June 20, 2011
Five times as many U.S. residents may have hepatitis C virus as have HIV, a New York epidemiologist recently wrote, but that prevalence is not reflected in the scale of HCV prevention, testing, treatment, and research efforts.
"Hepatitis C has been sort of a quiet epidemic," said Brian Edlin, a professor of medicine at the State University of New York Downstate College of Medicine-Brooklyn. "There hasn't been the political pressure exerted to garner the necessary support for resources to be committed to it."
The U.S. government's recently released action plan for viral hepatitis "does not include an intention to increase funding," Edlin observed in a Nature commentary. More resources will be urgently needed to avert HCV's spread and the resulting financial costs and loss of life, Edlin wrote.
The United States should advocate providing HCV testing wherever HIV screening is available, Edlin said. Evidence suggests that community-based outreach and education, testing and counseling, sterile syringe access and substance-use treatment markedly reduce HCV transmission, he wrote.
About half of HCV infections can be cured with a six- to 12-month course of therapy, and newer therapies promise to be quicker and more effective. However, testing and care resources remain inadequate, "even though more than 10 times as many Americans have undiagnosed HCV as have undiagnosed HIV infection," Edlin wrote.
"Perspective: Test and Treat this Silent Killer," was published in Nature (2011;474:s18-s19).
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