Greenview Hepatitis C Fund Deborah Green Home:734- 665-3395 Cell: 734-223-8400 [email protected] 5/31/2008.

Greenview Hepatitis C Fund

Deborah Green www.hepcfund.org

Home:734- 665-3395Cell: [email protected]

5/31/2008

Differences Between Hepatitis A, B and C

Hepatitis A (HAV)• Transmitted through drinking water or eating food contaminated by fecal

matter• Usually runs its course in 6 months without treatment• Vaccine availableHepatitis B (HBV)• Transmitted through bodily fluids• About 5% of adult cases result in chronic condition which can lead to serious

liver problems and death (approx. 5,000/year in U.S.)• Vaccine availableHepatitis C (HCV)• Transmitted through blood• About 80% result in chronic condition which can lead to serious liver

problems and death (about 10,000 -12,000/year in the U.S.)• No vaccine available ( about 50 subtypes of the virus)

Hepatitis C (HCV)Magnitude of the Problem

• Worldwide: 170 million (3%)

• U.S.: 4 million (1.6%)

• Most common chronic blood borne infection in the U.S., affecting 3-5 times as many people as HIV/AIDS.

• Most common cause of chronic liver disease in western countries and accounts for 40-60% of adult liver transplants in the U.S.

Death Rate from HCV vs. AIDS

• Annual deaths in the U.S related to HCV as estimated by the National Institute (NIH) :

10,000 - 12,000

• CDC figures for HIV/AIDS deaths have not been updated since 2005 when they were 16,000, but a poll of the Departments of Health in all 50 states conducted by www.fairfoundation.org, yielded 10,962 deaths in 2007.)

At Risk Populations

• IV drug abusers • Veterans, especially Vietnam veterans• Homeless • Minorities• Prison inmates• Recipients of blood products prior to 1992

Hepatitis C Symptoms

• Most patients with acute hepatitis C have few or no symptoms.

• Many patients with chronic hepatitis C have no symptoms until they develop complications of cirrhosis.

• Common symptoms including fatigue, anorexia, and other flu-like symptoms correlate poorly with severity of liver disease.

• Quality of life frequently becomes impaired, even in pre-cirrhotic patients

Diagnosis of Hepatitis C

• Clinical evaluation

• Lab tests

• Liver biopsy

Factors Associated With Disease Progression

• Alcohol consumption

– 30 g/day in men

– 20 g/day in women

• Disease acquisition at >40 years

• Male gender

• HIV coinfection

• Hepatitis B virus coinfection

• Immunosuppression

• Obesity

NIH Consensus Development Conference Statement. 2002.NIH Consensus Development Conference Statement. 2002.Poynard et al. Poynard et al. Lancet.Lancet. 1997;349:825-832. 1997;349:825-832.

~ 2 drinks per day~ 2 drinks per day

Current Treatment

• 48 weeks of injected Pegylated Interferon and Ribavirin pills

Possible Side Effects of Treatment

• Flu-like symptoms - fever, chills, headache, muscle ache

• Anemia, fatigue and/or sleep disturbance

• Anxiety, irritability, depression

• Hair loss, dry cough, skin rash

• Decrease in white cells and platelets

• Retinal hemorrhage/loss of vision in rare cases

•Birth defects and miscarriages

•Unmasking or exacerbation of autoimmune disease

Possible Long Term Complications of Untreated HCV

• Increased cirrhosis, liver cancer, liver failure• Increased skin, joint and muscle problems• Increased incidence of vascular disease

( circulation problems, heart attack, stroke)• 3 times higher rate of type 2 diabetes after age 40• Increased incidence of kidney disease and possible

kidney failure • Increased incidence of autoimmune thyroid disease.

Goals of Treatment of Individual

• Primary goal

- Eradicate HCV infection

• Secondary goals

- Slow or prevent disease progression and scarring of the liver (fibrosis) which otherwise might lead to extensive scarring, (cirrhosis).

- Reduce risk of liver cancer

- Improve health-related quality of life

2005 NIH Research Budget per DeathSource: Fair Foundation (http://www.fairfoundation.org/news_letter/2004/hepatitis_magazine.htm)

0

500

1000

1500

2000

2500

3000

3500

HIV HCV

Pe

r P

ati

en

t S

pe

nd

ing

($

)

2007 NIH Spending per Patient

$3052

$25

Can Awareness and Spending Impact Future of Disease? AIDS Case Study

CA AIDS CasesCA AIDS Deaths

0100002000030000400005000060000700008000090000

Pre 1990

1990-1999

2000-2007

Data from NIH Office of Budget and the FAIR Foundation

Pre 1990 1990-1999 2000-2007

NIH Spending (in Billions) 4.1 9.97 19.6