Feb 4, 2020, 

Nina ShapiroContributor 
Healthcare
Dispelling health myths, fads, exaggerations and misconceptions.

Baby boomers have gotten a lot of flack lately. Those born between 1945-1965, during the post-World War II years, many of who are entering retirement age, have been the subject of many a snarky millennial-driven meme. Not sure what a meme is? OK, Boomer, you need to Google that. You’re not sure what Google is? OK, Boomer. You still don’t get what “OK, Boomer” means? OK...
But all memes aside, and all acute devastating viruses aside, including influenza virus and the novel coronavirus, a more prevalent virus, which is hardly new, is wreaking havoc on baby boomers.

While many of the newer viruses can infect and affect anybody at any age, certain viruses, especially those prevented by widespread vaccination programs, have become infections of the past. Thanks to Dr. Jonah Salk, polio, a viral infection which decimated and paralyzed swaths of pre-boomer populations, is something most boomers never saw. But in the 1960’s-1980’s, the years before utilization of universal precautions and infection control in the healthcare setting, transmission of the Hepatitis C virus, via contaminated medical equipment, or by contact with contaminated blood products, led to easy transmission of this virus from either person to person or via contaminated needles or medical instruments. The virus can also be transmitted via sexual contact, with much higher incidence of transmission risk prior to more commonly used protection against more widely recognized sexually transmitted infections. While even back in those distant decades it would seem rare to have contact with contaminated medical supplies, the numbers declare otherwise, likely, in part, due to lesser use of condoms during sexual contact as well as substandard cleaning practices of medical instruments. Approximately one in thirty individuals born from 1945-1965 screen positive for Hepatitis C. Another way of looking at it shows that over 75% of those with Hepatatis C are baby boomers. Routine screening of blood products used for transfusion to eliminate transmission of Hepatitis C began in 1992.

TO CONTINUE READING: https://www.forbes.com/sites/ninashapiro/2020/02/04/baby-boomers-have-high-incidence-of-hepatitis-c-virus-what-does-this-mean-boomer/#37c3c82c103f

​Jan. 23, 2020
The National Academies of Science. Engineering .Medicine

WASHINGTON — The opioid epidemic in the U.S. is driving a simultaneous epidemic of infectious diseases — including HIV, hepatitis C virus (HCV) and bacterial infections, and sexually transmitted infections — but workforce shortages, stigma, and financial and policy barriers are preventing the integration of opioid use disorder (OUD) and infectious disease services, says a new report from the National Academies of Sciences, Engineering, and Medicine. The report recommends state and federal policy actions, including removing insurance requirements on prescribing medications for OUD (i.e., buprenorphine), expanding access to medications in criminal justice settings, and lifting state bans on syringe service programs.

The rise of infectious diseases related to OUD is attributed to sharing needles, having unprotected sex, and lacking access to medical care, says Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic. Over the past few years, four states hardest hit by the opioid epidemic — Tennessee, Kentucky, Ohio, and West Virginia — have seen a 364 percent increase in acute HCV infections. In rural areas in particular, there is a shortage of providers — including physicians, social workers, therapists, and counselors — available to care for patients in an integrated way.

Methadone clinics, primary care clinics, and jails and prisons see thousands of patients with concurrent OUD and infectious diseases annually, and should be leveraged as integrated care sites, the report says. However, some organizations are unable to provide integrated services because of restrictions on the types of services they can provide. For example, some state Medicaid laws do not allow billing for medical care and behavioral health services on the same day. Other states ban syringe service programs, despite evidence that these programs can link patients to more intensive treatment for OUD and infectious disease as well as prevent new cases of infectious disease.

“Substance and opioid use disorder treatment is already segregated from traditional medical care. Treating OUD and infectious diseases as separate epidemics only reinforces stigma,” said Carlos del Rio, professor of medicine at Emory University School of Medicine and professor of global health at the Rollins School of Public Health of Emory University, and chair of the committee that wrote the report. “The better we integrate services, the sooner we can connect people to diagnosis, treatment, and prevention and achieve successful health outcomes.”

​TO CONTINUE READING:http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25626

[WASHINGTON, D.C.] – U.S. Senator Tammy Duckworth (D-IL) today introduced legislation to increase federal support for liver cancer research and help make life-saving preventive and treatment services more accessible to people all across the country. The Liver Illness Visibility, Education and Research (LIVER) Act would boost funding for liver cancer research at the National Institutes of Health (NIH) by $45 million and the Centers for Disease Control and Prevention (CDC) by $90 million while also implementing other new initiatives at these agencies to elevate this critical issue. A companion version was introduced in the U.S. House of Representatives by Representative Nydia Velazquez (D-NY-07).
“Far too many Americans have died due to liver cancer, a disease that disproportionately impacts the Asian-American and Pacific Islander (AAPI) community,” Duckworth said.  “I’m proud to introduce this important legislation in the Senate today to help make sure the federal government is properly investing in studying liver cancer, finding a cure and increasing access to preventive and primary cancer services that detect the disease early and save lives.” 
“As the Representative of the Manhattan and Brooklyn Chinatowns, my office hears frequently the disproportionate burden that liver cancer has on Asian American communities,” said Velázquez, who previously introduced the House version of the bill. “Early detection can be the difference between life or death for many of our families and that’s why I’m proud Senator Duckworth joined me in introducing this legislation allocating $135 million to liver cancer research and preventative resources.”

TO CONTINUE READING: https://www.duckworth.senate.gov/news/press-releases/duckworth-introduces-bill-to-increase-investments-in-liver-cancer-research-and-raise-awareness

​Today’s meth is far more potent than earlier versions, but because it isn’t an opioid, many federal addiction treatment funds can’t be used to fight it.

By Abby Goodnough, December 17, 2019

TULSA, Okla. — The teenager had pink cheeks from the cold and a matter-of-fact tone as she explained why she had started using methamphetamine after becoming homeless last year.
“Having nowhere to sleep, nothing to eat — that’s where meth comes into play,” said the girl, 17, who asked to be identified by her nickname, Rose. “Those things aren’t a problem if you’re using.”
She stopped two months ago, she said, after smoking so much meth over a 24-hour period that she hallucinated and nearly jumped off a bridge. Deaths associated with meth use are climbing here in Oklahoma and in many other states, an alarming trend for a nation battered by the opioid epidemic, and one that public health officials are struggling to fully explain.
The meth problem has sneaked up on state and national leaders. In Oklahoma, meth and related drugs, including prescription stimulants, now play a role in more deaths than all opioids combined, including painkillers, heroin and fentanyl, according to the Centers for Disease Control and Prevention.

The spending package that lawmakers agreed on this week includes legislation from Senators Jeanne Shaheen, Democrat of New Hampshire, and Rob Portman, Republican of Ohio, that would allow states to address the resurgence of meth and cocaine by using some of the billions of dollars that Congress had appropriated to combat opioid addiction.
Meth use first ballooned in the United States from the 1990s into the early 2000s, when it was often made in small home labs with pseudoephedrine, the main ingredient in many drugstore cold medicines. But today’s meth, largely imported from Mexico, is far more potent.

TO CONTINUE READING:
​https://www.nytimes.com/2019/12/17/health/meth-deaths-opioids.html?nl=todaysheadlines&emc=edit_th_191218?campaign_id=2&instance_id=14601&segment_id=19684&user_id=ccde51e4ec9251b4505257eedc2ee927&regi_id=357473341218

Liz Highleyman
Published:13 November 2019

​

Leaders of liver disease associations from Europe, the United States, Latin America and Asia issued a global call to action at the AASLD Liver Meeting this week in Boston, aiming to advance toward the goal of eliminating hepatitis C as a public health threat.
Approximately 71 million people worldwide have chronic hepatitis C virus (HCV), and around 1.75 million more acquire the virus annually, according to the American Association for the Study of Liver Diseases (AASLD), which sponsors the conference.
In 2016, World Health Organization member states committed to eliminating viral hepatitis, with targets including an 80% reduction in new hepatitis B and C infections and a 65% reduction in mortality by 2030. Studies have shown that these targets are achievable, but to date countries have had variable success in moving toward them.
The new statement, signed by representatives of AASLD, the European Association for the Study of the Liver (EASL), the Latin American Association for the Study of the Liver (ALEH) and the Asian Pacific Association for the Study of the Liver (APASL), calls for efforts to simplify HCV testing and treatment in order to make them more widely available, especially in resource-limited settings.
The four associations, which are undertaking this initiative in partnership with the Clinton Health Access Initiative (CHAI), outlined four strategies to achieve this goal:

• Simplifying diagnosis and treatment algorithms
• Integrating hepatitis C treatment into primary care and other disease programmes
• Decentralising HCV services to the local level
• Task-sharing with primary care clinicians and other health care practitioners.

TO CONTINUE:http://www.infohep.org/page/3547774/?utm_source=NAM-Email-Promotion&utm_medium=conference-bulletin&utm_campaign=English

By MICHAEL NINBURG​ NOVEMBER 15, 2019

I traveled to Boston last weekend for the annual meeting of the American Association for the Study of Liver Diseases. This meeting is personal for me — it was where 11 years ago I decided to begin treatment for hepatitis C, which I had been diagnosed with nearly 20 years earlier.
Hepatitis C is the nation’s deadliest infectious disease and a leading cause of liver cancer. Although recent advances in treatment represent lifesaving progress, more must be done to deliver on the promise of these advances and eliminate viral hepatitis in the United States.
I was initially diagnosed with hepatitis C in 1990, but, like many people with it, I deferred treatment — the options available had low success rates, significant side effects, and were time-consuming. For a while the complications were minimal, but by the early 2000s my tests began to show signs of liver disease. By 2008, I had signs of cirrhosis, which is scarring of the liver, a sign of late-stage liver disease and a precursor to liver failure.

At the 2008 liver diseases meeting in San Francisco, which I was attending as a longtime viral hepatitis advocate, Dr. Nezam Afdhal, who is now the chief of the division of gastroenterology, hepatology, and nutrition at Beth Israel Deaconess Medical Center in Boston, convinced me to enroll in a clinical trial for a promising new hepatitis C drug.
The 48 weeks of treatment included weekly injections of pegylated interferon, twice daily doses of ribavirin, an antiviral medication, and 12 weeks of an experimental drug called telaprevir, a direct-acting antiviral. When the treatment ended in December 2009, my blood tests showed no signs of the hepatitis C virus. Six months later, I was told I was cured. Even better, scans show that my liver has started to heal itself and reverse the decades of damage from hepatitis C.

Related:
Most state Medicaid programs continue to restrict access to hepatitis C medicines
My story — and my health — are a testament to the lifesaving potential of new treatments. Yet even though we now have cures for hepatitis C, and a vaccine to prevent hepatitis B, steps must be taken to reach the populations who are disproportionately affected by this disease, including certain racial and ethnic minorities, baby boomers, people who inject drugs, and some recipients of blood transfusions and organ transplants, in order to eliminate viral hepatitis in the U.S.
To start, the U.S. needs a national elimination strategy with dedicated funding. In 2016, the World Health Organization drafted the global viral hepatitis strategy to eliminate viral hepatitis as a public health threat by 2030. It was signed by all WHO members, including the U.S. The U.S. Department of Health and Human Services also has a National Viral Hepatitis Action Plan, but it’s not enough. We need dedicated funding from Congress for national awareness and testing efforts. We also need funding to support the CDC’s draft recommendation for all adults to receive a one-time hepatitis C antibody test.

TO CONTINUE READING: https://www.statnews.com/2019/11/15/hepatitis-needs-more-action-united-states/?fbclid=IwAR017eh6-7z2CalzqGbDSeEM0PHaP

OCTOBER 30, 2019 / NEWS RELEASES
Goal of procedure is to improve recovery of living donors, which may encourage more donationsMedia ContactCaroline Auger 216.636.5874

Cleveland Clinic has successfully performed the Midwest’s first purely laparoscopic living donor surgery for liver transplantation in an adult recipient. The advanced procedure is available at only a few hospitals worldwide, and Cleveland Clinic is the second U.S. academic medical center to offer this approach for living donor liver transplantation.
Unlike open surgery that requires a large incision to access the liver, the laparoscopic procedure is performed with surgical tools and a camera inserted through a few half-inch holes in the abdomen of the living donor. Once the piece of the liver is dissected, the surgeon retrieves the graft through a small incision below the navel. The minimally invasive technique benefits the living donor, who experiences better postoperative recovery and a quicker return to normal life, less pain, smaller scars, and lower risk of an incisional hernia compared with traditional open surgery.

About five percent of people who undergo a liver transplant receive the organ from a living donor who has made the altruistic decision to give up a portion of their liver to save someone else’s life. The liver is the only organ that can regenerate, which makes it possible for a living person to donate a portion of their liver. It can take six to eight weeks for a healthy liver to grow back to its original size.

TO CONTINUE STORY: https://newsroom.clevelandclinic.org/2019/10/30/cleveland-clinic-performs-its-first-purely-laparoscopic-living-donor-surgery

​A new case of hepatitis C was reported nearly every eight hours in Kanawha County last year.

The number of men and women diagnosed in 2018 with the infectious disease soared in the months after the Kanawha-Charleston Health Department closed its public syringe exchange earlier that same year.

Hepatitis C, a virus that can lead to liver cancer or early death if left untreated, is commonly contracted through sharing needles.

New data from the West Virginia Department of Health and Human Resources revealed 1,114 newly reported chronic hepatitis C cases in 2018. It’s the highest number of chronic hepatitis C cases reported in the past five years in West Virginia’s largest county.

“Everyone understands we have a problem, but no one understands just how big the problem is,” said Dr. Letitia Tierney, director of the hepatitis C clinic for Cabin Creek Health Systems.
Tierney emphasized that the area is nearing a hepatitis C outbreak and a potential HIV outbreak, as both viruses can be shared through needles.
Two new HIV cases were confirmed in Kanawha County this summer, according to Angie Settle, executive director of West Virginia Health Right. The nonprofit clinic tested 1,550 “high risk individuals.”
The DHHR did not provide its HIV numbers by Monday’s press time.
“We have a very narrow window of opportunity here to make a significant change,” Tierney said.

TO CONTINUE READING: ​https://www.wvgazettemail.com/news/health/hepatitis-c-numbers-soar-in-kanawha-following-syringe-exchange-closure/article_0

​By Alyssa Kitlas September 11, 2019

One month ago, the National Viral Hepatitis Roundtable (NVHR) hosted its first ever Patient Summit with the theme of “Nothing About Us Without Us.” Nearly 100 hepatitis C patient advocates from across the country joined to share their stories, strengthen advocacy skills, and identify opportunities to lead the way in our national response to viral hepatitis. You can follow the conversation on Twitter by searching #Voices4Hep. I had the pleasure of helping facilitate a discussion about building coalitions and working with health departments with Ronni Marks from the New York State Hepatitis C Elimination Task Force/Hepatitis C Mentor and Support Group (HCMSG) and Robin Lord Smith from the Maryland Hepatitis Coalition/ Help4Hep. It was an incredible meeting to be part of and the room was filled with both support and a strong sense of community. You could feel the excitement as patients shared their experiences and provided invaluable critique and suggestions on how to eliminate hepatitis in communities across the United States. Many patient advocates are currently part of their state or local elimination planning processes and others are looking for ways to become involved with this work.
“The voice of the patient advocate is as important if not more important than other voices at the table. If health departments don’t include the patient perspective, they are missing essential insight and information. The Patient Summit was an incredible success and we are already seeing results with patient advocates connecting with state and local health departments and other key partners. This is just the beginning….the patients are coming to the table.” - Robin Lord Smith from Maryland Hepatitis Coalition and Help4Hep
I sat down with the new Director of NVHR, Lauren Canary, to discuss the importance of engaging people with lived experience in hepatitis work and ways that health departments can support their state and local patient advocates.

TO CONTINUE READING: https://www.nastad.org/blog/nothing-about-us-without-us-importance-centering-voices-patient-advocates-public-health