Americans with hepatitis C are at increased risk of developing liver cancer, says NVHR

National Viral Hepatitis RoundtableNov 24 2009

New peer-reviewed data finding that fewer than one-fifth of the nearly 4 million Americans infected with chronic hepatitis C virus have received anti-viral therapy in recent years should be a wake-up call that Congress needs to move urgently on bipartisan legislation to support new state-based detection, research, and surveillance efforts, the National Viral Hepatitis Roundtable (NVHR) said today.

The NVHR warns that without congressional action, millions of Americans infected with chronic hepatitis C virus - particularly African Americans - are at serious risk of developing cirrhosis, liver cancer, and liver failure and will add billions of dollars in unnecessary costs to our health care system every year.

The NVHR is a coalition of more than 150 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from viral hepatitis in the United States through strategic planning, leadership, coordination, advocacy, and research. www.nvhr.org

"These shocking data should serve as a wake-up call that current public-health detection, treatment, and surveillance efforts for chronic hepatitis C viral infection are wholly inadequate," said NVHR Chair Lorren Sandt. "In terms of detection and treatment, the proverbial low-hanging fruit has been picked. In order to help our system reach under-served populations, Congress needs to act now on the bipartisan Honda-Dent legislation. Without action from Washington to support state-based efforts, millions of Americans will suffer from severe hepatitis-related complications and cost our health system tens of billions of dollars annually in avoidable medical costs."

The alarming research trends identified in the new study were conducted by researchers at the University of Michigan and published in the December issue of Hepatology, a journal of the American Association for the Study of Liver Diseases (AASLD). Among the key findings:

• Only about 663,000 of the estimated 3.9 million Americans infected with chronic hepatitis C virus received antiviral therapy between 2002 and 2007;
• Treatment rates appear to be declining in part because only one-half of all HCV patients know they are infected;
• Barriers to HCV screening including the absence of health insurance coverage, limited access to standard medical care, and lower priority of HCV testing by primary care physicians; and
• Increased public health efforts are needed to improve access to antiviral therapy and the researchers recommend further research of health services delivery and quality of care for HCV patients.

Last month, bipartisan legislation, "the Viral Hepatitis and Liver Cancer Control Act," was introduced in the US House of Representatives by Congressmen Mike Honda (D-Calif.) and Charles Dent (R-Penn.) and co-sponsored by 10 House Members. HR 3974 would support a comprehensive prevention, research, and medical management referral program for chronic hepatitis B and chronic hepatitis C virus infection. The bill would provide a relatively modest $90 million in funding in 2011 - with additional funding thereafter - that will increase the ability of the Centers for Disease Control and Prevention (CDC) to support state health departments in their prevention, immunization and surveillance efforts.

An estimated 5.4 million Americans are infected with either chronic hepatitis B or chronic hepatitis C infection. Most individuals are not aware they are infected and unable to take advantage of promising treatments. According to the respected research firm Milliman, the cost of chronic hepatitis C virus infection alone could reach $85 billion annually by 2024. Medicare and Medicaid are projected to absorb a disproportionate share of those costs.

In January 2010, the Institute of Medicine (IoM) is expected to release a report on viral hepatitis in the United States that outlines strategies for reducing the incidence of viral hepatitis infection and to mitigate complications in those individuals with chronic infections.