By JAN HOFFMANMAY 29, 2017
​

Do doctors need to know their patients’ sexual orientation and gender identity?A growing number of federal agencies has been pushing health care providers to ask. Federally funded community health centers, which treat millions of patients, have begun to collect the data. Electronic health software must be able to store it. And blueprints for national health goals recommend collecting the information from all patients.
By knowing whether a patient is lesbian, gay, bisexual, transgender or straight, say public health experts, clinicians can be more alert to a person’s medical needs and more thoughtful in interactions. If hospitals report statistics on all patients, health care disparities among L.G.B.T. patients can be identified and redressed more effectively.
But most doctors and nurses are in no rush to comply. In several studies, they have said they feel uneasy about asking because they don’t want to make patients uncomfortable.
Research now suggests those assumptions may be wrong.
A new study of both patients and providers in the journal JAMA Internal Medicine looked at the feasibility of gathering such information in emergency departments. Nearly 80 percent of providers surveyed believed that patients would refuse to disclose their sexual orientation.
TOCONTINUEREADING:https://www.nytimes.com/2017/05/29/health/lgbt-patients-doctors.html?emc=edit_th_20170530&nl=todaysheadlines&nlid

BY DR. JAY C. BUTLER AND DR. DAVID L. LAKEY, OPINION CONTRIBUTORS - 05/23/17 01:40 PM EDT 13
THE HILL

​The United States has reached a critical point in the hepatitis C epidemic: the virus affects at least 3.5 million Americans. Chronic hepatitis C infection is now the leading cause of liver cancer and it causes more deaths than any other blood-borne infectious disease. Untreated, the virus can destroy the liver’s ability to filter blood and produce proteins that protect our bodies from infection.
 
Many people don’t even realize they have hepatitis C, as the infection can go for decades without causing any symptoms. People who are infected can transmit infection to others through exposure to their blood. The primary treatment for hepatitis C infection, until very recently, was interferon therapy, which requires months of treatment and is brutally toxic, and not always effective.
 
Over the last decade, infection control measures have dramatically changed. Blood is now screened for Hepatitis C virus to prevent infection from transfusions. As a result of improved screening tests, we know that somewhere between 2.7 and 3.9 million Americans have a chronic hepatitis C infection. Most of those infected are baby boomers, but rates are increasing fastest among young adults, due in large part to the opioid epidemic and the resulting increase in injection drug use and needle-sharing.
 
In 2013, the FDA approved the first treatment in a new class of drugs that is over 90 percent effective in curing most hepatitis C infections. Some of the new medications require just one pill a day for three months and have no serious side effects for most people. Early treatment can prevent liver cirrhosis and avert the high costs of a liver transplant. And curing hepatitis C can prevent the infection from spreading further.
 
Today we have more knowledge about the disease, and more urgency, superior treatment, and excellent long-term public health and economic arguments for testing and treating more people.
 
We have the opportunity now to turn things around if we want to eliminate this disease. There are millions of Americans living with this potentially fatal virus, but fewer will suffer if we implement a screening system to diagnose infections and make treatment available for everyone. However, one of the largest barriers we face in stopping this epidemic is, simply, money.
 
Money is needed to screen baby boomers and other high risk groups. As a result, only about half of those who are infected know it, and for too many people, the diagnosis comes after serious liver damage has already been done.
 
An even more significant obstacle is the cost of treatment, which can run as high as $150,000 per patient. According to a recent study, it would require an additional $65 billion over the next five years to treat everyone who could benefit from treatment at the current drug prices. That is almost three times the entire Medicaid budget of Texas, and about 50 times the Medicaid budget of Alaska.
 
Because of the high cost of curative treatment, most private insurers, and the Medicaid programs in most states, will not cover the drugs until the liver disease is advanced. As a result of this lack of screening and coverage, only about 9 percent of those infected have been treated with the new drugs.
 
Centers for Disease Control and Prevention (CDC) estimates that comprehensive screening of baby boomers alone could diagnose 800,000 new cases and save 120,000 lives.
 
The pharmaceutical companies that developed these extraordinary drugs deserve credit and profit for their effort, but it is also incumbent on them to collaborate with insurers and governments to make sure that people who can be cured will be cured. In fact, a recent report from the National Academies of Sciences, Engineering, and Medicine outlines a strategy by which we can lower the cost of treatment through public and private collaboration.
TO CONTINUE READING: http://thehill.com/blogs/pundits-blog/healthcare/334755-treatment-challenges-fuel-the-silent-hepatitis-c-epidemic

  ​Hep C cure has doctors concerns focused on fatty livers       By Doreen Gentzler and Christina Romano

Hepatitis C rates in the United States soared to a 15-year high, the Centers for Disease Control and Prevention reported last week, but while the virus kills more Americans than any other infections disease reported to the CDC, now there’s a cure. Doreen Gentzler reports.
(Published Thursday, May 18, 2017)Hepatitis C rates in the United States soared to a 15-year high, the Centers for Disease Control and Prevention reported last week, but while the virus kills more Americans than any other infections disease reported to the CDC, now there’s a cure.
Hepatitis C was officially discovered and named in 1989. Up to 3.5 million Americans live with hepatitis C, and the majority of them are baby boomers. Because it is often asymptomatic, the only way to diagnose it is through a blood test.
Getty Images“In general, it's a silent killer because you don't really know you have it,” hepatitis C patient Duncan MacInnes.
The virus can eventually lead to severe liver damage, cancer or cirrhosis, and death.
It is transmitted by blood -- transfusions or sharing dirty needles are two common ways to get it.
MacInnes believes he got it while working overseas for the State Department. He said a doctor used a dirty needle. A routine blood test showed something was wrong.
TO CONTINUE:
​http://www.nbcwashington.com/news/health/With-Hepatitis-C-Rates-High-Health-Professionals-Urge-Diagnosis-422592424.html



Source: With Hepatitis C Rates High, Health Professionals Urge Diagnosis, Treatment | NBC4 Washington http://www.nbcwashington.com/news/health/With-Hepatitis-C-Rates-High-Health-Professionals-Urge-Diagnosis-422592424.html#ixzz4htkPz3If 

May 11, 2017

​(HealthDay)—Hepatitis C can be cured in about three months, allowing people with the viral disease to live longer, healthier lives, the U.S. Food and Drug Administration (FDA) says.
Drugs used to clear the virus from the body are not only more effective than they once were but also more tolerable for patients, according to Dr. Jeffrey Murray, an internist at the FDA who specializes in infectious diseases.
Hepatitis is inflammation of the liver that is caused by different viruses. In the United States, hepatitis C is the most common chronic bloodborne infection. Avoiding risky behaviors, such as sharing drug needles, can help prevent the spread of the disease, but there is no vaccine for hepatitis C.
Hepatitis is often a silent disease. Many people are unaware they are infected for years and learn about their infection only after they have developed serious liver disease or failure.
Three-quarters of Americans with chronic hepatitis C are baby boomers (born between 1945 and 1965). Many became infected before the virus was identified and the blood supply was screened, according to the FDA.
"Hepatitis C is a bit like smoking, the longer you've had it, the higher your risk of developing complications—in this case, liver cancer, cirrhosis [liver scarring] and end-stage liver disease. It's a progressive disease that takes years, even decades, before the patient develops cirrhosis or cancer," Murray said in an FDA news release.
"The good news is that when you cure hepatitis C, you also lower its risks, though you don't completely erase the years of damage to your liver," he added.
In the past, being diagnosed with hepatitis C meant months of painful drug injections with interferon-based injections.
"Interferon-based injections often make patients feel ill and give them flulike symptoms,
Murray said. The drug also cures only about half of those with hepatitis C, according to the FDA.
Today, patients with the condition have more and better options. "Now, patients can treat their hepatitis C with only pills—drug combinations that are faster and have a higher cure rate," Murray said.


Read more at: https://medicalxpress.com/news/2017-05-hepatitis-treatments-effective-tolerable-fda.html#jCp

Injection comes more quickly to those born in the ’80s and ’90s, increasing their risk of HIV, mental health disorders, overdose and early death​
BY Zen Vuong
MAY 8, 2017      USC NEWS                                                                 USC University of Southern California

​Abuse of prescription painkillers may be driving a new phenomenon: users of illicit drugs turning to needles sooner than they used to, a new USC-led study suggests.
“The prescription opioid epidemic is creating a heroin epidemic, which will create an injection drug use epidemic,” said Ricky Bluthenthal, lead author of the study and a professor of preventive medicine at the Keck School of Medicine of USC. “We’ve seen the first two. Now we’re waiting to see the last emerge on the national level. I predict we’ll see an uptick in injection-related diseases over the next couple of years.”
The USC-led study, published in April in the journal Drug and Alcohol Dependence, is based on 776 drug users in Los Angeles and San Francisco. Participants born in the 1980s or 1990s, on average, took six years to escalate from first illicit drug use to first drug injection. The average for participants born in the 1970s was nine years.
“The more rapid transition to injection is an impact of the prescription opioid-to-heroin use phenomenon,” Bluthenthal said. “Heroin is most efficiently used via injection as compared to other formerly popular drugs such as crack cocaine or even cocaine.”
Uptick in hepatitis C, HIV?Injection-related diseases can include HIV, which affects more than 1.2 million Americans, and hepatitis C, which affected an estimated 3.9 million Americans in 2014, according to the Centers for Disease Control and Prevention. People who inject drugs also are at elevated risk for sexually transmitted infections, abscesses and soft-tissue infections, mental health disorders, drug overdose and dying young, the study stated.
Researchers found that the first drug injected changed in tandem with national drug use trends. In general, however, heroin and prescription opiates were the most common first drug injected. Drug users born in the 1980s and 1990s moved quicker from initial illicit drug use to syringe use than those born in the ’70s.
TO CONTINUE READING:
​http://news.usc.edu/121287/opioid-epidemic-may-be-driving-illicit-drug-users-to-use-needles-sooner-usc-stud