support groups are now an arm to medical care and they
improve quality of life for most participants. 

Support groups are more important than ever
for Hepatitis C patients considering treatment, in a clinical trial, or on treatment, using one of
the new protease inhibitor drugs along with PegInterferon and Ribavivin.  
 Adding one of the new protease inhibitors has increased SVR (sustained
viral response) or cure rates for patients, dramatically.  Including one of
the new drugs may or cure rates for patients Including one of the new drugs may
also allow some patients to be on treatment for a lot less time than in the
past.  That's the good news!

But the new meds have also made treatment more complicated and
added to the side effects some people experience.  Support groups provide
an important forum for patients to talk with
their peers about questions to ask and the pros and cons of treatment, while
they are consulting with their doctors about whether and when to treat.  Once
patients start treatment, support groups provide an opportunity to discuss any
difficulties or side effects they are experiencing, and share tips to manage or
reduce side effects and other problems such as adherence.

Having a place to talk about Hepatitis C and treatment with peers provides fellowship
and encouragement.  Support groups make it clear to individuals that they are 
not facing Hepatitis C and treatment alone.  They are more important now than 
ever.

If you want to find a Hepatitis C or Hepatitis C/HIV/AIDS
co-infection support group in New York, go to the Hepatitis
C Support Group www.hepatitisCmsg.org
list under the Resources section of this website.
or if you are looking to start a group, we provide resources and trainings free of charge,
look at website  under current projects.
9 Comments

Detonating a viral time bomb—the Hepatitis C pandemic

1/18/2013

1 Comment

 
The Lancet 19 January 2013


Economist Intelligence Unit  Report Calls for Global Policy
Innovation to Tackle the 'Silent Pandemic' that  is Hepatitis C - new global HCV
policy paper
- (01/15/13)

"Hepatitis C may be the  serious disease that most combines
widespread prevalence with widespread  ignorance." - New HCV Policy Paper:
"Economist Intelligence Unit Report Calls  for Global Policy Innovation to
Tackle the 'Silent Pandemic' that is Hepatitis  C" from Janssen
-
(01/16/13)
 
The  Lancet 
On Jan 15, the Economist Intelligence Unit supported
by  Janssen Pharmaceuticals published a report: The Silent
Pandemic: Tackling hepatitis C with  policy innovation.
The report examines
the health challenge posed by the  hepatitis C virus (HCV), and how
comprehensive approaches that reflect the local  needs and available resources
can improve the health-care response to this  deadly virus worldwide.
 
Hepatitis C is a blood-borne infectious disease, but
the  infection is often asymptomatic for years, even decades, and so many people
are  unaware of their condition. By the time they fall ill and seek help,
  considerable damage has been done to their liver, resulting in end-stage
  conditions that are complex to treat and impose huge medical and societal
costs.  The report notes that the lack of robust epidemiological data means the
  magnitude of the problem is unknown, but the number of people with chronic HCV
  is set to rise substantially in the future.
 The report calls for effective disease surveillance to
  create an accurate picture of the problem and to ensure appropriate policies
can  be developed. Greater public and physician awareness of the disease is
crucial,  especially to combat the associated stigma the disease has with
injecting drug  use. Measures are needed to prevent transmission through unsafe
health-care  practices, which is the major route of HCV transmission in
developing countries.  And innovative ways are required to reach out to patients
to ensure those who  need treatment receive it before end-stage conditions
develop. For example, in  Australia, use of hepatology nurse practitioners
within the liver service has  streamlined care in a patient-centred way.
 
As seen in the response to HIV, strong leadership in
the  clinical and patient communities is key to raising the profile of a disease
and  securing government investment. Stronger and more coherent leadership from
the  many clinicians, public health specialists, and patient groups who are
committed  to tackling HCV would go a long way to alerting the public to the
risks of the  virus and the importance of screening and diagnosis, and gaining
an effective  political response.
 
 
 
 
 
 
1 Comment

CHRONIC HEPATITIS C VIRUS DISEASE BURDEN AND COST IN U.S.

1/8/2013

11 Comments

 
.....the
"incidence of more advanced liver diseases will  continue to increase, with
incidence of decompensated cirrhosis and HCC peaking  in
2016-2017......
by
2030, compensated cirrhosis cases will account for  37% of all prevalent cases.
The HCV compensated cirrhotic population is  projected to peak in 2015, while
the decompensated cirrhotic population will  peak in 2019
”


"The effects of new
therapies were excluded from our  model. However, if the number of treated
patients is doubled and kept constant  at 126,000 per year in 2012-2030 and the
average SVR is increased to 70%, the  2030 prevalent population is projected to
be less than 100,000 cases. This  illustrates that it is possible to
substantially reduce HCV infection in the US  through active
management."




Hepatology  Accepted Article Dec 22
2012


H. Razavi1,
A. El Khoury2,
E. Elbasha2,
C. Estes1,
K. Pasini1,
T. Poynard3,
R. Kumar2
1. Center for Disease Analysis, Louisville,
Colorado, USA
2. Merck, Sharp, & Dohme Corp., Whitehouse
Station, NJ
3. Université Pierre et Marie Curie Liver
Center, Paris,  France


"The goal of this study is to
describe the future disease  and cost burden of HCV infection in the United
States using a systems approach,  assuming there is no incremental increase in
treatment as the result of the new  therapies......In conclusion, our analysis
demonstrated that overall HCV  prevalence in the US is in decline due to lower
incidence. However, the
prevalence of advanced liver disease will  continue to increase,

as will  the corresponding healthcare
costs
......we
forecast that mortality will continue to increase  and peak in
2020.....
Patients experiencing decompensated cirrhosis
  accounted for the majority of future costs
Lifetime healthcare costs for an  HCV infected person
are significantly higher than for non-infected persons, and  the expected cost
is higher among populations with a higher life expectancy.  Finally, it is
possible to substantially reduce HCV infection in the US  through active
management
.......the prevalence of
more advanced liver diseases has been  increasing
. The prevalent
population with compensated cirrhosis is  projected to peak in 2015 at 626,500
cases, while the population  with decompensated cirrhosis will peak in 2019 with
107,400 cases. The number of  individuals with HCC, caused by HCV infection,
will increase to 23,800 cases in  2018 before starting to decline. In 2011, the
total healthcare cost associated  with HCV infection was $6.5 ($4.3-$8.2)
billion.......
Total cost is expected to peak  in 2024 at $9.1
billion ($6.4-$13.3 billion), as shown in Figure  3
. The majority of
peak cost will be attributable to more  advanced liver diseases—decompensated
cirrhosis (46%), compensated cirrhosis  (20%), and hepatocellular carcinoma
(16%). The maximum cost associated with mild  to moderate fibrosis (F0-F3)
occurred in 2007 at nearly $780 million. The cost  associated with compensated
cirrhosis is expected to peak in 2022 at $1.9  billion, while the peak cost for
decompensated cirrhosis and HCC is predicted to  occur in 2025, with annual
costs in excess of $4.2 billion and $1.4 billion  respectively.”
11 Comments

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