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from Jules: in NYC -From 1999 to 2014, hepatitis C-related deaths increased by 38 percent.An estimated2.4 percent of New York City residents aged 20and older (about 146,500 people) have hepatitis C. Reported new HCV cases in NYC 2012-2015 n NYC: 23% of HCV-infected are genotype 1b, 8% GT3, 48% Gt1a, 8.8% GT2.In people aged 0 to 29 years, the highest rate of newly reported hepatitis C cases is seen in theincarcerated population at 169.2 per 100,000 people.Among all boroughs in 2015, Manhattan had the highest rate of newly reported hepatitis Ccases in people aged 0 to 29 years (34.7 per 100,000 people).Neighborhoods with the highest rates of newly reported hepatitis C in young people are EastHarlem, Chelsea-Clinton and the Lower East Side (Manhattan), Coney Island (Brooklyn), PortRichmond and Stapleton-Fort George (Staten Island). (NYC DOH).Liver cancer incidence and mortality remain high among New York City residents. From 2009 to2013, the incidence of liver cancer was higher in New York City (rate of 18.2 per 100,000 men and5.9 per 100,000 women) than in the rest of New York State (rate of 10.4 per 100,000 men and3.4 per 100,000 women).Brooklyn has the highest incidence and mortality rates of all New York City boroughs.In 2013, there were 718 cases of liver cancer among men (rate of 17.7 per 100,000 people) and 305cases among women (rate of 5.9 per 100,000 people).Annual average liver cancer incidence rates with hepatitis C infection are highest by far in the Bronx reflecting the need for better screening, linkage to care & treatment in the Bronx, but are also high inpacketsthroughout NYC including parts of Brooklyn & Queens (Jamaica, Rockaway, the Lower Eastside, also reflecting the need in the IDU community for more attention and services.People with chronic hepatitis C and cirrhosis should be screened for liver cancer every six months EVEN IF SUCCESSFULLY TREATED with new DAA therapy.In 2015, approximately 5,600 Medicaid recipients were prescribed hepatitis C treatments, a 63 percentincrease from 2014. Estimates are 150,000 have HCV in NYS but all these estimates are underestimates because of inadequate screening and surveillance not just in NY but throughout the USA and from the federal government. There is essentially no funding from the federal government for national HCVscreeningprograms. funding from Congress is only $34 million which goes to the CDC. We need $100 million or morealonein NYS to fund screening, linkage to care and unfettered treatment access.
Time is right to eliminate hepatitis C with new data, medications, and a plan to prevent and treat

San Francisco, June 12, 2017 - New research shows that San Francisco has an estimated 13,000 residents with hepatitis C infection. The disease, which can go undetected and without symptoms for years, is the leading cause of death from infectious disease in the United States. Nationwide, about 80% of people infected with hepatitis C develop chronic infection, and 2 in 3 people will develop chronic liver disease, which can lead to liver cancer if left untreated.
The good news is that highly effective treatments for hepatitis C now exist, which have few side effects and cure the disease in nearly all people who complete treatment, which is covered by Medi-Cal and private insurance. With the expansion of health coverage brought about by the Affordable Care Act, 133,000 San Franciscans are now Medi-Cal or Covered California members with access to hepatitis C treatment.
Dr. Annie Luetkemeyer, a physician at UCSF and Zuckerberg San Francisco General Hospital, notes, "Given recent medical advances, we now have the potential not just to reduce but to eliminate hepatitis C as a public health threat in San Francisco."
The first-ever estimate of hepatitis C cases in the city was produced by End Hep C SF, a consortium of doctors, public health experts and community members working to eliminate the disease in the city. End Hep C SF was formed in 2016 by the San Francisco Department of Public Health, University of California, San Francisco (UCSF) and more than 30 community partners.
To help understand the hepatitis C epidemic in San Francisco, End Hep C SF compiled and analyzed public health data from multiple sources to complete this first-ever estimate of hepatitis C cases for the city. End Hep C SF estimates that approximately 17,500 people (about 2% of San Franciscans) would have had active hepatitis C infection in 2015 if no one had yet been treated with the new, effective treatments. The good news is that to date, more than 4,500 people in San Francisco have been reported by medical facilities to have received the new treatments, significantly reducing the overall estimate of people with active infection.
Hepatitis C is a bloodborne illness that disproportionately affects some groups. "If you inject drugs or did so in the past, if you are a baby boomer, a transgender woman, or if you are a man who has sex with men – especially if you also are living with HIV – you should talk to your medical provider about testing for hepatitis C. Now that treatment is better and widely available, we can save the lives of thousands of San Franciscans," said Barbara Garcia, San Francisco Health Director. The public health department, medical providers and community activists have made great strides in reducing these health disparities over the years. Syringe access and disposal programs, access to methadone and buprenorphine, widespread hepatitis education and testing options, and a citywide harm reduction policy have contributed to the reduction.
The number of people living with hepatitis C is similar to the number of people living with HIV in San Francisco, estimated to be approximately 16,000. To eliminate hepatitis C in San Francisco, End Hep C SF is drawing on experiences from the battle against the HIV epidemic. According to Luetkemeyer, "Through an aggressive commitment to HIV prevention, testing, and treatment, we have greatly reduced the number of people becoming infected with HIV, and increased the number of people starting treatment. If we build on the lessons learned from HIV and commit as a citywide community to preventing, testing, and treating hepatitis C, we can eliminate it as a public health threat in our city."
Data summary
⋅Approximately 17,500 people would have had active infection with hepatitis C if new treatments were not being used in San Francisco
⋅At least 4,500 people have already received the new hepatitis C treatments
⋅Approximately 70% of people infected with hepatitis C are people who inject drugs, although people who inject drugs make up less than 3% of the city's population
⋅Around 13% of infections are among men who have sex with men, and almost 3/4 those infected with hepatitis C are also living with HIV
⋅40% of infections are among baby boomers (people born from 1945 – 1965), who make up 21% of the overall population of San Francisco
The estimated percentage of people with HCV antibodies in San Francisco (2.7%) is significantly higher than the national percentage (1.7%).1 It is not a surprise that the burden of HCV disease is greater in San Francisco, since a higher proportion of our residents are in the groups at highest risk for HCV.


For more information and a summary of the findings and analysis released by End Hep C SF, visit https://tinyurl.com/sfhcvprevalence.

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