Hepatitis C Elimination Hinges on Improved Monitoring, Modest Investment, Report Says

Surveillance and monitoring are key to eliminating the hepatitis C virus — and even modest investments can improve lives and save money, a new report concludes.

Effective medicines are already available to treat and often cure liver-attacking HCV. These drugs have contributed to a growing consensus that the virus can be wiped out as a global health threat.

However, healthcare personnel lack information on how to deploy resources to prevent new infections, screen and diagnose cases, and treat those living with the disease, according to the O'Neill Institute for National and Global Health Law at Georgetown University in Washington, DC.

"Most of the newly infected HCV cases are among injection opioid drug users,” noted co-author and institute associate Sonia L. Canzater, JD, MPH (pictured). “But we often do not have even basic information to adequately monitor where and how the HCV epidemic is unfolding in the US and we are not using the clinical data that is already collected."

Canzater identified five priorities for monitoring HCV with fellow author Jeffrey S. Crowley, MPH, the institute’s program director of infectious disease initiatives.

The suggested steps are: Expand and standardize reporting to the US Centers for Disease Control and Prevention (CDC); use electronic medical records to collect data; fund research employing clinical data sets; integrate HCV monitoring with responses to the opioid epidemic; and establish hepatitis C elimination plans across major US health systems.

At least 3.5 million Americans are infected with HCV. Rates of new infections have increased nearly 2.9-fold between 2010 and 2015, according to the CDC.

While three out of four Americans living with HCV are “Baby Boomers” born from 1945 to 1965, young adults aged 20 to 39 account for the highest rate of new cases, according to the report.

"Even with a constrained federal budget, more resources are needed for HCV surveillance and monitoring," Crowley said. "Relatively modest investments, however, can have a big impact toward eliminating HCV."

The authors estimate that stamping out the virus would drastically cut liver cancer rates. Elimination of HCV would also save almost $300 million a year in health care costs because it would help patients avoid liver transplant surgeries.

Canzater and Crowley wrote the report after consulting with hepatitis C medical and non-medical providers, patient advocates, epidemiologists, and federal HCV policy and program staff. Gilead Sciences Inc., a Foster City, CA, maker of direct-acting antiviral (DAA) drugs that target hepatitis C, provided a grant to support the project.

"Unlike some pressing problems where the scope of need is so large it can be immobilizing, modest new investments can have a significant impact,” the authors conclude. “Boosting the capacity to monitor the HCV epidemic can move the nation toward eliminating HCV as a public health threat in the United States."

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