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`Hepatitis C killing more Americans than HIV: studies
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`#HEALTH NEWS
`FEBRUARY 23, 2012 / 12:00 PM / 6 YEARS AGO
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`Hepatitis C killing more Americans than HIV: studies
`
`Amy Norton
`
`NEW YORK (Reuters Health) - Hepatitis C has surpassed HIV as a killer of U.S. adults, and
`screening all “baby boomers” could be one way to stem the problem, according to two new
`government studies.
`
`Hepatitis C is a liver infection caused by a virus of the same name that is usually passed through
`contact with infected blood. An estimated 75 to 85 percent of infections become chronic, which
`can eventually cause serious diseases like cirrhosis (scarring of the liver) and liver cancer.
`
`In one of the new studies, researchers at the Centers for Disease Control and Prevention (CDC)
`found that by 2007, hepatitis C was killing more Americans than HIV -- the virus that causes
`AIDS.
`
`In 2007, hepatitis C killed 15,100 Americans, accounting for 0.6 percent of all deaths that year.
`That compared with a little over 12,700 deaths related to HIV.
`
`Those numbers are based on death certificates, and almost certainly underestimate the real
`scope, according to the CDC. Compared with HIV, hepatitis C infection is more likely to still be
`unrecognized at the time of a person’s death.
`
`“Hepatitis C mortality has, regrettably, been on the rise for a number of years,” said Dr. John
`Ward, director of the CDC’s viral hepatitis division and an author of the new study.
`
`But, he told Reuters Health, “many of those deaths could be prevented.”
`
`https://www.reuters.com/article/us-hepc/hepatitis-c-killing-more-americans-than-hiv-studies-idUSTRE81M1HR20120223
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`Hepatitis C killing more Americans than HIV: studies
`Of the estimated 3.2 million Americans with chronic hepatitis infection, about half of them don’t
`know it, according to the CDC.
`
`That’s because the initial infection causes no symptoms in most cases. Instead, the virus silently
`damages the liver over the years, and people may only discover they are infected when they
`develop irreversible liver cirrhosis.
`
`Chronic hepatitis C is most common in “baby boomers” -- about two thirds of U.S. infections are
`in people born between 1945 and 1964, Ward’s team notes in their report, which is published in
`the Annals of Internal Medicine.
`
`That predominance among boomers has a lot to do with casual injection-drug use back in the
`1960s, 70s and 80s, since sharing tainted needles is a major route for passing on the virus.
`
`Some people also contracted hepatitis C through blood transfusions during that era. Since 1992,
`all blood donations in the U.S. have been tested for hepatitis C.
`
`Baby boomers with hepatitis C are now getting to an age where the consequences of the infection
`would be evident, said Dr. Harvey Alter, a researcher with the National Institutes of Health who
`wrote an editorial on the new studies.
`
`“The big issue is that most people with chronic infection are still not identified,” Alter told
`Reuters Health.
`
`Right now, health officials recommend that certain people at increased risk have blood tests to be
`screened for hepatitis C. That includes anyone who’s used injection drugs, people who received
`blood transfusions or organ transplants before 1992 and people with HIV.
`
`“But that approach hasn’t been very effective,” Alter said.
`
`Another option, Ward said, would be to screen all baby boomers.
`
`Experts are only seriously considering that option now because of recent advances in hepatitis C
`treatment.
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`Before 1990, the infection was virtually incurable. Then researchers found that a combination of
`two medicines, interferon and ribavirin, could boost the cure rate to 45 percent (“cure” meaning
`the virus is cleared from the body).
`
`The downside is that the regimen is hard to take. Interferon has to be injected, and the whole
`treatment course takes about a year. The drugs can also have side effects ranging from flu-like
`symptoms to sleep problems to depression.
`
`Less than a year ago, the U.S. approved two new oral drugs that, when added to the old regimen,
`send the cure rate to 70 percent. Adding either one of the drugs -- boceprevir (sold as Victrelis in
`the U.S.) or telaprevir (Incivek in the U.S.) -- can also cut the treatment time to about six
`months in some people.
`
`The side effects are still there with the triple-drug approach. But with the high possibility of a
`cure, more people with chronic hepatitis C may want treatment, both Ward and Alter said.
`
`So in a second study, the CDC researchers estimated the cost-effectiveness of doing one-time
`hepatitis C screening in all Americans born between 1945 and 1965.
`
`They calculated that compared with the “status quo,” screening baby boomers would catch an
`extra 808,580 cases of hepatitis C, at a cost of almost $2,900 for each one.
`
`Ultimately, screening would prevent an extra 82,000 deaths, the CDC estimates -- assuming a
`certain percentage of people agree to treatment with interferon and ribavirin.
`
`As far as cost-effectiveness, Ward said, that would put baby-boomer screening in line with other
`widely accepted types of screening, like tests for colon cancer and high blood pressure.
`
`If screened people received one of the new hepatitis C drugs, that would save even more lives --
`an additional 121,000 over current screening policy, the CDC says. But the cost would be greater,
`since both new drugs are very expensive.
`
`Incivek costs nearly $50,000 for the whole course, while Victrelis rings up at roughly $26,000 to
`$48,000 depending on the duration of treatment.
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`Still, Alter, who supports baby boomer screening, said the approach looks to be “very cost-
`effective” -- especially when compared to the costs of treating cirrhosis and liver cancer, which
`are the most common reasons for liver transplants.
`
`“The beauty of this is, it’s six months to one year of treatment,” Alter said.
`
`Both Alter and Ward also pointed to other medications now in the drug industry’s pipeline that
`are aimed at taking interferon injections out of the equation.
`
`“Hopefully, we’ll soon have oral therapies that are easier to take and have fewer adverse effects,”
`Alter said.
`
`For now, the screening focus in the U.S. is on baby boomers. Whether it could be a good idea in
`younger generations is not clear.
`
`New hepatitis C infections in the U.S. are down sharply since the 1980s, according to a CDC
`study published last year.
`
`In the mid-1980s, roughly 70 of every million Americans developed acute hepatitis C each year.
`Between 1994 and 2006, that rate was 90 percent lower: only seven per million per year.
`
`As it stands, there are roughly 18,000 new hepatitis C infections each year -- most of which occur
`in injection-drug users.
`
`SOURCE: and Annals of Internal Medicine, February 21, 2012.
`
`This story update clarifies that Victrelis and Incivek are U.S. brand names, in paragraph 21
`
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`All quotes delayed a minimum of 15 minutes. See here for a complete list of exchanges and delays.
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`© 2018 Reuters. All Rights Reserved.
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