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SVR Reduces Kidney Disease & CVD, Cancer Risk - 'These findings argue for the prescription of HCV therapy in coinfected/all patients regardless of fibrosis stage.'
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Federal & State Govts Ignore HCV Epidemic - Immediate HCV Treatment is BEST / Delayed Treatment Increases Risk 7-20 fold for Death & Liver Cancer - federal & state governments support denial of early treatment - HCV is CURABLE with 12 weeks therapy!!!!
from Jules: "another silent epidemic within the opioid & IDU outbreak BUT ALSO within the HCV epidemic in the USA - is - the doubling of HCV infection among young pregnant women of reproductive age. The federal [congress, white house] and state governments have essentially ignored the HCV epidemic - clearly, by Congress only giving the CDC Hepatitis Division $38 million a year, while we need a billion a year just to get started in implementing a national strategy to eliminate HCV. HCV is curable & we could eliminate HCV in the USA. Elimination is cost effective - over the long term a lot of healthcare costs would be saved & a lot of lives would be saved and much disease would be prevented.
THIS STUDY is the latest in a series of studies providing evidence that treating HCV earlier prevents disease progression & delaying treatment increases risk for liver cancer & death quite a to, and earlier treatment is cost effective too:
EASL: Early versus delayed hepatitis C treatment provides increased health benefits at lower costs: A UK cost-effectiveness analysis of genotypes 1 and 4 treatment-naïve patients - (05/03/17)
Right now state Medicaid programs impose restrictions on access to new HCV "cure" drug regimens to those with advanced disease, by this point in the progression of HCV disease this increases the rates & risk for developing serious disease. HCV-infected should be treated immediately, in early disease as studies show this prevents disease progression & response to therapy is better & this prevents risk for future HCC (liver cancer), not to treat early increases the risk for developing liver cancer. The federal government knows very well that state medicaid programs impose these harsh restrictions to access to treatment, so they are complicit. We need national & state screening & linkage to care programs but there are very few, and with congress providing only $38 mill to the CDC they are very limited.
Can you imagine if cancer or heart disease, or diabetes were curable with 12 weeks of treatment? I think there would be a public outcry that the federal and state governments would have to respond to, the stigma of HCV is a big barrier. The White Hose & Congress are responsible for major policy implementation & funding, they are responsible for this but where are federal officials? Advocacy has not been effective.
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Reported at AASLD was this study showing improved renal function with SVR-
AASLD: The Impact of Hepatitis C Viral Cure on Progression of Renal Disease - (11/14/16)
EASL: Prognostic value of viral eradication for major adverse cardiovascular events in hepatitis C cirrhotic patients. ANRS CO12 CirVir Cohort - (04/26/17)
EASL: THERAPY WITH DIRECT ANTIVIRAL AGENTS IN PATIENTS WITH HCV-RELATED LYMPHOPROLIFERATIVE DISORDERS AND MIXED CRYOGLOBULINEMIA- (04/26/17)
Considering patients with B-NHL, one patient died for disease progression, while the others showed partial haematological regression or disease stability. At follow-up all patients with MC had an improvement in clinical symptoms, in 27 patients (84%) cryoglobulines were undetectable, while 5 had a decrease in cryoctrit.
EASL: The cumulative prevalence and incidence of extra-hepatic manifestations in patients with hepatitis C virus infection: real-world evidence from the United States - (05/03/17)
HCV+ have much more Extra Hepatic Manifestations or comorbidities which results in high clinical burden and increased healthcare costs.
EASL: Extra-hepatic manifestations from hepatitis C virus infection related to female infertility and adverse pregnancy outcomes: A real-world observation - (05/03/17)
Extrahepatic Morbidity and Mortality of Chronic Hepatitis C Review - SVR Clears/Reduces Extrahepatic Manifestations.....http://www.natap.org/2015/HCV/110515_04.htm,
Eradication of HCV and non-liver-related non-AIDS-related events (CVD/diabetes/kidney/cancers) in HIV/HCV coinfection - (02/01/17) - After a median five-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR 0.57 [95% CI, 0.35 - 0.93] P= .024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR 0.43 [95% CI, 0.17 - 1.09], P=.075).
HCV & active IDU associated with immune activation -
CROI/2016: Understanding the Relative Contributions of IDU and HCV on Systemic Immune Activation HCV should be aggressively treated in current IDUs even more if HIV and/or HCV positive - (04/4/16) HCV treatment should be aggressive in IDUs because their immune system is activated, immune activation can lead to inflammation which can have poor long-term outcomes, we know that the onset of & early & accelerated & premature onset of comorbidities like heart disease, neurologic impairment, and perhaps kidney disease, bone disease & frailty are all associated with immune activation & to inflammation
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