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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