Ending hepatitis C in the United States: the role of screening

Phillip O Coffin,1 Andrew Reynolds21San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; 2Project Inform, San Francisco, CA, USAAbstract: The US faces at least two distinct epidemics of hepatitis C virus infection (HCV), and due largely to revised screenin...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Coffin PO, Reynolds A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/22c76f4dea54402c8c656b94af2c7648
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:22c76f4dea54402c8c656b94af2c7648
record_format	dspace
spelling	oai:doaj.org-article:22c76f4dea54402c8c656b94af2c76482021-12-02T06:02:55ZEnding hepatitis C in the United States: the role of screening1179-1535https://doaj.org/article/22c76f4dea54402c8c656b94af2c76482014-07-01T00:00:00Zhttp://www.dovepress.com/ending-hepatitis-c-in-the-united-states-the-role-of-screening-a17457https://doaj.org/toc/1179-1535 Phillip O Coffin,1 Andrew Reynolds21San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; 2Project Inform, San Francisco, CA, USAAbstract: The US faces at least two distinct epidemics of hepatitis C virus infection (HCV), and due largely to revised screening recommendations and novel therapeutic agents, corresponding opportunities. As only 49%–75% of HCV-infected persons in the US are aware of their infection, any chance of addressing HCV in the US is dependent upon screening to identify undiagnosed infections. Most HCV in the US consists of longstanding infections among persons born during 1945–1965 who are suffering escalating rates of liver-related morbidity and mortality. Mathematical modeling supports aggressive action to reach and treat these persons to minimize the subsequent burden of advanced liver disease on patients and the health care system. Incident infection is primarily among persons who inject drugs, less than 10% of whom have been treated for HCV. Expanded screening and treatment of active persons who inject drugs raises the prospect of utilizing "treatment as prevention" to stem the tide of incident HCV infections in this population. HIV-positive men who have sex with men (MSM) represent a population at risk for sexually transmitted HCV who may also benefit from adjusted screening guidelines to identify both acute and chronic infections. Prisoners also represent a critical population for aggressive screening and treatment. Finally, the two-stage testing algorithm for HCV diagnosis is problematic and difficult for patients and providers to navigate. While emerging therapeutics raise the prospect of reducing HCV-related morbidity and mortality, as well as eliminating new infections, major barriers remain with regard to identifying infections, improving access to treatment, and ensuring payer coverage of costly new therapeutic regimens.Keywords: HCV screening, HCV treatment, treatment as preventionCoffin POReynolds ADove Medical PressarticleDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol 2014, Iss default, Pp 79-87 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Coffin PO Reynolds A Ending hepatitis C in the United States: the role of screening
description	Phillip O Coffin,1 Andrew Reynolds21San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; 2Project Inform, San Francisco, CA, USAAbstract: The US faces at least two distinct epidemics of hepatitis C virus infection (HCV), and due largely to revised screening recommendations and novel therapeutic agents, corresponding opportunities. As only 49%–75% of HCV-infected persons in the US are aware of their infection, any chance of addressing HCV in the US is dependent upon screening to identify undiagnosed infections. Most HCV in the US consists of longstanding infections among persons born during 1945–1965 who are suffering escalating rates of liver-related morbidity and mortality. Mathematical modeling supports aggressive action to reach and treat these persons to minimize the subsequent burden of advanced liver disease on patients and the health care system. Incident infection is primarily among persons who inject drugs, less than 10% of whom have been treated for HCV. Expanded screening and treatment of active persons who inject drugs raises the prospect of utilizing "treatment as prevention" to stem the tide of incident HCV infections in this population. HIV-positive men who have sex with men (MSM) represent a population at risk for sexually transmitted HCV who may also benefit from adjusted screening guidelines to identify both acute and chronic infections. Prisoners also represent a critical population for aggressive screening and treatment. Finally, the two-stage testing algorithm for HCV diagnosis is problematic and difficult for patients and providers to navigate. While emerging therapeutics raise the prospect of reducing HCV-related morbidity and mortality, as well as eliminating new infections, major barriers remain with regard to identifying infections, improving access to treatment, and ensuring payer coverage of costly new therapeutic regimens.Keywords: HCV screening, HCV treatment, treatment as prevention
format	article
author	Coffin PO Reynolds A
author_facet	Coffin PO Reynolds A
author_sort	Coffin PO
title	Ending hepatitis C in the United States: the role of screening
title_short	Ending hepatitis C in the United States: the role of screening
title_full	Ending hepatitis C in the United States: the role of screening
title_fullStr	Ending hepatitis C in the United States: the role of screening
title_full_unstemmed	Ending hepatitis C in the United States: the role of screening
title_sort	ending hepatitis c in the united states: the role of screening
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/22c76f4dea54402c8c656b94af2c7648
work_keys_str_mv	AT coffinpo endinghepatitiscintheunitedstatestheroleofscreening AT reynoldsa endinghepatitiscintheunitedstatestheroleofscreening
_version_	1718400098121023488

Ending hepatitis C in the United States: the role of screening

Ejemplares similares