Brianna Norton, DO: Current and Future State of Hepatitis C

Brianna Norton, DO, MPH, Albert Einstein College of Medicine/Montefiore Medical Center:

Hep. C has definitely increased in the past couple years, and unfortunately it's overarchingly increased about 50% and in multiple states it's greater than 200%. And you know, there used to be sort of 1 large hump you know for people born between 1945 and 65 and then a smattering of other people, and now we essentially have a bimodal incident rate and prevalence data where there's a young cohort and a older cohort. And so this younger cohort unfortunately is increasing the amount of Hep. C that we're seeing, and we're really gonna have to make some pretty quick policy changes I think, if we're going to get these people treated before they start to have poor outcomes.

So certainly there is, I mean mavyret was just approved 2 weeks ago and, or a couple weeks ago, and will be a potentially very beneficial drug treatment, because it's 8 weeks of therapy. So when we're talking about, I mean it's interesting, because there's a double-edged sword. When we're talking about treating people who might have more chaotic lives, the fact that this new drug is only 8 weeks of treatment could be very beneficial — because then keeping them engaged in care, is only within 8 weeks. The double-edged sword is you know, the more the more simple that we make Hep. C treatment then the less opportunity we have to engage people in other aspects of their medical care like drug treatment or their HIV care or mental health issues. So I think that mavyret is 8 weeks is going to be really beneficial in terms, the fact that it's pan-genotypic, can be used in renal disease, is 8 weeks — I mean that provides an amazing opportunity to go into resource-poor areas and when I say that I don't just mean you know, developing countries I mean resource poor places in Appalachia, in the Bronx, etc. where if you could go in and do rapid testing that said hey not just antibody testing, but we do rapid testing, we know your viral load is positive, then essentially we'd have to do very little blood work to start the Hep. C treatment and this could be 1 of the most beneficial ways to have a true public health benefit. So I see that as a potentially great advantage in the near future, as long as we keep people then engaged in other parts of their healthcare.