The United States could eradicate the hepatitis C virus, but significant strides in public health have to be taken to achieve that goal, say researchers at Weill Cornell Medical College and National Development and Research Institutes.
Dr. Brian EdlinWritten for a symposium on hepatitis C in Antiviral Research, the commentary outlines a comprehensive approach to eliminating the disease. While new HCV treatments are now approved for wide use, they will not end the epidemic by themselves, according to the authors. Instead, they write, public health practitioners must work with policymakers, physicians, scientists and advocates to wipe out the infection, a serious illness that attacks the liver and often leads to cirrhosis or cancer.
“There is no question that the disease could be eliminated, but there is also no question that it’s going to require effort, resources and commitment,” said lead author Dr. Brian Edlin, an associate professor of medicine at Weill Cornell. “I think it’s clear that we’re entering an area where morbidity and mortality will begin to respond to our efforts. But without a balanced, full approach to the problem there’s a risk that it will continue to linger and disparities between advantaged and disadvantaged communities will sharpen.”
The approach the authors outline spans six arenas: epidemiology and surveillance, prevention, testing, care, social determinants of hepatitis C, and research. They say targeting these areas will help to rid the country of hepatitis C, which affects over 3 million people in the United States.
Within each sphere, the researchers identify specific approaches that they say will collectively contribute to eliminating hepatitis C, such as monitoring where and how the disease spreads; increasing access to prevention resources like sterile syringes and other equipment used to inject illicit drugs; expanding education and outreach services; ramping up testing efforts, especially among those at highest risk; training primary care physicians to treat hepatitis C with the new regimens; assuring access to new therapies for everyone with the infection, including indigent and incarcerated people; and eliminating the demonization of people who use illicit drugs.
One of the biggest challenges is for large organizations – including pharmaceutical companies, insurance companies, and governmental organizations – to work together to make hepatitis C drugs affordable. A full course of treatment can cost patients up to $150,000, and insurers do not always cover the cost.
“There is a battle going on between drug makers and payers, each pursuing their own financial interests. I think what’s needed is a vision of how to work in the interest of the public and the country,” Dr. Edlin said. “By expanding and broadening their view, the problems can easily be solved, but there needs to be agreement by all stakeholders that everything must be done to make these drugs available so that we can stop this epidemic.”
With the new drugs in development, Dr. Edlin says, hepatitis C eradication is “within our grasp.” But if this is to happen, he adds, “the time for action is now.”
Posted August 26, 2014 1:22 PM | Permalink to this post