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HCV/IDU-African Americans Bear Greatest Burden-NHANES
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From Jules: Both in HCV & in HIV African Americans & Latinos, and the poor are disproportionately affected. Care & treatment in HIV is worse, care & treatment in HCV is worse. IDU in the USA disproportionately affects African Americans - see data below. HCV is more prevalent among African Americans & death rates due to HCC are highest among African Americans. However with the new HCV oral treatments which have 95%+ SVR/cure rates response to treatment is the same for African Americans & Latinos as for whites. Unless access to screening & care & treatment is equal for all affected by HCV we will not be able to eliminate HCV. The federal government & wall the States need "HCV Elimination Programs" which has to provide deep funding for screening & linkage to care, treatment and awareness. Right now the federal government is complicit with States imposing Medicaid restrictions to access to treatment for HCV. Here is the new NYS HCV guidelines - New NYS HCV Guidelines - (07/11/17) - but without adequate funding to remove restrictions (Medicaid) & provide large scale open-ended screening & linkage to care and care/treatment we will not be able to eliminate HCV & all these inequities will persist. In NYS we do not have the funding for such a full scale program, funding in NYS has not increased at all despite these new Guidelines & there is no indication that NYS nor the federal government will change this. No State in the USA is providing the funding, and the federal government is not providing the funding needed. No State is willing to fund these programs nor remove Medicaid restrictions. The White House & Congress refuse to address this. 25 years ago when I first realized the impact of HCV & started to focus on policy & education I knew that we could eliminate HCV when the oral drugs became available. Yes that's how long we have been researching these new HCV oral drugs. I started following their development from the very beginning. Now that we are into the 2nd and 3rd generation of these new drugs with 99% SVR rates across all genotypes with 8/12 weeks therapy, which is the greatest medical breakthrough in the last 50 years, the federal government, Congress & The White House refuse to take the steps necessary to eliminate HCV when it is now finally eliminate-able. I did not anticipate this lack of commitment to funding elimination would occur. When telapravir & boceprevir, the first generation of oral HCV drugs, became available access was not restricted, but limited access and restrictions emerged when the next generation of oral HCV drugs emerged several years ago. Now the 3rd or you might say the 4th generation of newrap HCV drugs is emerging with FDA approval for the newest regimens expected by August 2017. Drug prices are now at the lowest levels with regimens costing $15,000 to $25,000, don't tell me the federal government can't negotiate and figure out a way to address access & treatment, but HCV is a very stigmatized disease without much political juice like we had in the mid 1990s in HIV when activists infected with HIV & dying stormed the FDA & protested their way into changing the federal response to HIV. Jules Levin, NATAP
HCV & IDU - African Americans Bear Greatest Burden in USA
HCV Key Topics - IDUs/African-Americans/Latinos/treatment-experienced cirrhotics 24 weeks - (09/17/14)
New CDC Hepatitis Surveillance Report - 33,900 New HCV Infections - (06/23/17)
Reported cases of acute HCV infection increased more than 2.9-fold from 2010 through 2015.....The increase in acute HCV case reports reflects new infections associated with rising rates of injection-drug use, and, to a much lesser extent, improved case detection ......that most occur among young, white persons who live in non-urban areas (particularly in states within the Appalachian, Midwestern, and New England regions of the country)
Hepatitis C Virus Infection in African Americans - (04/19/06) "....HCV infection is more prevalent in the African American population than in any other racial group in the United States (table 1). Although African Americans represent only 12% of the US population, they represent 22% of the estimated Americans with chronic HCV infection....
NHANES: "non-Hispanic blacks bore the greatest burden of HCV infection in the United States... IDU remains Strongest Risk Factor for HCV infection" - (07/30/14)
Death Rates Highest Among Blacks & Secondly Hispanics, Rate Double for African Americans vs Whites & 50% Higher for Hispanics vs Whites......deaths associated with HCV are largely underestimated; the only large U.S. study of deaths among persons with confirmed HCV infection indicated that only 19% had HCV listed anywhere on the death certificate despite 75% having evidence of substantial liver disease
US liver cancer mortality rates increased with age in all racial/ethnic groups ( Table 1). All reported mortality rates are per 100,000 people. Among individuals aged 35-49 years, Asians/Pacific Islanders had the highest mortality rates (2.8), followed by blacks (2.0), Hispanics (1.4), and whites (0.9). Among individuals aged 50-64 years, blacks had the highest mortality rate (18.6), followed by Hispanics (13.5), Asians/Pacific Islanders (13.0), and whites (7.7). - Changing Hepatocellular Carcinoma Incidence and Liver Cancer Mortality Rates in the United States..... "US liver cancer mortality rates increased with age in all racial/ethnic groups..... Among individuals aged 50-64 years, blacks had the highest mortality rate (18.6), followed by Hispanics (13.5), Asians/Pacific Islanders (13.0), and whites (7.7)." - (05/05/14)
IDUs - also African Americans disproportionately affected
Estimating the Number of Persons Who Inject Drugs in the United States by Meta-Analysis to Calculate National Rates of HIV and Hepatitis C Virus Infections - (05/30/14) .....we estimated that persons who ever injected drugs comprised 2.6% (CI: 1.8%-3.3%) of the U.S. population......This represents approximately 6,612,488 million PWID (range: 4,583,188-8,641,788) aged 13 years or older in 2011.......we estimate that approximately 774,434 adults and adolescents (range: 494,605-1,054,263) injected drugs in the past year in the United States - see Table 4: 3.4% Black/African Americans, 3.4% whites
"Injection drug use remains the strongest risk factor for HCV infection.[47-49]....The prevalence was noted to be highest among male non-Hispanic Blacks (2.2%) compared to Non-Hispanic whites (1.3%) [2.9% among Black men, 1.7% among Black women]" - [new survey] The Changing Epidemiology of Hepatitis C Virus Infection in the United States: National Health and Nutrition Examination Survey 2001 through 2010 - (01/13/14)
How Many/Who HAS HCV in USA - (01/14/14)
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