A major city tries to eliminate hepatitis C — and build a model for others

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A major city tries to eliminate hepatitis C — and build a model for others

San Francisco works to fight hepatitis C.

Just a few years after the introduction of a reliable cure for hepatitis C, this city has launched a campaign built on shoe leather and shrewd epidemiology to eliminate the virus.

Health workers are expanding testing and searching the streets for homeless patients who don’t pick up their medication. Clinicians are training more doctors to treat infections. Patients can store their medications at a syringe exchange.

It’s all to combat a pressing and growing problem: In the U.S., more deaths are tied to hepatitis C, which can eventually cause liver cancer and failure, than the 60 other top communicable diseases combined, HIV and tuberculosis among them.

Before the development of the latest hepatitis C drugs, which are remarkably effective at curing the disease, the notion of eradication would have been implausible. That is no longer the case. But the virus is now being fueled by drug use, hitting patients who are the hardest to reach and have the least access to care and the pricey medications. Many are homeless, mentally ill, or incarcerated.

“Taking the medication is one thing, and it’s not hard on their bodies,” said Katie Burk, the viral hepatitis coordinator at the city’s public health department. “But getting them there, and through the hoops they need to get through, that takes a lot of work.”

“People are still getting infected with hepatitis C,” she added. “But what we need to do is outpace infection rates with treatments. If we start every year curing more people than are getting infected, then you can turn that curve around.”

San Francisco’s campaign — called End Hep C SF — is the result of an alliance among health officials, hospitals, advocates, and clinicians to cobble together funding, coordinate care, and combat the stigma of a disease associated with prison, drug use, and unsafe sex.

Organizers acknowledge that even if they somehow eradicated hepatitis C in the city, the virus would reappear. But the campaign still aims to dramatically reduce the city’s disease burden — and to become a model for what elimination would require elsewhere.

The effort starts with patients like Bill, whose case reflects both the potential of End Hep C SF and the challenges.

A homeless man who said he sometimes injects drugs, Bill was sick with hepatitis C for years but never got treated. That changed earlier this year, when his methadone clinic, which previously didn’t treat hepatitis C, found a way to get him the therapy.

Read full article: A major city tries to eliminate hepatitis C — and build a model for others

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