Hep C on the Rise in New York City

Hepatitis C infection, tied to a rise in illicit use of opioid drugs, is on the rise in New York City, according to a January report from the New York City Department of Health and Mental Hygiene.

In the report, which is based on 2014 statistics, researchers concluded that fully1.2% of all New Yorkers including 2.4% of New Yorkers over age 20 were infected with the virus.

HCV is rampant in city prisons, with 814.4 cases per 100,000 inmates.

The hardest hit borough is that of Staten Island, with a rate of 34.7 cases per 100,000 population in people under the age of 29. That compares to a city average of 24.8 cases per 100,000.

About half these patients are covered by Medicaid.

Those prescribed medications for their infections are mostly getting directing acting antivirals, with sofosbuvir (Solvadi/Gilead) accounting for nearly 80% of prescriptions as of 2014.

Sofosbuvir/ledipasvir (Harvoni/Gilead) was available for only three months of 2014 and more recent prescribing statistics were not included in the report.

Before 2014 nearly all medications prescribed contained interferon, a drug that is often less effective and comes with severe side effects that can lead patients to stop using it..

Overall, the researchers found, most new NYC cases (52.7%) were in the baby boomer generation, defined as those born between 1945 and 1965.

Much testing remains to be done, the report noted.

Overall 41% of New Yorkers surveyed by the health department said they had ever been tested, and among baby boomers that percentage dropped to 36%.

Deaths in th city from hepatitis C increased 46% from 1999 to 2013 and 62.8% occurred in people under age 65 (412 deaths).

Liver cancer (hepatocellular carcinoma) incidence and mortality rates have also climbed.

In 1976 there were about 3 cases and six deaths per 100,0000 population in the city. By 2012 were 16.8 cases per 100,000 men and 9.6 deaths per 100,000 men. That year there were. 4.7 cases per 100,000 women and 2.8 deaths per 100,000 women.

Patients in NYC who died of liver cancer from hepatitis C lived a median of 13.1 months after diagnosis.