National Institutes of Health Consensus Development Conference Panel statement: Management of hepatitis C

Abstract

The objective of this article is to provide health care of hepatitis C among injection drug users. (HEPATOLOGY providers, patients, and the general public with a respon-1997; 26(Suppl 1):2S-10S.) sible assessment of current available methods to diagnose, treat, and manage hepatitis C. A non-Federal, nonadvocate, 12-member panel representing the fields of The hepatitis C virus (HCV) is one of six viruses (A, B, C, D, E, and G) that together account for the majority of general internal medicine, hepatology, gastroenterology, infectious diseases, medical ethics, transfusion medicine, cases of viral hepatitis. According to the National Health and Nutrition Examination Survey of 1988 to 1994 and other epidemiology, biostatistics, and the public participated. In addition, 25 experts from these same fields presented population-based surveys, estimates of the incidence and prevalence of HCV infection have been made. Nearly four data to the panel and a conference audience of 1,600. The literature was searched through Medline, and an ex-million Americans are infected with hepatitis C. The infection is more common in minority populations (3.2% of blacks tensive bibliography of references was provided to the panel and the conference audience. Experts prepared ab-and 2.1% of Mexican-Americans) than in non-Hispanic whites (1.5%). The incidence of hepatitis C infection appears stracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anec-to be declining since its peak in 1989. Currently, approximately 30,000 acute new infections are estimated to occur dotal experience. The panel, answering predefined questions, developed their conclusions based on the sci-each year, approximately 25% to 30% of which are diagnosed.Hepatitis C accounts for 20% of all cases of acute hepatitis. entific evidence presented in open forum and the scientific literature. The panel composed a draft statement Currently, hepatitis C is responsible for an estimated 8,000to 10,000 deaths annually, and without effective intervention that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel re-that number is postulated to triple in the next 10 to 20 years.Hepatitis C is now the leading reason for liver transplantation solved conflicting recommendations and released a revised statement at the end of the conference. The panel in the United States.The switch from commercial to volunteer blood donors finalized the revisions within a few weeks after conference. Hepatitis C is a common infection with variable and the development of a diagnostic blood test for hepatitis B in the early 1970s led to screening of blood donors and course that can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. The course of illness may be reduced from 30% to 10% the incidence of hepatitis after multiple transfusions. The remainder of these transfusionadversely affected by various factors, especially alcohol consumption. Therefore, more than one drink per day is ass...

Incidence and prevalence of hepatitis c virus infection among persons who inject drugs in New York City: 2006–2013

“…Prior to 1998, HCV treatment included interferon only; in 1998, HCV treatment became a dual treatment regimen of both interferon and ribavirin (Gow and Mutimer, 2001). In 1997, the NIH management of HCV consensus statement that people who use illicit drugs should not be offered HCV treatment until they abstain from drug use for 6 months (National Institutes of Health, 1997). This was reiterated and reinforced through a MMWR CDC publication on HCV in 1998 (Centers for Disease Control, 1998).…”

Treatment and primary prevention in people who inject drugs for chronic hepatitis C infection: is elimination possible in a high-prevalence setting?

“…Prior to 2002, guidelines in the US recommended against treating active PWID due to considerations about treatment adherence and the possibility of re-infection (21). Recent studies have shown that PWID, under Peg-IFN+RBV therapy, exhibit similar SVR compared to non-PWID (22–24), and have low rates of re-infection (1–5% per year) (25–28).…”

Inability to access health and social services associated with mental health among people who inject drugs in a Canadian setting

“…These include: early HCV treatment guidelines which exclude PWID (Kensington, 1997); clinicians who withhold antiretroviral therapy (ART) from HIV-infected PWID (Westergaard et al, 2012) or regard substance use or HIV-HCV co-infection as a challenge (Kamarulzaman and Altice, 2015 and Grebely and Tyndall, 2011); addiction treatment which limits access for people with concurrent mental health and substance use disorders (el-Guebaly, 2004); exposure to correctional facilities which disrupt access to evidence-based care (Milloy et al, 2014); and social and structural barriers such as stigma and discrimination, lack of housing, and fear of criminalization (Harris and Rhodes, 2013, Krusi et al, 2010, Neale et al, 2008, Treloar et al, 2013 and Wolfe et al, 2010). …”