The headlines are compelling when it comes to new medications for treating infection with the hepatitis C virus (HCV):
- Harvoni cures up to 98% of patients with genotype 1 HCV.
- Viekira Pak cures 100% of those with genotype 1b HCV.
- Sovaldi cures 95% of those with genotype 2 HCV.
With amazing research results like this, one would think hepatitis C mortality would be plummeting. Yet this is not the case.
This discrepancy was discussed at IDWeek, a week of scientific presentations hosted by the Infectious Diseases Society of America, in a study presented by Scott Holmberg, MD of the Division of Viral Hepatitis at the US Centers for Disease Control and Prevention. Dr. Holmberg reviewed deaths associated with HCV infection and other infectious diseases during a 10-year period, while also tracking the numbers of HCV-infected individuals each of those years. This resulted in a mortality rate for HCV.
Even after much more effective HCV medications were approved by the FDA, the HCV death rates continued to rise in the US. In fact, hepatitis C deaths continued to be the most common infectious disease leading to death, surpassing even the combination of HIV, hepatitis B, and tuberculosis deaths. HCV-related deaths rose from 11,000 in 2003 to 19,358 in 2013. In a sub-set of patients examined in this study, the researchers noted that while 75% of them had documentation of liver disease, only 19% listed HCV on the death certificate. This indicates that HCV is underrepresented as a contributing factor in deaths in the US.
So why aren’t cures for HCV reaching those who need them? In large part, the answer to this traces back to the many people who are infected with HCV but simply don’t know it. In fact, up to half of those with HCV may not yet be diagnosed since this disease often shows no symptoms at the early stages. This is why continued efforts to get more Americans screened for HCV is so important. In addition to anyone with risk factors for HCV (such as IV drug use), all Baby Boomers should be screened for hepatitis C. When more people are diagnosed, then more people can access treatment.
Highleyman L. Hepatitis C-related mortality continues to increase in the US. HIVandHepatitis.com October 16, 2015.
Holmberg SD et al. Continued rising mortality from hepatitis C virus in the United States, 2003-2013. IDWeek 2015, abstract 1972, 2015.