Annual chronic hepatitis C (HCV) cases among adults in Alaska significantly declined between 2016 and 2023 but remain high among certain groups, according to the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) from March 27.

 

HCV is a blood-borne virus most easily transmitted through direct blood-to-blood contact. It is a leading cause of chronic liver disease, liver cancer and liver-related death. The CDC estimates that approximately two million people in the United States are living with chronic HCV.

 

New annual diagnoses in Alaska fell 30% from 2016 to 2023. During that period, 5,352 cases of HCV were confirmed, according to the report.

 

Most new diagnoses were among younger adults ages 30 to 39 years (196 per 100,000), rural residents (162 per 100,000) and American Indian or Alaskan Native people (223 per 100,000).

 

About two thirds of those newly diagnosed were men, and a quarter were women of reproductive age. The average age of at diagnosis was 38 years in 2016 and 35 in 2023.

 

MMWR authors suggest that the decrease in newly reported chronic HCV is likely multifactorial, including increased prevention efforts throughout the last decade such as access to direct-acting antiviral (DAA) therapy and updated CDC testing recommendations.

 

Indeed, older guidelines recommended HCV testing only for people thought to be at increased risk, but current guidelines say all adults should be tested for HCV at least once. In addition, women should be tested during each pregnancy, and people with ongoing risk should be tested regularly. This includes people who inject drugs, people living with HIV and gay and bisexual men who take HIV pre-exposure prophylaxis (PrEP).

 

“Alaska Native and American Indian people are disproportionately affected by HCV, so expansion of testing and treatment efforts contribute to positive trends and can be applied to other areas and/or groups with higher rates,” Jennifer Ross, PharmD, an infectious disease clinical pharmacist told Healio.

 

HCV treatment is easier and shorter than ever before, and the majority of people can be cured with a brief course of combination antiviral therapy.  

 

In the past, HCV treatment required weekly injections for six months to a year, caused difficult side effects, including flu-like symptoms, depression and anemia, and cured only about half of treated patients. 

 

Today, modern DAA therapy usually involves one pill once daily, usually for two or three months. The medications are generally well tolerated, and more than 90% of treated people achieve a sustained virological response, meaning continued undetectable virus 12 or 24 months after completing therapy.

 

“These findings validate the need for continued focus on underserved areas that are at higher risk for HCV,” Ross added. “The impacts of the COVID-19 pandemic, such as access to screening, and a reported decrease in injection drug use are harder to quantify.”

 

To read more, click #Hepatitis C. There, you’ll find headlines such as “Addressing Treatment Gap for People With HIV and Hepatitis C,” “More Than 321,000 U.S. Children Lost a Parent to Drug Overdose From 2011 to 2021” and “Encouraging HIV and Viral Hepatitis Testing in Substance Use Disorder Treatment.”