Hepatitis C Case Study Summary
Hepatitis C Infection:
Disease Management
Considerations
Agenda
• US Prevalence of Hepatitis C Infection
• Risk Factors and Disease Progression
• Treatment Goals
• Barriers to Treatment
• Summary
2
Hepatitis C Infection Is the Most Common
Chronic Blood-Borne Infection in the US
• Accounts for up to two-thirds of newly diagnosed chronic liver disease cases1,2
• Contributes to significant morbidity (cirrhosis, liver failure, liver cancer), extrahepatic complications, and mortality3-5
• Leading cause of liver transplantation1,3
– Responsible for 41% of transplants6
3
1. Gonzalez SA, Davis GL. Clin Liver Dis. 2012;1(1):2-5. 2. Bell BP, et al. Am J Gastroenterol. 2008;103(11):2727-2736.
3. Smith BD, et al. MMWR …show more content…
§CDC recommendations. USPSTF recommendations state “other percutaneous exposures (such as in health care workers or from having surgery before the implementation of universal precautions).”
ALT=alanine aminotransferase.
• However, many persons infected with HCV do not recall or report having any of the risk factors listed in the above table1
7
1. Smith BD, et al. MMWR Recomm Rep. 2012;61(RR-4):1-32. 2. US Department of Veterans Affairs. http://www.hepatitis.va.gov/ provider/guidelines/testing-prevention-counseling.asp. 2001. Updated January 2013. Accessed February 12, 2013. 3. Moyer VA, on behalf of USPSTF. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement.
This article was published at www.annals.org on 25 June 2013.
The Rate of Disease Progression Is Estimated to
Increase With Duration of Hepatitis C Infection
• After 30 years of HCV infection, ~40% of patients are estimated to progress to cirrhosis
8
Thein HH, et al. Hepatology. …show more content…
Clin Gastroenterol Hepatol. 2011;9(6):509-516.
The Majority of People With Hepatitis C
Infection Remain Undiagnosed and Untreated
• Approximately 50% of individuals with HCV infection are unaware they are infected1,2
Estimate of Chronic HCV Infection Prevalence Versus
Infections Diagnosed and Treated in the US*
• Majority of those diagnosed are not successfully treated2,3
*Prevalence estimate based on NHANES data from 1999 through 2002. 4,5 NHANES data likely underestimate the actual prevalence of HCV in the US by not accounting for incarcerated, homeless, hospitalized, nursing home and active military duty populations. 6,7
17
1. Denniston MM, et al. Hepatology. 2012;55(6):1652-1661. 2. Holmberg SD, et al. N Engl J Med. 2013;368(20):1859-1861.
3. Moorman AC, et al. Clin Infect Dis. 2013;56(1):40-50. 4. Armstrong GL, et al. Ann Intern Med. 2006;144:705-714.
5. Centers for Disease Control. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Accessed June 11, 2013. 6. Chak E, et al.
Liver Int. 2011;31:1090-1101. 7. Smith BD, et al. MMWR Recomm Rep. 2012;61(RR-4):1-32.
Many Barriers Exist That Impact Treatment
Initiation for Hepatitis C Infection
HCV Infection
Patient
Disease Management
Considerations
Agenda
• US Prevalence of Hepatitis C Infection
• Risk Factors and Disease Progression
• Treatment Goals
• Barriers to Treatment
• Summary
2
Hepatitis C Infection Is the Most Common
Chronic Blood-Borne Infection in the US
• Accounts for up to two-thirds of newly diagnosed chronic liver disease cases1,2
• Contributes to significant morbidity (cirrhosis, liver failure, liver cancer), extrahepatic complications, and mortality3-5
• Leading cause of liver transplantation1,3
– Responsible for 41% of transplants6
3
1. Gonzalez SA, Davis GL. Clin Liver Dis. 2012;1(1):2-5. 2. Bell BP, et al. Am J Gastroenterol. 2008;103(11):2727-2736.
3. Smith BD, et al. MMWR …show more content…
§CDC recommendations. USPSTF recommendations state “other percutaneous exposures (such as in health care workers or from having surgery before the implementation of universal precautions).”
ALT=alanine aminotransferase.
• However, many persons infected with HCV do not recall or report having any of the risk factors listed in the above table1
7
1. Smith BD, et al. MMWR Recomm Rep. 2012;61(RR-4):1-32. 2. US Department of Veterans Affairs. http://www.hepatitis.va.gov/ provider/guidelines/testing-prevention-counseling.asp. 2001. Updated January 2013. Accessed February 12, 2013. 3. Moyer VA, on behalf of USPSTF. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement.
This article was published at www.annals.org on 25 June 2013.
The Rate of Disease Progression Is Estimated to
Increase With Duration of Hepatitis C Infection
• After 30 years of HCV infection, ~40% of patients are estimated to progress to cirrhosis
8
Thein HH, et al. Hepatology. …show more content…
Clin Gastroenterol Hepatol. 2011;9(6):509-516.
The Majority of People With Hepatitis C
Infection Remain Undiagnosed and Untreated
• Approximately 50% of individuals with HCV infection are unaware they are infected1,2
Estimate of Chronic HCV Infection Prevalence Versus
Infections Diagnosed and Treated in the US*
• Majority of those diagnosed are not successfully treated2,3
*Prevalence estimate based on NHANES data from 1999 through 2002. 4,5 NHANES data likely underestimate the actual prevalence of HCV in the US by not accounting for incarcerated, homeless, hospitalized, nursing home and active military duty populations. 6,7
17
1. Denniston MM, et al. Hepatology. 2012;55(6):1652-1661. 2. Holmberg SD, et al. N Engl J Med. 2013;368(20):1859-1861.
3. Moorman AC, et al. Clin Infect Dis. 2013;56(1):40-50. 4. Armstrong GL, et al. Ann Intern Med. 2006;144:705-714.
5. Centers for Disease Control. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Accessed June 11, 2013. 6. Chak E, et al.
Liver Int. 2011;31:1090-1101. 7. Smith BD, et al. MMWR Recomm Rep. 2012;61(RR-4):1-32.
Many Barriers Exist That Impact Treatment
Initiation for Hepatitis C Infection
HCV Infection
Patient