A Road Map to Hepatitis C Elimination: Yesterday, Today, and Tomorrow

Luis A Gonzalez Corro1, Gregory M Lucas2, Kathleen R Page2

  • 1Division of Infectious Diseases, New York University School of Medicine, New York, New York, USA.

PubMed

Insights

Hepatitis C virus (HCV) infection impacts millions in the US, with rising cases and deaths. Eradicating HCV requires addressing social determinants of health alongside biomedical tools.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Health Policy

Background:

  • An estimated 3.5 million individuals in the US have hepatitis C virus (HCV) infection.
  • HCV-related deaths reached 15,000 in 2019, with annual healthcare costs around $7 billion.
  • Despite previous declines, hepatitis C infections have resurged in the US since 2010.

Purpose of the Study:

  • To highlight the ongoing public health challenge posed by hepatitis C virus (HCV) infection in the United States.
  • To emphasize the critical role of social determinants of health in achieving better patient outcomes.
  • To advocate for cohesive action among public health systems, hospital networks, and governments to eradicate HCV.

Main Methods:

  • This study is a review and analysis of the current state of hepatitis C virus (HCV) infection in the US.
  • It synthesizes information on HCV incidence, mortality, costs, and treatment advancements.
  • It examines the impact of social determinants of health on HCV outcomes and proposes a public health strategy.

Main Results:

  • Hepatitis C virus (HCV) infection remains a significant public health issue in the US, characterized by increasing incidence and substantial mortality.
  • Current biomedical treatments, while successful, are insufficient alone to curb the epidemic.
  • Social determinants of health profoundly influence health outcomes for individuals with HCV, necessitating integrated interventions.

Conclusions:

  • The eradication of hepatitis C virus (HCV) is achievable through a combination of advanced biomedical treatments and targeted social interventions.
  • A coordinated effort involving public health systems, healthcare providers, and governmental bodies is essential.
  • Addressing social determinants of health is paramount to overcoming the hepatitis C epidemic and improving patient outcomes.

Related Concept Videos

Drug Elimination: Non-Renal Routes01:23

Drug Elimination: Non-Renal Routes

The liver plays a pivotal role in eliminating drugs and their metabolites, primarily through a process known as biliary excretion. This process involves the hepatocytes, the primary cells in the liver that generate bile. A range of transporters actively expels polar drugs or hydrophilic drug metabolites into the bile, which transports the drugs and metabolites into the small intestine. From here, they are eventually expelled from the body through feces. In some instances, the original drug or a...
2.3K
Hepatic Drug Excretion: Enterohepatic Cycling01:17

Hepatic Drug Excretion: Enterohepatic Cycling

Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
1.0K
Enhanced Elimination of Poison01:26

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
476
Drug Elimination: Overview01:18

Drug Elimination: Overview

Drug elimination involves many complex processes and does not necessarily differentiate between distribution and elimination. It is divided into two primary components: excretion and biotransformation.
Excretion refers to removing a drug from the body, either in its unchanged form or as its metabolites. Nonvolatile and polar drugs are primarily excreted through the kidneys, with other pathways including bile, sweat, saliva, and milk. Volatile drugs such as anesthetic gases are excreted via the...
1.1K
Drug Elimination: The Concept of Clearance01:06

Drug Elimination: The Concept of Clearance

Drug elimination refers to removing drugs from the body, either through urine by the kidneys or through bile by the liver. Drug clearance is a pharmacokinetic parameter that measures the efficiency of drug removal from the bloodstream within a specific time frame. It is calculated as the rate at which a drug is eliminated from plasma divided by the plasma concentration of the drug.
Drug clearance is not limited to renal excretion but encompasses all organs involved in drug elimination,...
2.5K
Retrovirus Life Cycles01:10

Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
45.7K