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Hepatitis C News and Research


ND Supreme Court dismisses last hepatitis claim against Trinity Health

In an unanimous decision, ND Supreme Court dismissed the last hepatitis claim against Trinity Health. Mark Krebsbach (the plaintiff) challenged whether the phlebotomist who allegedly infected his late wife with Hepatitis C was a “professional” and thus under a two-year medical malpractice statute of limitations.

ND Supreme Court agreed with the district court, and held that while the phlebotomist did not meet the definition of a “medical professional,” the phlebotomist was part of a professional continuum of care, and that falls under the statute of limitations. Additionally, regarding Krebsbach’s argument for fraud/deceit, the court concluded that Krebsbach failed to establish Trinity had a duty to disclose information about the phlebotomist or drug diversion.

Read the full article here.


U.S. Preventive Services Task Force Issues New Recommendation Statement on Screening for Hepatitis C in Adolescents and Adults

On March 2, 2020, the U.S. Preventive Services Task Force (Task Force) published a B recommendation for clinicians to screen all adults between the ages of 18 and 79 for hepatitis C. Read the full article here.


Plans are on hold for a Philadelphia safe-injection site to combat overdoses

Safehouse, a non-profit in Philadelphia, delayed the opening of the safe-injection site to combat overdoses amid growing community concerns. Read the full article here.


South Philadelphia to become site of nation’s first supervised-injection facility next week, organizers say

Federal judge in Philadelphia gives a final green light to the nation’s first supervised-injection site, setting up a clash with the Justice Department. Read the full article here.


drawn image of kidney, stomach and intestines

Liver Transplants due to HCV decline dramatically

Liver transplants due to chronic HCV infections have declined dramatically. Non-alcoholic steatohepatitis (NASH) and alcohol liver disease are now the leading causes of liver transplants in the U.S.

While this decline can be credited to improvements in early screening and treatment of HCV, much more needs to be done to promote prevention, screening, and treatment to eliminate HCV as a public health threat.

Read the full article from Hep Magazine here.


photo of Hepatitis Virus in the liver

Curing Hepatitis C is Linked to Improved Cognitive Health

A recent study shows that curing HCV is linked to improved liver and cognitive health. The complete article can be read here.


photo of Hepatitis Virus in the liver

Woman with Liver Cancer Receives Liver Transplant with HCV+ Liver – Cured of Infection Post-Transplant

HCV+ organs are being utilized more frequently as transplant organs for recipients who have been waiting for years on the organ donor list with little hope of receiving a needed organ. Betty Huart was the first person in Colorado to receive an HCV+ organ and then be subsequently treated and cured of her HCV infection. With more than 17,000 people waiting to receive a liver transplant, this can be a life-saving strategy to make more organs available for those on the list. Johns Hopkins and Brigham and Women’s Hospital have also successfully transplanted and treated HCV+ livers, hearts and lungs, and the virus was undetectable in all cases following DAA treatment.

The link to Betty’s story can be found here.

 


photo of HEP-C cells

Latest CDC Data shows that Hepatitis C Cases Continue to Rise

Today, the CDC released its 2017 Viral Hepatitis Surveillance Report that shows that reported cases of new hepatitis C infections increased 7%, from 2,967 in 2016 to 3,186 in 2017.

Injection drug use seems to still be driving the increase in HCV infections, with 73% of cases reporting risk behaviors citing recent injection drug use.

The full 2017 surveillance report can be found here.


image showing make up of Chlorine Dioxide

Deadly Product Containing Bleach Marketed as Cure for Hepatitis

Miracle Mineral,  potentially life-threatening product that claims to be a treatment for many conditions such as hepatitis and autism, contains mostly sodium chlorite, the compound similar to household bleach.

The FDA has issued a warning against the use of this product, found here.


image of text "Eliminate HEP-C"

United States lags last in meeting hepatitis C elimination targets

A recent report from the European Association for the Study of Liver Disease states that the U.S. is last among progress among high-income countries to meet the hepatitis C elimination targets sets by the World Health Organization. As of now, the U.S. is not projected to hit the elimination target until 2050 or later. 

Find the study report here.


cropped image of a woman's pregnant mid-section

New Study Recommends Universal Screening to Prevent Mother-to-Child Transmission of HCV

A new study featured in the Canadian Medical Association Journal recommends universal screening of all pregnant women for hepatitis C, as is done for hepatitis B, in order to prevent vertical transmission of the virus from mother to child. A commentary on the research report, along with links to the original journal article can be found here.


photo showing a variety of pills on a $100 bill.

New study shows cost savings to Medicaid due to Direct-Acting Antivirals to treat Hepatitis C

A recent study indicates that Medicaid is saving money by avoiding other costly health expenses due to people being treated for hepatitis C by direct acting antiviral medications. Read the article here.


photo of a hand holding a tube for hepatitis-c-titer-testing

Hep C may increase risk for cancers other than liver cancer

Recent research suggests that hepatitis C may be associated with not just liver cancer, but other cancers such as B cell non-Hodgkin lymphoma. Full article can be found here.


photo of hands reaching out of jail cell bars

Prisoners Fight to Access Hepatitis C Treatment

Hepatitis C treatment is notoriously difficult for incarcerated people to access, which leaves them vulnerable for serious health consequences and increases the likelihood for spread of the infection throughout the prison population. 

An article in The Nation can be found here.


Hepatitis A virus

Rise in Hepatitis A Outbreaks Across the Country

Many new outbreaks of Hepatitis A are occurring across the country, mostly among homeless populations. 

https://www.huffpost.com/entry/hepatitis-a-outbreak-america_n_5c0ecf0fe4b06484c9fd9d0c


photo of a syringe in the street

Despite Increased Risk Factors and Soaring Cases of New Infections, Screening for Hepatitis C is Still Low Among Injection Drug Users

A new report from Kaiser Health News discusses the continued lag in hepatitis C testing among people who use drugs, despite injection drug use being directly correlated to soaring rates of new infections. 

 

Article can be found at this link: 

Hep C And Drug Abuse Often Go Hand In Hand, But Screening For Infection Lags


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CDC Launches 2nd Edition of Hepatitis C Online Educational Resource

The Centers for Disease Control and Prevention released the updated Hepatitis C Online, a free, up-to-date comprehensive educational resource for healthcare providers that covers diagnosing, monitoring, and managing HCV infection. Free CME credits and CNE contact hours are available for 33 lessons. The site also features an in-depth HCV medications section, nine clinical calculators, and individual or group progress tracking.

For more information, visit Hepatitis C Online.


photo of a hand holding a hepatitis-c tester and a tube for titer-testing

Despite Infectious Disease Outbreaks Linked To Opioid Crisis, Most Substance Abuse Facilities Don’t Test For HIV Or HCV

A recent article from amfAR reports that many substance abuse centers are not testing for infectious diseases known to be at significantly greater risk of transmission among people who inject drugs. This further emphasizes the need for holistic strategies that address the varied social and health needs of people with substance use issues. 

The full article can be found here. 


red and white pill with the text 'generic'

Gilead Sciences Authorize Generic Hepatitis C Treatments for the US Market

Gilead Sciences, Inc., makers of the Hepatitis C (HCV) drugs Sovaldi, Harvoni, Epclusa, and Vosevi, have announced that they will be releasing authorized generic versions of its two most popular drugs, Harvoni and Epclusa, in the United States. The drugs will be introduced into the U.S. market beginning in January 2019 at a list price of $24,000.

More information can be found here.


artistic image of kidneys

Transplanting Hepatitis C-positive Kidneys Appears Safe and Effective

A recent study conducted in Philadelphia showed that 20 volunteers who agreed to receive HCV-positive kidney transplants followed by a course of treatment with direct-acting antivirals to cure the infection have had successful health outcomes following the transplants. This may allow more people to receive life-saving organ donations instead of having these organs rejected for use because of the HCV-positive status. 

The official press release for the study is found here. 

The abstract for the study is here. 


photo of a hand holding a tube for hepatitis-c-titer-testing

Kentucky Becomes First State to Require Pregnant Women be Tested for Hepatitis C

Kentucky now requires all pregnant women be tested for the virus. It is the first state to require this testing, and it is leading the charge to fight the increasing rates of vertical transmission of hepatitis C from mother to child. 

More information can be found here. 


photo of syringes and drug paraphernalia laid out on a table

The Opioid Crisis is spawning an “epidemic of epidemics” in new HCV infections and other bacterial infections.

The opioid crisis has claimed 64,000 lives in 2016 which is more than the entire death toll of the Vietnam War. Following current trends, there appears to be no end in sight for this emergency. A related offshoot of the opioid epidemic is a largely overlooked and gravely underfunded public health crisis of increasing Hepatitis C infections and bacterial endocarditis.

Lawmakers and federal officials often cite $45 billion as the amount of money needed to treat the drug crisis but experts that it is likely four times that. It should account for the costs of treating hepatitis c which is priced at $20,000 to 90,000 per patient and open-heart surgery for bacterial endocarditis which is estimated to costs $100,000 to $ 200,000 per person. The recently passed bipartisan spending bill contains only $ 6 billion in funding for opioid and mental health treatment which is a far cry from what is actually needed.


image of Hepatitis-C cell

The American Association for the Study of Liver Diseases and Infectious Disease Society of America have released updated Guidelines for Hepatitis C Management

The American Association for the Study of Liver Diseases and Infectious Disease Society of America have released updated Guidelines for Hepatitis C Management which includes updated guidelines on One-Time Testing for those with risk factors such as injection drug use, intranasal drug use and the like as well as annual HCV testing for People Who Inject Drugs and HIV positive Men who have Sex with Men.

The guidelines also updated HCV Testing and follow up recommendations as well as counseling recommendations and physician linkage who test positive for HCV.

 

For more information, see https://communityaccessnationalnetwork.wordpress.com/2018/06/04/aasld-and-idsa-release-new-hepatitis-c-guidance/


infographic showing new Hepatitis-C-Infections have nearly tripled since 2010

New Hampshire at high-risk for uncontrolled HIV and Hepatitis C transmission due to IV Drug Use

The State’s Public Health Division issued an alert to care providers describing a notable increase in HIV and Hepatitis C cases specifically in Hillsborough County. New diagnosis of HCV were only made provider reportable in 2016 but of all new diagnosis of HCV, 85% reported injecting drugs.

For more information, see: https://manchesterinklink.com/alert-nh-at-high-risk-of-uncontrolled-hiv-hepatitis-c-transmission-due-to-iv-drug-use/


Is Criminalizing HCV Transmission on the Horizon?

Back when AIDS was the hot thing in the news, 33 states passed laws making it illegal for HIV-infected people to have sex without their partner’s knowledge of the individual’s HIV status. However, efforts to repeal these laws have gained momentum in recent years due to the fact that HIV is no longer considered a fatal disease.

In a surprising twist of fate, some of these efforts to repeal resulted to the broadening of these laws to include viral hepatitis, tuberculosis and meningitis. One such state to implement this in 2014 is Iowa and the latest to attempt Hepatitis C- specific legislation is South Dakota. Fortunately, the South Dakota measured failed but currently, 12 states now have criminal laws specific to hepatitis.

For more information, see: https://www.medpagetoday.com/practicemanagement/medicolegal/72471


Cherokee Nation Lauded for Aggressive Hepatitis C Elimination Program

The Cherokees, the second largest tribe in the US after the Navajo Nation, operates the largest tribal health care system in the United States. 3 years ago, it started a program to screen 80,000 0f its 350,000 citizens which specifically targeted those 20 to 65 which had a statistically higher chance of having the disease.  More than half of the target group has been screened and more 1,300 citizens tested positive. A 90 percent cure rate has been seen among those who have started treatment with the health care system shouldering the cost of the program.

For more information, see: https://www.usnews.com/news/healthiest-communities/articles/2018-05-16/cherokee-nation-lauded-for-hepatitis-c-elimination-effort


Michigan Settles Lawsuit over Hepatitis C Treatment Access

Michigan has settled a class-action lawsuit over a policy which limits hepatitis C treatment access in its Medicaid program to people only with serious liver damage. This policy unduly subjects the enrollees to a second-class standard of health insurance coverage for the sole reason of being poor.  This settlement could affect more than 12,000 Michigan residents who have Hep C.

 

For more information, see: https://www.usnews.com/news/best-states/michigan/articles/2018-03-14/michigan-settles-lawsuit-over-access-to-hep-c-treatment


As Opioid Crisis worsens, Increasing Infants and Mothers are Exposed to Hep C

A growing number of mothers and infants are being exposed to Hepatitis C but fewer than a third are monitored and treated for the virus. Between 2006 and 2014, a 60 percent increase in pregnant women tested positive for Hep C and of the 10,000 infants born each year in Magee-Women’s Hospital in Pittsburgh, more than 300 infants were born to women with test confirmed cases of Hep C. Most of these infected were more than likely to say that they were struggling with opioids.

For more information, see: https://www.pbs.org/newshour/health/as-opioid-crisis-grows-babies-and-moms-with-hepatitis-c-fly-under-the-radar


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CDC Reports that new cases of Hepatitis C increased by 22% in 2016

Last week, the Centers for Disease Control and Prevention (CDC) released the 2016 Surveillance Report for Viral Hepatitis. The report states that new cases of hepatitis C actually reported to the CDC rose from 2,436 in 2015 to 2,967 in 2016, and the estimated number of new infections increased from 33,900 in 2015 to 41,200 in 2016.

This rise in infections is largely attributed to sharing contaminated needles and other supplies during illicit injection drug use that is at the center of this Nation’s opioid epidemic.

The complete 2016 CDC Viral Hepatitis Surveillance report can be found here. 


hand hold a Hepatitis C Drug-FDA by Gilead Sciences, Inc

Colorado Lift Restrictions for Treating Hepatitis C Starting 2018

Colorado will begin treating needy Hepatitis C patients immediately starting January 1 of 2018 instead of waiting for the disease to progress. This decision comes in the midst of a class-action lawsuit filed by the ACLU together with the drop in prices of the antiviral drugs from $84,00o to $14,000.

The state Medicaid department expects to spend the same yearly amount on treatment but treat an increase of about 20% more patients

For more information, see: https://www.denverpost.com/2017/12/01/colorado-hepatitis-c-medicaid-patients-can-receive-antiviral-drugs/


ACLU sues Kansas Medicaid over Denial Hepatitis C Coverage

The American Civil Liberties Union (ACLU) sued KanCare or the Kansas Medicaid Program for setting too many barriers for patients with hepatitis C to receive direct-acting retrovirals which have cure rates of over 90%.

Lauren Bonds says “No person in this country should be forced to get sicker before they are allowed to get better.”

 

For more information, see the following:

http://kcur.org/post/lawsuit-kansas-medicaid-should-pay-pricey-hep-c-treatment#stream/0

http://www.kansascity.com/news/politics-government/article200336009.html


photo of a BD Sharps collection bin

Cure Available for Hepatitis C but Oregon Limits Access

5 years ago, drugs to treat Hepatitis C called direct-acting retrovirals came out into the market. These drugs had cure rates of more than 90% of Hepatitis C infections. However, due to the costs of the drug, the Oregon Health Plan which is the State’s version of Medicaid limits access to only the sickest individuals.

In January of this year, Oregon’s Medicaid loosened its rules and allowed people with less severe damage or those deemed fibrosis stage two through four to have access. However, stage 1 is still currently denied access contrary to guidelines of health professional groups.

 

For more information, see: https://www.opb.org/news/article/oregon-hepatitis-c-cure-opioid-epidemic/


Changing Demographics-at-risk in California: Millennials and Hepatitis C

California’s Department of Public Health is reporting that HCV infection is skyrocketing among millennials or people aged 20 to 29. A 55 percent increase among men and a 37 percent increase among women was found to have occurred over the last decade in the Golden State. This changing demographic calls for a major shift in California’s HCV screening policies and outreach programs.

For more information, see: https://www.hepmag.com/article/millennials-hepatitis-c-new-younger-crisis-california


photo showing many syringes in a trash can

Syringe Exchange Programs Strives to Slow Hepatitis C Infections in Alaska

Transmission of blood-born viruses like Hepatitis C is exploding due to the opioid epidemic. In some rural areas, infections have gone up by 490 percent in just the last few years. This is driving up healthcare costs in times when low oil prices have left the state in years-long financial crisis.

One program run by the Alaska AIDS Assistance Association or Four As is working to prevent the transmission and spread of disease by running a needle exchange program. Last year, Four As gave out nearly 500,000 syringes which was double the number dispensed just two years earlier.

For more information, see: https://www.npr.org/sections/health-shots/2017/08/29/547054395/syringe-exchange-program-aims-to-slow-hepatitis-c-infections-in-alaska


New York Governor Andrew Cuomo

New York Governor Andrew Cuomo announces first U.S. state-level HCV Elimination Strategy

New York Governor Andrew Cuomo announces a new state-level HCV elimination strategy which aims to increase medication access and expand outreach programs to high-risk communities. The governor proposed to increase funding for HCV prevention, testing and treatment programs including education efforts, patient navigation and increasing prevention programs in primary care.

 

For more information, see: https://www.healio.com/hepatology/hepatitis-c/news/online/%7Bad6ee339-3ade-43e9-9d80-0949e504c927%7D/new-york-governor-announces-state-level-hcv-elimination-strategy and https://www.hepmag.com/article/ny-governor-announces-statewide-hepatitis-c-elimination-strategy


A New Hepatitis C Treatment Costing $300 has 97 Percent Cure Rate

The non-profit research team Drugs for Neglected Diseases Initiative (DNDI) announced that after a 12-week Clinical Trial conducted in Malaysia and Thailand involving new drug candidate ravidasvir and existing drug sofosbuvir showed that ravidasvir/sofosbuvir combination to be safe and effective with an extremely high cure rate.

The treatment is produced by Egyptian drug manufacturer Pharco Pharmaceuticals and costs approximately $3.50 a day. Both DNDI and Pharco hopes that this will provide a viable alternative to those who cannot afford the treatment.

For more information: see: https://www.msn.com/en-us/health/medical/24300-hepatitis-c-treatment-has-97-percent-cure-rate/ar-AAvO2xe and https://www.sciencedaily.com/releases/2018/04/180412085720.htm


infographic of USA map showing 2014 Hep-c death rates

Oregon Found to Have the Highest Rates of Mortality from Hepatitis C

Recent data showed that the overall U.S. mortality rate for Hepatitis C is six deaths per 100,000 people. This makes it the deadliest infectious disease in the country with 20,000 deaths attributed to it in 2013. However, it is even deadlier in Oregon with data showing that mortality rates is as high as 15 per 100,000 or more than 500 people annually.

 

For more information, see: http://www.oregonlive.com/health/index.ssf/2017/04/oregon_no_1_in_hepatitis_c_dea.html


photo of a hand holding a hepatitis-c tester and a tube for titer-testing

All inclusive Screening for Hepatitis C may be the Most Cost Effective Strategy to Identify Persons Infected

Current CDC recommendations include testing for highest risk population of people born between 1945 and 1965. However, due to the increasing number of injection drug users, an increase of incidence in the younger population has been seen. To address this gap, researchers from Boston Medical Center, Massachusetts General Hospital and Stanford University created a simulation model to estimate the effectiveness of testing across all adult age groups.

It was found that testing all adult age groups could lead to identification of an additional 250,000 people infected with the disease.

For more information, see: https://psychcentral.com/news/2018/02/18/screening-all-adults-for-hepatitis-c-is-most-cost-effective-way-to-id-those-infected/132670.html


New Jersey Expands Access to Hepatitis C Medications for Patients on Medicaid

A proposed rule change would allow patients afflicted with Hepatitis C access to medications prior to exhibiting fibrosis or liver damage. In addition, $ 10 million were allocated to expand Medicaid Hep C services beginning fiscal year 2019, which begins in July.

This is in line with overall efforts of Gov. Phil Murphy to expand coverage for the state’s vulnerable residents which includes $ 4.3 billion in state funding for Medicaid.

For more information, see: http://www.njspotlight.com/stories/18/04/01/state-expands-access-to-hepatitis-c-drugs-for-medicaid-patients/


University of Texas Health San Antonio is awarded a $6.5 million grant to study Hepatitis C in people living with HIV

In 2016, University of Texas Health Science Center at Houston School of Public Health tested blood from 1,331 Cameron County residents and found 30 of those participants tested positive. That translates to 2.3 percent which is appreciably higher than the national average of 1.6 percent.

The University of Texas Health San Antonio was awarded a $6.5 million grant to study Hepatitis C in people living with HIV and has partnered with the Valley AIDS Council to identify people suffering from Hep C thru a two-part screening program for a period of three years.

For more information, see: http://www.valleymorningstar.com/news/local_news/million-grant-will-help-fight-hepatitis-c-in-the-valley/article_348f9332-3237-11e8-921b-abd8f8cd589b.html


Boston, New Bedford and Springfield identified as Hep C hotspots in Massachusetts using innovative techniques.

Posted on March 20, 2018

Using innovative techniques in spatial epidemiology, geographical information systems, and statistical modeling, 3 areas in Massachusetts, namely, Boston, New Bedford and Springfield has been identified as hotspots of Hepatitis C infections.

These techniques offers new tools in identifying areas where maximal benefit for Hepatitis C intervention strategies can be set up. It also offers up areas where education efforts and other support systems can give the most benefit especially in an age if limited resources.

For more information: see http://now.tufts.edu/news-releases/spatial-epidemiology-used-identify-three-key-hepatitis-c-hotspots-massachusetts


Florida State Prisons Ordered to Treat Inmates with Hepatitis C

Posted on March 20, 2018

In the Florida State prison system, between 7,000 to 20,000 inmates are believed to be infected with Hepatitis C.  Yet, only 13 of them have received treatment using direct acting retrovirals (DAA) which have been found to cure the disease due to the high cost of treatment.

Last November 17, 2017, Judge Mark Walker found that Florida corrections officials have a “long and sordid history” of failing to treat inmates infected with the Hepatitis C virus and ordered the state to immediately come up with a plan to properly provide care.

For more information, see: http://www.theledger.com/news/20171118/state-prisons-ordered-to-treat-hepatitis-c


photo of imaged hepatitis_c_virus cells

A subset of exposed patients are resistant to Hep C.

Posted on March 20, 2018

A small subset of exposed individuals appear to be resistant to Hepatitis C infection. This phenomenon appears to be linked to enhanced Natural Killer Cell activity among this population.

for more information, see: https://www.ncbi.nlm.nih.gov/pubmed/29063663


photo of Idaho state capitol building

Idaho Appropriations Committee Approves 3 Million for Inmate Hepatitis C Treatment

Idaho Joint-Finance Appropriations Committee approves 19-0 the request for $3 million supplementary budget request of the Idaho Department of Correction. Currently, roughly 30% of prisoners  or about 2,500 individuals are infected with the virus with the cost of treatment costing as much as $62,000 per inmate.

 

For more information, see https://www.usnews.com/news/best-states/idaho/articles/2018-01-18/state-budget-panel-oks-3m-for-inmate-hepatitis-c-cure


Liver Cancer risks not linked to Hepatitis C treatment with Direct Acting Antiretrovirals

Being treated with Direct Acting Antiretrovirals (DAA) which is the treatment modality for Hepatitis C is not directly correlated with the development of liver cancer. Researchers found that development of cancer was linked with the patients’ preexisting likelihood of developing cancer rather than the use of the drug.

For more information, see https://www.healio.com/hepatology/hepatitis-c/news/online/%7Be33049e8-2b8e-47f5-ba1e-6ad01e1e88b8%7D/liver-cancer-incidence-after-hcv-therapy-linked-to-risk-factors-not-treatment%20%C2%A0


cropped image of a woman's pregnant mid-section

Crossing the placental barrier: Infected Moms-to-be transmit Hep C

Wisconsin has seen a doubling of women on Medicaid with hepatitis C infection in pregnancy which resulted in an increase of babies being afflicted with the liver disease.  This rapid rise of cases is attributed to the needle-sharing practices of a rising number of people addicted to opiates.

CDC estimates a 6 percent mother-to-child transmission rate nationwide which underscores the need for testing of pregnant women for the disease and an intensive education campaign to increase awareness of the disease among this population.

For more information, see https://www.drugs.com/news/tiny-opioid-victims-addicted-moms-transmit-hepatitis-c-67525.html



photo of a hepatitis_c cell

FDA Approves first 8 week treatment for Hepatitis C Genotype 1-6

The FDA has recently approved Mavyret, a combination of glecaprevir and pribentasvir, for Hepatitis C Genotype 1-6 without cirrhosis. The new drug shortens a previous 12-week treatment to 8 weeks. It is also an additional option for patients who have not been successful previously.

For more information, see https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm570038.htm

 


17 States have a High HCV rate due to lack of policies to prevent drug users from getting the disease

A report published by the CDC Morbidity and Mortality Weekly Report correlated the lack of policy on injection drug users with an increase incidence of infection of Hepatits C. Most of these States new cases of the disease were attributed to this population but the States lack a tailored policy for this segment of the population.

 

For more information, see  https://hepatitisnewstoday.com/2017/05/18/report-links-high-hepatitis-c-rate-in-17-american-states-to-policy-shortcomings/