The development of direct-acting antiviral agents (DAAs) can safely cure virtually all individuals infected with the hepatitis C virus (HCV) and may have the potential to completely eliminate the disease in the U.S., according to a panel of experts in the AASLD Clinical Symposium HCV Treatment: Gastroenterologists Role in Eradicating HCV, on Monday. The symposium featured a panel of experts who discussed strategies and implementation processes that will maximize the number of individuals who are treated for chronic HCV.
Fasiha Kanwal, MD, MSHS, AGAF, professor and section chief of gastroenterology at the Baylor College of Medicine, Houston, TX, opened the symposium with a discussion of the changing epidemiology of HCV, including the challenge of identifying and treating people with undiagnosed HCV.
“With HCV screening and treatment policies in flux, our understanding of the number of patients currently needing treatment is limited,” Dr. Kanwal said. “Besides the treatment demand, the number of HCV patients who remain undiagnosed in the era of oral DAAs is not precisely known; however, recent evidence indicates that HCV incidence is increasing in the U.S.”
Robert S. Brown Jr., MD, MPH, AGAF, clinical chief of the division of gastroenterology and hepatology in the department of medicine at Weill Cornell Medical College, New York, NY, followed with a presentation covering strategies to increase HCV screening and to improve access to care and treatment.
“Despite recommendations and, in some states, mandates, we are falling behind on HCV screening,” Dr. Brown said. “A big problem is that we focus almost entirely on the baby boomers, but most of the rising incidence of hepatitis C is not seen in baby boomers, but in younger people, particularly those who are having problems with opiate abuse. If we only focus on identifying baby boomers, we’re going to miss this large group of patients and allow ongoing spread of the infection.”
In the final presentation of the symposium, Andrew Aronsohn, MD, associate professor of medicine in the Center for Liver Diseases at the University of Chicago Medical Center, IL, said GI providers must become advocates and leaders in improving access to care.
“Currently, the requirement of specialty care to treat HCV represents a bottleneck to achieve elimination,” Dr. Aronsohn said. “We need to consider new high-risk groups for screening and then we need to think about task-shifting more of these patients to primary care.”