HCV Hub

By mapping the testing and care of patients with the hepatitis C virus on a continuum, health care providers can get a better picture of the stages at which the disease is being managed effectively and where along the spectrum there may be room for greater improvement, according to a study published in Hepatology.

“This continuum provides a ‘real-life’ snapshot of how this disease is being managed in a major U.S. urban center,” according to the investigators, led by Kendra Viner, Ph.D., of the Philadelphia Department of Public Health (PDPH). “Many patients are lost at each stage, highlighting the need to raise awareness among health care professionals and at-risk populations about appropriate hepatitis testing, referral, support, and care.”

In a retrospective, population-based study, Dr. Viner and her coinvestigators – all of whom are also with PDPH – examined reports of hepatitis filed in the city between January 2010 and December 2013. During this time, 70% of hepatitis reports were from electronic laboratory reporting (ELR), 25% were from fax or phone reports, and the remaining 5% came from “active case findings.” Investigators also used enhanced surveillance data to find hepatitis cases reported during the study period (Hepatology 2014 ([doi:10.1002/hep.27584]).

Using population estimates from the 2010 United States Census, the American Community Survey (ACS), and the National Health and Nutrition Examination Survey (NHANES), the authors were also able to estimate hepatitis C (HCV) seroprevalence in certain demographics. The HCV care continuum (HCV-CoC) was defined as follows: stage 1: HCV Ab screening; stage 2: HCV Ab and RNA testing; stage 3: RNA-confirmation and continuing care; stage 4: RNA-confirmation, care, and HCV treatment.

Based on their estimates, Dr. Viner and her associates postulated that of approximately 1,584,848 Philadelphia residents, 47,207 (2.9%) would have HCV, with test results anticipated for 28,990 (61%) of those individuals. Positive HCV results were received for 13,596 individuals, of whom 6,383 (47%) had a positive HCV RNA test. Of these, 1,745 (27%) were in care, and 956 (15%) had received or were currently receiving treatment.

“These findings elucidate how few HCV-infected residents are successfully mobilized from screening through confirmatory testing and into care and treatment,” wrote Dr. Viner and her coauthors. “Understanding and addressing the specific reasons why patients are lost at each stage is critical if public health and clinical care practitioners hope to affect the outcomes of chronic HCV infection.”

In each category of testing and treatment, men presented nearly twice as often as women: 61% vs. 39%, Ab only; 64% vs. 36%, Ab plus RNA; 64% vs. 36%, Ab plus RNA with no antiviral treatment; and 71% vs. 29%, Ab plus RNA with antiviral treatment, respectively (P < .001). Patients aged 45-64 years presented the most often for both genders (P < .001), and blacks and whites were most common in the study population (P < .001).

The investigators noted that their findings were consistent with national estimates, which say that fewer than half of a city’s population would have HCV infections, and that 3%-5% of cases would be underreported, thus possibly explaining some missing cases in their own data.

“To promote movement through the continuum of HCV care, state and local health departments need to devise ways to improve surveillance and enhance screening and linkage and retention in HCV care services,” concluded the authors. “However, none of this can happen effectively without strong federal support and greater efforts to promote an implementation science agenda that pulls on surveillance data to execute the CDC’s recommendation for routine baby boomer and risk-based screening, and enhance the HCV care continuum,” they added.

The authors reported no financial conflicts of interest.

AGA Resources

AGA provides a HCV Clinical Service Line at www.gastro.org/practice/clinical-service-line/hcv-clinical-service-line.

dchitnis@frontlinemedcom.com

By mapping the testing and care of patients with the hepatitis C virus on a continuum, health care providers can get a better picture of the stages at which the disease is being managed effectively and where along the spectrum there may be room for greater improvement, according to a study published in Hepatology.

“This continuum provides a ‘real-life’ snapshot of how this disease is being managed in a major U.S. urban center,” according to the investigators, led by Kendra Viner, Ph.D., of the Philadelphia Department of Public Health (PDPH). “Many patients are lost at each stage, highlighting the need to raise awareness among health care professionals and at-risk populations about appropriate hepatitis testing, referral, support, and care.”

In a retrospective, population-based study, Dr. Viner and her coinvestigators – all of whom are also with PDPH – examined reports of hepatitis filed in the city between January 2010 and December 2013. During this time, 70% of hepatitis reports were from electronic laboratory reporting (ELR), 25% were from fax or phone reports, and the remaining 5% came from “active case findings.” Investigators also used enhanced surveillance data to find hepatitis cases reported during the study period (Hepatology 2014 ([doi:10.1002/hep.27584]).

Using population estimates from the 2010 United States Census, the American Community Survey (ACS), and the National Health and Nutrition Examination Survey (NHANES), the authors were also able to estimate hepatitis C (HCV) seroprevalence in certain demographics. The HCV care continuum (HCV-CoC) was defined as follows: stage 1: HCV Ab screening; stage 2: HCV Ab and RNA testing; stage 3: RNA-confirmation and continuing care; stage 4: RNA-confirmation, care, and HCV treatment.

Based on their estimates, Dr. Viner and her associates postulated that of approximately 1,584,848 Philadelphia residents, 47,207 (2.9%) would have HCV, with test results anticipated for 28,990 (61%) of those individuals. Positive HCV results were received for 13,596 individuals, of whom 6,383 (47%) had a positive HCV RNA test. Of these, 1,745 (27%) were in care, and 956 (15%) had received or were currently receiving treatment.

“These findings elucidate how few HCV-infected residents are successfully mobilized from screening through confirmatory testing and into care and treatment,” wrote Dr. Viner and her coauthors. “Understanding and addressing the specific reasons why patients are lost at each stage is critical if public health and clinical care practitioners hope to affect the outcomes of chronic HCV infection.”

In each category of testing and treatment, men presented nearly twice as often as women: 61% vs. 39%, Ab only; 64% vs. 36%, Ab plus RNA; 64% vs. 36%, Ab plus RNA with no antiviral treatment; and 71% vs. 29%, Ab plus RNA with antiviral treatment, respectively (P < .001). Patients aged 45-64 years presented the most often for both genders (P < .001), and blacks and whites were most common in the study population (P < .001).

The investigators noted that their findings were consistent with national estimates, which say that fewer than half of a city’s population would have HCV infections, and that 3%-5% of cases would be underreported, thus possibly explaining some missing cases in their own data.

“To promote movement through the continuum of HCV care, state and local health departments need to devise ways to improve surveillance and enhance screening and linkage and retention in HCV care services,” concluded the authors. “However, none of this can happen effectively without strong federal support and greater efforts to promote an implementation science agenda that pulls on surveillance data to execute the CDC’s recommendation for routine baby boomer and risk-based screening, and enhance the HCV care continuum,” they added.

The authors reported no financial conflicts of interest.

AGA Resources

AGA provides a HCV Clinical Service Line at www.gastro.org/practice/clinical-service-line/hcv-clinical-service-line.

dchitnis@frontlinemedcom.com

By mapping the testing and care of patients with the hepatitis C virus on a continuum, health care providers can get a better picture of the stages at which the disease is being managed effectively and where along the spectrum there may be room for greater improvement, according to a study published in Hepatology.

“This continuum provides a ‘real-life’ snapshot of how this disease is being managed in a major U.S. urban center,” according to the investigators, led by Kendra Viner, Ph.D., of the Philadelphia Department of Public Health (PDPH). “Many patients are lost at each stage, highlighting the need to raise awareness among health care professionals and at-risk populations about appropriate hepatitis testing, referral, support, and care.”

In a retrospective, population-based study, Dr. Viner and her coinvestigators – all of whom are also with PDPH – examined reports of hepatitis filed in the city between January 2010 and December 2013. During this time, 70% of hepatitis reports were from electronic laboratory reporting (ELR), 25% were from fax or phone reports, and the remaining 5% came from “active case findings.” Investigators also used enhanced surveillance data to find hepatitis cases reported during the study period (Hepatology 2014 ([doi:10.1002/hep.27584]).

Using population estimates from the 2010 United States Census, the American Community Survey (ACS), and the National Health and Nutrition Examination Survey (NHANES), the authors were also able to estimate hepatitis C (HCV) seroprevalence in certain demographics. The HCV care continuum (HCV-CoC) was defined as follows: stage 1: HCV Ab screening; stage 2: HCV Ab and RNA testing; stage 3: RNA-confirmation and continuing care; stage 4: RNA-confirmation, care, and HCV treatment.

Based on their estimates, Dr. Viner and her associates postulated that of approximately 1,584,848 Philadelphia residents, 47,207 (2.9%) would have HCV, with test results anticipated for 28,990 (61%) of those individuals. Positive HCV results were received for 13,596 individuals, of whom 6,383 (47%) had a positive HCV RNA test. Of these, 1,745 (27%) were in care, and 956 (15%) had received or were currently receiving treatment.

“These findings elucidate how few HCV-infected residents are successfully mobilized from screening through confirmatory testing and into care and treatment,” wrote Dr. Viner and her coauthors. “Understanding and addressing the specific reasons why patients are lost at each stage is critical if public health and clinical care practitioners hope to affect the outcomes of chronic HCV infection.”

In each category of testing and treatment, men presented nearly twice as often as women: 61% vs. 39%, Ab only; 64% vs. 36%, Ab plus RNA; 64% vs. 36%, Ab plus RNA with no antiviral treatment; and 71% vs. 29%, Ab plus RNA with antiviral treatment, respectively (P < .001). Patients aged 45-64 years presented the most often for both genders (P < .001), and blacks and whites were most common in the study population (P < .001).

The investigators noted that their findings were consistent with national estimates, which say that fewer than half of a city’s population would have HCV infections, and that 3%-5% of cases would be underreported, thus possibly explaining some missing cases in their own data.

“To promote movement through the continuum of HCV care, state and local health departments need to devise ways to improve surveillance and enhance screening and linkage and retention in HCV care services,” concluded the authors. “However, none of this can happen effectively without strong federal support and greater efforts to promote an implementation science agenda that pulls on surveillance data to execute the CDC’s recommendation for routine baby boomer and risk-based screening, and enhance the HCV care continuum,” they added.

The authors reported no financial conflicts of interest.

AGA Resources

AGA provides a HCV Clinical Service Line at www.gastro.org/practice/clinical-service-line/hcv-clinical-service-line.

dchitnis@frontlinemedcom.com

Gilead Sciences Inc. and Aetna Inc. have announced a partnership wherein the drug company will offer Aetna’s approximately 20 million health plan members a discounted rate on its hepatitis C drugs, Sovaldi (sofosbuvir) and Harvoni (ledipasvir and sofosbuvir).

The amount of the discount has not yet been announced, although it should be significantly less than the current rate: Sovaldi costs $84,000 for a 12-week course of treatment, and Harvoni costs $94,500 for 12 weeks.

For more information, go to www.reuters.com.

mbock@frontlinemedcom.com

Gilead Sciences Inc. and Aetna Inc. have announced a partnership wherein the drug company will offer Aetna’s approximately 20 million health plan members a discounted rate on its hepatitis C drugs, Sovaldi (sofosbuvir) and Harvoni (ledipasvir and sofosbuvir).

The amount of the discount has not yet been announced, although it should be significantly less than the current rate: Sovaldi costs $84,000 for a 12-week course of treatment, and Harvoni costs $94,500 for 12 weeks.

For more information, go to www.reuters.com.

mbock@frontlinemedcom.com

Gilead Sciences Inc. and Aetna Inc. have announced a partnership wherein the drug company will offer Aetna’s approximately 20 million health plan members a discounted rate on its hepatitis C drugs, Sovaldi (sofosbuvir) and Harvoni (ledipasvir and sofosbuvir).

The amount of the discount has not yet been announced, although it should be significantly less than the current rate: Sovaldi costs $84,000 for a 12-week course of treatment, and Harvoni costs $94,500 for 12 weeks.

For more information, go to www.reuters.com.

mbock@frontlinemedcom.com

The recent advent of new treatments for hepatitis C prompted organizations including the Centers for Disease Control and Prevention, the U.S. Preventive Services Task Force, and the World Health Organization to recommend expanded hepatitis C screening, but such screening may be premature, according to a subject analysis.

Too much uncertainty exists regarding the validity of surrogate markers for treatment efficacy that were used in trials, and evidence regarding clinical outcomes and screening strategies is lacking, according to Dr. Ronald L. Koretz of the University of California, Los Angeles, and his colleagues, who evaluated the current understanding of the incidence and natural course of hepatitis C infection, treatment efficacy, and potential harms of treatment for their analysis.

Courtesy NIH

The best available data suggest that 80%-85% of patients with chronic hepatitis C will die of nonhepatic causes; thus screening could lead to unnecessary treatment. This is important, as safety data for newer drugs are limited, and the existing data suggest a small but concerning rate of serious adverse events associated with the use of some treatments and treatment regimens; the risk-benefit profile of treatment cannot be adequately evaluated because of the lack of data regarding treatment benefits, the investigators reported online Jan. 13 in the British Medical Journal ([doi:10.10036/bmj.g7809]).

Clinical trials to determine the outcomes of treatment in screen-detected patients, as well as the long-term hazards of treatment, are needed, they said, noting that currently available trials included small numbers of patients and/or only short-term follow-up. Until data from such trials are available, physicians should not be pressured to enforce recommended screening strategies “out of enthusiasm for new treatments that have not yet been shown to cause long-term clinical improvement,” they concluded.

Dr. Koretz is a member of the editorial board of the Cochrane Hepato-Biliary Group. The authors reported having no other financial conflicts.

The recent advent of new treatments for hepatitis C prompted organizations including the Centers for Disease Control and Prevention, the U.S. Preventive Services Task Force, and the World Health Organization to recommend expanded hepatitis C screening, but such screening may be premature, according to a subject analysis.

Too much uncertainty exists regarding the validity of surrogate markers for treatment efficacy that were used in trials, and evidence regarding clinical outcomes and screening strategies is lacking, according to Dr. Ronald L. Koretz of the University of California, Los Angeles, and his colleagues, who evaluated the current understanding of the incidence and natural course of hepatitis C infection, treatment efficacy, and potential harms of treatment for their analysis.

Courtesy NIH

The best available data suggest that 80%-85% of patients with chronic hepatitis C will die of nonhepatic causes; thus screening could lead to unnecessary treatment. This is important, as safety data for newer drugs are limited, and the existing data suggest a small but concerning rate of serious adverse events associated with the use of some treatments and treatment regimens; the risk-benefit profile of treatment cannot be adequately evaluated because of the lack of data regarding treatment benefits, the investigators reported online Jan. 13 in the British Medical Journal ([doi:10.10036/bmj.g7809]).

Clinical trials to determine the outcomes of treatment in screen-detected patients, as well as the long-term hazards of treatment, are needed, they said, noting that currently available trials included small numbers of patients and/or only short-term follow-up. Until data from such trials are available, physicians should not be pressured to enforce recommended screening strategies “out of enthusiasm for new treatments that have not yet been shown to cause long-term clinical improvement,” they concluded.

Dr. Koretz is a member of the editorial board of the Cochrane Hepato-Biliary Group. The authors reported having no other financial conflicts.

The recent advent of new treatments for hepatitis C prompted organizations including the Centers for Disease Control and Prevention, the U.S. Preventive Services Task Force, and the World Health Organization to recommend expanded hepatitis C screening, but such screening may be premature, according to a subject analysis.

Too much uncertainty exists regarding the validity of surrogate markers for treatment efficacy that were used in trials, and evidence regarding clinical outcomes and screening strategies is lacking, according to Dr. Ronald L. Koretz of the University of California, Los Angeles, and his colleagues, who evaluated the current understanding of the incidence and natural course of hepatitis C infection, treatment efficacy, and potential harms of treatment for their analysis.

Courtesy NIH

The best available data suggest that 80%-85% of patients with chronic hepatitis C will die of nonhepatic causes; thus screening could lead to unnecessary treatment. This is important, as safety data for newer drugs are limited, and the existing data suggest a small but concerning rate of serious adverse events associated with the use of some treatments and treatment regimens; the risk-benefit profile of treatment cannot be adequately evaluated because of the lack of data regarding treatment benefits, the investigators reported online Jan. 13 in the British Medical Journal ([doi:10.10036/bmj.g7809]).

Clinical trials to determine the outcomes of treatment in screen-detected patients, as well as the long-term hazards of treatment, are needed, they said, noting that currently available trials included small numbers of patients and/or only short-term follow-up. Until data from such trials are available, physicians should not be pressured to enforce recommended screening strategies “out of enthusiasm for new treatments that have not yet been shown to cause long-term clinical improvement,” they concluded.

Dr. Koretz is a member of the editorial board of the Cochrane Hepato-Biliary Group. The authors reported having no other financial conflicts.

HCV SCREENING DECISION TOOL
The initial screening tool for HCV infection is an HCV antibody test. A positive anti-HCV antibody result can signify either current or resolved infection, followed with an HCV ribonucleic acid (RNA) test to determine if active infection is present. Screening should be offered to all individuals falling within one or more of the following at-risk categories or behaviors.^1-4

HIGH-RISK INDIVIDUALS HAVE/ARE…
• Been born between 1945 and 1965, regardless of other risk factors; should be screened one time
• Currently or formerly used injection drugs, including injecting only once many years ago; current injection drug users should be screened annually
• Received clotting factor concentrates made before 1987 (before more advanced methods for manufacturing those products were developed)
• Received blood transfusions or solid organ transplants before July 1992 (before better testing of blood donors became available)
• Born to HCV-positive mothers (If diagnosis is required for children younger than 18 months, use the HCV ribonucleic acid (RNA) test at 1 to 2 months.)
• Ever received long-term hemodialysis
• Human immunodeficiency virus (HIV) infection
• Known exposures to HCV
     • Health care workers after needle stick injuries involving HCV-positive blood  
     • Recipients of blood or organs from donors who tested positive for HCV
• HIV-positive men who have sex with men; should be screened annually
• Signs and symptoms of liver disease (elevated transaminase levels)

LOWER-RISK INDIVIDUALS HAVE...
• Heterosexual intercourse with an HCV-infected person or multiple sexual partners
• Shared personal items that may contain blood, such as razors and toothbrushes
• Other invasive health care procedures, such as injections
• Cosmetic procedures, such as tattoos and piercings, where infection control is substandard
• Used intranasal drugs, cocaine, or marijuana

The following HCV screening algorithm, which includes the points at which referrals to specialists are indicated, is useful for determining the right test to use for a specific risk group.

Because of the potentially serious consequences of untreated chronic HCV, it is critical that primary care clinicians identify and screen patients who are at risk for having or acquiring the disease.

Read Sturm D, Gurevitz SL, Davidson D, Fritchley A, Wagaman A. Chronic hepatitis C infection: Bane of baby boomers. 2014;24(11):24-32 to earn 1 hour AAPA Category 1 CME credit, expires November 31, 2015.

URL: http://www.clinicianreviews.com/articles/cecme-activities/article/chronic-hepatitis-c-infection-bane-of-baby-boomers/73b211cce27d01b93463584dd2c44083.html

REFERENCES
4. [1.] The World Health Organization. Guidelines for the screening, care and treatment of persons with hepatitis C infection. www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed January 7, 2015.
8. [2.] CDC. Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR. 2013;62(18):362-365.
9. [3.] Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(5):349-357.
10. [4.] American Association for the Study of Liver Diseases and Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. www.hcvguidelines.org/sites/default/files/full_report.pdf. Accessed January 7, 2015.

HCV SCREENING DECISION TOOL
The initial screening tool for HCV infection is an HCV antibody test. A positive anti-HCV antibody result can signify either current or resolved infection, followed with an HCV ribonucleic acid (RNA) test to determine if active infection is present. Screening should be offered to all individuals falling within one or more of the following at-risk categories or behaviors.^1-4

HIGH-RISK INDIVIDUALS HAVE/ARE…
• Been born between 1945 and 1965, regardless of other risk factors; should be screened one time
• Currently or formerly used injection drugs, including injecting only once many years ago; current injection drug users should be screened annually
• Received clotting factor concentrates made before 1987 (before more advanced methods for manufacturing those products were developed)
• Received blood transfusions or solid organ transplants before July 1992 (before better testing of blood donors became available)
• Born to HCV-positive mothers (If diagnosis is required for children younger than 18 months, use the HCV ribonucleic acid (RNA) test at 1 to 2 months.)
• Ever received long-term hemodialysis
• Human immunodeficiency virus (HIV) infection
• Known exposures to HCV
     • Health care workers after needle stick injuries involving HCV-positive blood  
     • Recipients of blood or organs from donors who tested positive for HCV
• HIV-positive men who have sex with men; should be screened annually
• Signs and symptoms of liver disease (elevated transaminase levels)

LOWER-RISK INDIVIDUALS HAVE...
• Heterosexual intercourse with an HCV-infected person or multiple sexual partners
• Shared personal items that may contain blood, such as razors and toothbrushes
• Other invasive health care procedures, such as injections
• Cosmetic procedures, such as tattoos and piercings, where infection control is substandard
• Used intranasal drugs, cocaine, or marijuana

The following HCV screening algorithm, which includes the points at which referrals to specialists are indicated, is useful for determining the right test to use for a specific risk group.

Because of the potentially serious consequences of untreated chronic HCV, it is critical that primary care clinicians identify and screen patients who are at risk for having or acquiring the disease.

Read Sturm D, Gurevitz SL, Davidson D, Fritchley A, Wagaman A. Chronic hepatitis C infection: Bane of baby boomers. 2014;24(11):24-32 to earn 1 hour AAPA Category 1 CME credit, expires November 31, 2015.

URL: http://www.clinicianreviews.com/articles/cecme-activities/article/chronic-hepatitis-c-infection-bane-of-baby-boomers/73b211cce27d01b93463584dd2c44083.html

REFERENCES
4. [1.] The World Health Organization. Guidelines for the screening, care and treatment of persons with hepatitis C infection. www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed January 7, 2015.
8. [2.] CDC. Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR. 2013;62(18):362-365.
9. [3.] Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(5):349-357.
10. [4.] American Association for the Study of Liver Diseases and Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. www.hcvguidelines.org/sites/default/files/full_report.pdf. Accessed January 7, 2015.

HCV SCREENING DECISION TOOL
The initial screening tool for HCV infection is an HCV antibody test. A positive anti-HCV antibody result can signify either current or resolved infection, followed with an HCV ribonucleic acid (RNA) test to determine if active infection is present. Screening should be offered to all individuals falling within one or more of the following at-risk categories or behaviors.^1-4

HIGH-RISK INDIVIDUALS HAVE/ARE…
• Been born between 1945 and 1965, regardless of other risk factors; should be screened one time
• Currently or formerly used injection drugs, including injecting only once many years ago; current injection drug users should be screened annually
• Received clotting factor concentrates made before 1987 (before more advanced methods for manufacturing those products were developed)
• Received blood transfusions or solid organ transplants before July 1992 (before better testing of blood donors became available)
• Born to HCV-positive mothers (If diagnosis is required for children younger than 18 months, use the HCV ribonucleic acid (RNA) test at 1 to 2 months.)
• Ever received long-term hemodialysis
• Human immunodeficiency virus (HIV) infection
• Known exposures to HCV
     • Health care workers after needle stick injuries involving HCV-positive blood  
     • Recipients of blood or organs from donors who tested positive for HCV
• HIV-positive men who have sex with men; should be screened annually
• Signs and symptoms of liver disease (elevated transaminase levels)

LOWER-RISK INDIVIDUALS HAVE...
• Heterosexual intercourse with an HCV-infected person or multiple sexual partners
• Shared personal items that may contain blood, such as razors and toothbrushes
• Other invasive health care procedures, such as injections
• Cosmetic procedures, such as tattoos and piercings, where infection control is substandard
• Used intranasal drugs, cocaine, or marijuana

The following HCV screening algorithm, which includes the points at which referrals to specialists are indicated, is useful for determining the right test to use for a specific risk group.

Because of the potentially serious consequences of untreated chronic HCV, it is critical that primary care clinicians identify and screen patients who are at risk for having or acquiring the disease.

Read Sturm D, Gurevitz SL, Davidson D, Fritchley A, Wagaman A. Chronic hepatitis C infection: Bane of baby boomers. 2014;24(11):24-32 to earn 1 hour AAPA Category 1 CME credit, expires November 31, 2015.

URL: http://www.clinicianreviews.com/articles/cecme-activities/article/chronic-hepatitis-c-infection-bane-of-baby-boomers/73b211cce27d01b93463584dd2c44083.html

REFERENCES
4. [1.] The World Health Organization. Guidelines for the screening, care and treatment of persons with hepatitis C infection. www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed January 7, 2015.
8. [2.] CDC. Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR. 2013;62(18):362-365.
9. [3.] Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(5):349-357.
10. [4.] American Association for the Study of Liver Diseases and Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. www.hcvguidelines.org/sites/default/files/full_report.pdf. Accessed January 7, 2015.

BOSTON– The number of hepatitis C virus antibody tests increased by 15.4% after the 2012 Centers for Disease Control and Prevention task force recommendation calling for one-time HCV testing in baby boomers, according to preliminary results from an analysis of 4.5 million tests.

Surprisingly, that increase in testing did not lead to an increase in the number of positive tests, which actually declined by 4.1%, R. Monina Klevens, D.D.S., MPH, reported at the annual meeting of the American Association for the Study of Liver Diseases.

“This is a huge question that we need to look at for implementation,” said Dr. Klevens, a medical epidemiologist with the CDC.

For a deep dive into the data and to hear what’s next, click here to see an interview with Dr Klevens.

Dr. Klevens reported no financial disclosures.

pwendling@frontlinemedcom.com

BOSTON– The number of hepatitis C virus antibody tests increased by 15.4% after the 2012 Centers for Disease Control and Prevention task force recommendation calling for one-time HCV testing in baby boomers, according to preliminary results from an analysis of 4.5 million tests.

Surprisingly, that increase in testing did not lead to an increase in the number of positive tests, which actually declined by 4.1%, R. Monina Klevens, D.D.S., MPH, reported at the annual meeting of the American Association for the Study of Liver Diseases.

“This is a huge question that we need to look at for implementation,” said Dr. Klevens, a medical epidemiologist with the CDC.

For a deep dive into the data and to hear what’s next, click here to see an interview with Dr Klevens.

Dr. Klevens reported no financial disclosures.

pwendling@frontlinemedcom.com

BOSTON– The number of hepatitis C virus antibody tests increased by 15.4% after the 2012 Centers for Disease Control and Prevention task force recommendation calling for one-time HCV testing in baby boomers, according to preliminary results from an analysis of 4.5 million tests.

Surprisingly, that increase in testing did not lead to an increase in the number of positive tests, which actually declined by 4.1%, R. Monina Klevens, D.D.S., MPH, reported at the annual meeting of the American Association for the Study of Liver Diseases.

“This is a huge question that we need to look at for implementation,” said Dr. Klevens, a medical epidemiologist with the CDC.

For a deep dive into the data and to hear what’s next, click here to see an interview with Dr Klevens.

Dr. Klevens reported no financial disclosures.

pwendling@frontlinemedcom.com

BOSTON – The estimated cost of treating all eligible U.S. hepatitis C patients with a new generation of high-priced medications may be breathtaking, but would the resulting savings over those cured patients’ lifetimes offset the initial financial blow?

A new analysis unveiled at the annual meeting of the American Association for the Study of Liver Diseases calculated the impact of the new drugs on treatment costs and compared the cost of treatment with new drugs to the old standard of care.

“We found that the cost of treatment is very high, as expected,” explained lead investigator Jagpreet Chhatwal, Ph.D., of MD Anderson Cancer Center, Houston. In fact, if everyone who was eligible for the new drugs were treated, the cost over the next 5 years would be $136 billion.

“This is clearly unsustainable for any payer,” he noted. “So the question is: How can we manage to treat people who need this treatment?”

In a video interview, Dr. Chhatwal outlined how the researchers calculated their cost estimates, what cost savings could be gained with the new drugs, and how patients and payers alike could manage the price of treatment.

BOSTON – The estimated cost of treating all eligible U.S. hepatitis C patients with a new generation of high-priced medications may be breathtaking, but would the resulting savings over those cured patients’ lifetimes offset the initial financial blow?

A new analysis unveiled at the annual meeting of the American Association for the Study of Liver Diseases calculated the impact of the new drugs on treatment costs and compared the cost of treatment with new drugs to the old standard of care.

“We found that the cost of treatment is very high, as expected,” explained lead investigator Jagpreet Chhatwal, Ph.D., of MD Anderson Cancer Center, Houston. In fact, if everyone who was eligible for the new drugs were treated, the cost over the next 5 years would be $136 billion.

“This is clearly unsustainable for any payer,” he noted. “So the question is: How can we manage to treat people who need this treatment?”

In a video interview, Dr. Chhatwal outlined how the researchers calculated their cost estimates, what cost savings could be gained with the new drugs, and how patients and payers alike could manage the price of treatment.

BOSTON – The estimated cost of treating all eligible U.S. hepatitis C patients with a new generation of high-priced medications may be breathtaking, but would the resulting savings over those cured patients’ lifetimes offset the initial financial blow?

A new analysis unveiled at the annual meeting of the American Association for the Study of Liver Diseases calculated the impact of the new drugs on treatment costs and compared the cost of treatment with new drugs to the old standard of care.

“We found that the cost of treatment is very high, as expected,” explained lead investigator Jagpreet Chhatwal, Ph.D., of MD Anderson Cancer Center, Houston. In fact, if everyone who was eligible for the new drugs were treated, the cost over the next 5 years would be $136 billion.

“This is clearly unsustainable for any payer,” he noted. “So the question is: How can we manage to treat people who need this treatment?”

In a video interview, Dr. Chhatwal outlined how the researchers calculated their cost estimates, what cost savings could be gained with the new drugs, and how patients and payers alike could manage the price of treatment.