Strategies for the Elimination of Hepatitis C Virus Infection as a Public Health Threat in the United States

Gowda, Charitha; Re, Vincent Lo

doi:10.1007/s11901-018-0394-x

Cited by 12 publications

(12 citation statements)

References 67 publications

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“…(1,(6)(7)(8) When more effective, curative direct-acting antiviral medications for hepatitis C became available in 2014, hepatitis C elimination became an imaginable goal for the first time. (9,10) States and public health coalitions have begun launching hepatitis C elimination strategies to scale up primary prevention, testing, and treatment interventions. (11)(12)(13) However, hepatitis C surveillance data for monitoring progress of such initiatives are limited.…”

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confidence: 99%

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

et al. 2020

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Hepatitis C virus (HCV) infection is a leading cause of liver‐related morbidity and mortality, and more than 2 million adults in the United States are estimated to be currently infected. Reducing HCV burden will require an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. We modeled state‐level estimates of hepatitis C prevalence among U.S. adults by sex, birth cohort, and race during 2013‐2016. National Health and Nutrition Examination Survey data were used in combination with state‐level HCV‐related and narcotic overdose–related mortality data from the National Vital Statistics System and estimates from external literature review on populations not sampled in the National Health and Nutrition Examination Survey. Nationally, estimated hepatitis C prevalence was 1.3% among males and 0.6% among females (prevalence ratio [PR] = 2.3). Among persons born during 1945 to 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969 (PR = 3.2). Among persons born during 1945 to 1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia. Among persons born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Hepatitis C prevalence was 1.8% among non‐Hispanic black persons and 0.8% among persons of other races (PR = 2.2), and the magnitude of this disparity varied widely across jurisdictions (PR range: 1.3‐7.8). Overall, 23% of prevalent HCV infections occurred among non‐Hispanic black persons, whereas 12% of the population was represented by this racial group. These estimates provide information on prevalent HCV infections that jurisdictions can use for understanding and monitoring local disease patterns and racial disparities in burden of disease.

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confidence: 99%

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

et al. 2020

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“…In spite that many countries have published their strategies to achieve the WHO 2030 hepatitis C elimination objective, 13–22 up to our knowledge there is not so much published information about how hepatitis C treatment is starting to impact on hospitalization rates. Two studies were found developed in Canada 23 and Australia 24 that reported a similar experience to ours with a significant decline in the hospitalization rates after 2015, in the direct‐acting antivirals era.…”

Section: Discussionmentioning

confidence: 99%

Reduction in hepatitis C‐related hospitalizations after the implementation of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System: regional level differences

Vegas

Flores‐Herrera

Latasa

et al. 2021

Journal of Viral Hepatitis

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This work evaluates the potential impact at territorial level of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System on hepatitis C virus (HCV)‐associated hospitalizations. Chronic HCV‐related hospitalization discharges from 2014 to 2018 were obtained from the National Registry of Hospitalisations. A descriptive analysis of the hospitalizations was performed for all chronic, advanced liver disease and non‐advanced liver disease. Hospitalization rates were calculated at national and regional level. Year 2015 and period 2016–2018 hospitalization rates were compared to 2014 hospitalization rates using a Poisson model. Municipal standardized hospitalization rates ratios adjusted by age‐group were calculated for 2016–2018 period (2014 hospitalization rates as reference). From 2014 to 2018, there were 22,352 chronic HCV‐related hospitalizations. In‐hospital fatality rate was 4.3% for non‐advanced liver disease and 11.7% for advanced liver disease patients. National hospitalization rate decreased 22% (95% CI: 21%–22%), 16% (95% CI: 15%–17%) and 34% (95% CI: 33%–35%) in 2016–2018 compared to 2014 for all chronic, non‐advanced and advanced liver disease, respectively. During 2016–2018 period, 11/19 Spanish regions achieved >20% decrease in the hospitalization rates (p < .001) for non‐advanced liver disease and 19/19 (except Melilla, the rest with p < .001) for advanced liver disease. At municipal level, 84.8% and 90.2% municipalities had <20% of chronic HCV‐related hospitalization need compared to 2014 adjusted by age‐group. Based on the data analysed, a high impact on reducing chronic HCV‐associated hospitalizations have been achieved after the implementation of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System. However, small differences between regions and rural/urban areas were noticed.

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“…[3][4][5][6][7] Various interventions have been de-veloped to address the unmet needs of HCV care in rural populations, but the effect of these interventions remains unclear. [8][9][10][11][12] Developed in 2003, the Project Extension for Community Healthcare Outcomes aims to use telementoring, a guided practice model where primary care phycisians (PCPs) keep managing patients through tele-education with specialists at academic health centers, to help PCPs in rural areas of New Mexico manage HCV patients. [13][14][15] In our previous research, we found that a telementoring, task-shifting model helped reduce urban-rural disparities in HCV treatment possibly through educating rural primary care providers to accumulate knowledge and confidence in using highly effective and well-tolerated direct-acting antiviral agents (DAAs) to treat HCV patients.…”

Section: Introductionmentioning

confidence: 99%

“… 3–7 Various interventions have been developed to address the unmet needs of HCV care in rural populations, but the effect of these interventions remains unclear. 8–12 …”

Section: Introductionmentioning

confidence: 99%

A Telementoring Program and Hepatitis C Virus Care in Rural Patients

Yin

Kong

et al. 2021

Telemedicine Reports

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Background: Rural patients with chronic hepatitis C virus (HCV) infection may be less likely to access HCV care than those in urban areas. A telementoring, task-shifting model has been implemented to address the unmet needs of HCV care. Evidence is needed on whether this intervention improves HCV care in rural HCV patients. Methods: We compared three key HCV care indicators among Medicare patients with chronic hepatitis C in 2014-2016 by urban-rural status between New Mexico with a telementoring program and Pennsylvania without such a program. We classified each patient's urban-rural status based on his or her ZIP code of residence. We used multivariable log-binomial regressions to examine the relative probability of receiving HCV care by urban and rural status in two states. Results: In New Mexico, 41.3% of HCV patients resided in rural areas (N = 1155). In Pennsylvania, rural patients accounted for 13.2% (N = 1775). The unadjusted overall rates of receiving HCV RNA or genotype testing within 12 months before HCV treatment were 76.1% in '' Post-treatment HCV RNA testing rate was also high in ''rural-New Mexico'' (83.0%). After adjusting for demographic and clinical characteristics, ''rural-New Mexico'' HCV patients who received HCV treatment still had the highest probability of taking HCV RNA or genotype testing before HCV treatment, compared with other groups (relative risk [95% confidence interval]: 0.91 [0.84-1.00] in ''rural-Pennsylvania,'' 0.85 [0.78-0.93] in ''urban-New Mexico,'' and 0.93 [0.87-1.00] in ''urban-Pennsylvania''). Conclusions: The telementoring program may help improve HCV care in rural patients.

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Strategies for the Elimination of Hepatitis C Virus Infection as a Public Health Threat in the United States

Cited by 12 publications

References 67 publications

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

Reduction in hepatitis C‐related hospitalizations after the implementation of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System: regional level differences

A Telementoring Program and Hepatitis C Virus Care in Rural Patients

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