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HBV & HCV Epidemics & Screening in USA
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'The Need for Implementation of HBV testing recommendations is high among some subgroups/Total medical costs for patients with HCV infection are expected to increase more than 2.5 times, from $30 billion to over $85 billion over the next 20 years- Over the next 10 years, the number of patients with decompensated cirrhosis will more than quadruple'
Liver Cancer Triples, NO HCV Testing Funds: Aging with HCV - (02/05/11)
Millions of Americans Are Living with Hidden Epidemics of Hepatitis B and C
The report, HBV & HCV: America's Hidden Epidemics, examines how new measures included in the Patient Protection and Affordable Care Act (ACA) combined with ...
www.natap.org/2010/newsUpdates/092710_02.htm
Consequences of Hepatitis C Virus (HCV): Costs of a Baby Boomer ...
www.natap.org/2009/HCV/051809_01.htm
"Author Conclusions: Our projections suggest that without improvements to the current low effective treatment rate, the U.S. healthcare system will be burdened with more HCV-infected patients progressing to cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma, and ultimately, more patients requiring liver transplants. As more HCV infected people progress to advanced liver disease, we project these serious conditions to generate a rapidly growing portion of medical costs for HCV-infected people over the next 5 to 10 years, and lead to a dramatic increase in costs over the next 20 years. In the absence of improved and accessible treatments that can alter the progression of disease, payers, especially Medicare, will feel the impact of a baby boomers' advanced liver disease epidemic."
Estimating future hepatitis C morbidity, mortality, and costs in ...
This study estimated future morbidity, mortality, and costs resulting from hepatitis C virus (HCV). We used a computer cohort simulation of the natural ...
www.natap.org/2003/Jan/012103_2.htm
Validation of a Hepatitis C Screening Tool in Primary Care - (02/11/10)
We sought to prospectively derive and validate a clinical predication tool to assist primary care providers in identifying patients who should be tested for HCV antibodies. A total of 1000 randomly selected patients attending an inner-city primary care clinic filled out a 27-item questionnaire assessing 5 HCV risk factor domains: work, medical, exposure, personal care, and social history......we have demonstrated the value of a simplified tool to assess HCV risk in patients attending a primary care practice.. Adopting risk assessment strategies that identify higher risk behaviors in all patient groups holds the most promise for identifying the greatest number of patients for whom antibody testing is indicated.20 Undertaking this task in all primary care settings is likely to reach the largest number of potential patients. In our inner-city primary care population, the prevalence rate was more than 4 times the reported national prevalence rate. Univariate analysis of the HCV risk factor domains showed that a positive medical history, exposure history, or social history was significantly associated with HCV antibody positivity (P < .01 for all comparisons [Table 2]). There was a trend toward higher rates of HCV antibody positivity among patients with a positive personal history
Hepatitis C testing practices and prevalence in a high-risk urban ambulatory care setting: 'prevalence 3-7 times higher than 1.6% reported by CDC'..... - pdf attached - (02/16/11)
"we found a very high estimated prevalence of HCV infection in a high-risk urban patient population with a high prevalence of risk factors. We found strong evidence that physicians are using a risk-based screening strategy to identify patients with HCV infection, using known risk factors and other conditions associated with HCV to guide testing. We also found evidence that screening recommendations should be expanded to include the high prevalence birth cohort."..."risk-factor-based testing preferable...12% among African-Americans & Latinos...43% among substance abusers....3% among alcohol abusers....16% with psych illness....9% with STDs....34% among HIV+"
Economic Analysis of Hepatitis B Screening and Treatment - Editorial - (06/01/11)
"The investigators found that screening for HBV infection among persons from regions where the HBsAg prevalence is at least 2%, followed by antiviral treatment for those identified with chronic HBV infection using a low-cost, high-resistance nucleoside or nucleostide analog (eg, lamivudine), was cost-effective, compared with no screening......."The results of this economic analysis support current HBV screening guidelines, but they also emphasize that it is the implementation of these recommendations that will decrease the morbidity and mortality associated with chronic HBV infection. Implementation of HBV testing recommendations is high among some subgroups...."The Institute of Medicine's 2010 report, "Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C," highlights the lack of knowledge and awareness about HBV infection and screening among health care and social-service providers, policymakers, and members of the public, and notes that resources being allocated for HBV surveillance, prevention, and control remain inadequate
The Cost-effectiveness of Screening for Chronic Hepatitis B Infection in the United States - (06/01/11)
"Guidelines such as those of the US Preventive Services Task Force do not recommend screening for HBV infection in the general adult population...."The full economic impact of chronic HBV infection remains unknown......."Current guidelines, such as those of the US Preventive Services Task Force [3], do not recommend universal screening for HBV infection in the general population and utilize relatively high rates of prevalence (2%) in targeted populations. Our analysis suggests that screening becomes cost-effective at a population prevalence of >0.3%.
CDC Study HCV Testing in >50 years Old Baby Boomers in Doctor's ...
www.natap.org/2011/newsUpdates/020611_08.htm
Insurance status and treatment candidacy of hepatitis C patients ...
Better insurance coverage may not only improve antiviral treatment rates, but also enhance rates of hepatitis C testing (i.e., screening) and diagnosis, ...www.natap.org/2011/HCV/050711_01.htm
HCV Treaters Shortage Editorial - Distributive justice and the arrival of direct-acting antivirals: Who should be first in line? - (06/09/11)
HIV and HCV health [mis]beliefs in an inner-city community - pdf attached: 'inaccurate understanding of HCV'.... - (02/16/11)
NEW Drugs in Development for HCV - (06/06/11)
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