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Finding and Treating the Young Hepatitis C Patient

How the opioid epidemic and high drug prices have brought the hepatitis C burden onto a younger population in 2018.

Deaths per persons in the United States have dropped by 22% since 1990, a study published in April of this year found. But how people are dying is also constantly changing—sometimes at a more severe rate.

Though cardiovascular disease, diabetes, Alzheimer’s, and others have remained among the greater drivers of mortality, other conditions have spread like wildfire in just less than 3 decades. Among them, opioid use disorder (OUD) mortality has raised by 447.3%, and liver disease due to hepatitis C by 75.4%.

With the rise of these conditions also came the fall of previously-feared epidemics: HIV/AIDS, a public health crisis and the 13th-leading cause of death in 1990, killed fewer Americans in 2016 than 50 other conditions. Access to highly-efficacious antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and a growing understanding of how and when to test at-risk patient populations have made HIV a good example of clinical response to a growing disease.

It’s one doctors and policy-makers could do well to apply to hepatitis C and OUD—2 diseases that are linked by more than just increased prevalence. Hepatitis C is a significant risk factor for people who inject drugs. As a study published in the journal Addiction this year reported, 8.5% of the 71 million-plus individuals with hepatitis C worldwide had recently injected drugs prior to their diagnosis. Among all people with recent injection drug use living with hepatitis C globally, half come from just 4 countries: Russia, China, Brazil, and the United States.

With the boom of drug use-related cases has come a new target population for hepatitis C care: adolescents and young adults—once shadowed in the national push for improved Baby Boomer screening—are in need of help.

It’s why the continually improving benefits of direct-acting antivirals (DAAs) have become something of a moot point to Global Liver Institute president and chief executive officer Donna Cryer, JD: it’s not benefitting a group of patients facing an epidemic.

“Looking at 2018, our biggest negative was the increasing rate of younger people contracting hepatitis C because of the opioid use crisis,” Cryer told MD Magazine®. “Seeing that wave increase was so sad.”

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The health and medical information on our website is not intended to take the place of advice or treatment from health care professionals. It is also not intended to substitute for the users’ relationships with their own health care/pharmaceutical providers.

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