U.S. Morbidity

[alagirl]

I was doing some research and was shocked by the number of people in the United states now dying due to hepatitis c every year.  It seems to be a rising number.

Around 26,000 people died of hep c in the U.S. in 2006, and that's the last year for which there are mortality numbers.  To put that into context, here are some other U.S. mortality figures from 2006:

Breast cancer: 40,970
Leukemia: 22,280
Pancreatic Cancer: 32,300
Prostate Cancer: 27,350
HIV: 14,627 (does it not FLOOR you that we now have TWICE as many deaths
as there are HIV deaths, with only a FRACTION of the funding!!???)
Heart Disease: 629,191
Cerebrovascular Disease: 137,265
Diabetes: 72,914

There are expected to be around 38,000/40,000, new deaths due to hepatitis c in 2010 (if not more)

Liver disease was in the top fifteen causes of death in the US in 2006.  Actually, I think it was in the top twelve.  Here is the entire list from 2006:

1. Diseases of heart
2. Malignant neoplasms
3. Cerebrovascular diseases
4. Chronic lower respiratory diseases
5. Accidents (unintentional injuries)
6. Alzheimer’s disease
7. Diabetes mellitus
8. Influenza and pneumonia
9. Nephritis, nephrotic syndrome and nephrosis
10 Septicemia
11. Intentional self-harm (suicide)
12. Chronic liver disease and cirrhosis
13. Essential hypertension and hypertensive renal disease

Here's a link to the cdc information if anyone is interested:

http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf

I just found the numbers to be so compelling.  I didn't realize it was quite as bad as it is.  We certainly need a great deal more attention to it.  I've been talking to people about it more and more, and it seems as though every time I tell someone about it, someone close to them has it as well.  Everyone knows someone, or has someone they care about who is suffering from hepatitis c.  I honestly don't think we have any idea about the true dimensions of the problem in the U.S. alone, much less in some of the other countries.  And growing fast.

[alagirl]

And frequently, people don't move to a place where they already have family if they can.  
------------------
Sorry, in reading this again, what I meant to say is that people DO move to a place where they already have family if they can.

[Trinity4]

Just so there is no room for "error" as I have been accussed of doing each time I post about HCV -  I did post on this thread.  What I should have said was I did not post during the last part of this discussion.  My posts were directed to ala and rita.  I challanged no one nor did I become accusatory.  

[Trinity4]

" What I really don't appreciate is people such as you and alagirl, and trinity making up things that I have never said. And to add to the insanity you and those others have gone on to attack those very words that I never uttered. That part is pretty funny to watch at first but it gets boring after awhile as I'm sure you can understand. "

I did not post on this thread so leave my name out it.  I'm so over you and your condescending, egotisistical bulls-h-i-t.  You sound like the victim you wrote about in one of your other babbles.  The same tone throughout- I didn't say that, and you didn't read it correctly and you don't understand my point.  Sounds like a victim to me.  I .  Don't utter my name again.  I don't want to see it in type.  Have I been prefectly clear on that?  You do understand, don't you?

[alagirl]

Actually, and I had suspected this but didn't know for certain, they started screening blood donors for high risk factors from the mid eighties on and this is why the new cases showed declines even prior to the ability to actually test those donors in '92.

[alagirl]

Ricky - Sorry about that.  I don't have any idea where that came from.

Syd

[alagirl]

I'm going to ignore your condescending tone and the fact that you think I don't read the studies and articles posted by you and others before replying.  I hardly see what the use would be in replying to you were that the case.  I read the information about HIV and national security and wasn't persuaded by the argument that it was an immediate national security concerns.  I do understand that others may find it significant.  It does not make me an idiot to think that there are other issues that have far greater impact on national security that we don't seem to care about very much - like allowing China to purchase so much of our debt.  Also, I believe that you have attributed a comment to me that was not actually made BY me on that topic.

I have been researching non-stop, hours a day, every day, for the past year.  My formal education was more than adequate and did include coursework in the sciences, anatomy, and experimental design so it is not as though I am unable to to grasp the nature of my disease.  I HAVE answered your questions and objections about my views on various topics during this chain of posts and I have backed my answers with studies and articles showing the opinions of others in this field.  I don't just pluck my viewpoints out of thin air, and certainly if the ponderence of research shows something different than my view, I will follow what the majority of the research holds.  The articles I posted included several recent studies backing my assertion that HCV has a role in the mortality of those with HIV, which you promptly ignored.  Instead of commenting on studies that I post - agreeing with them, or disagreeing and posting your own recent studies, you respond to me with personal attacks and tell me I don't know anything.  It's a manner of debate that really isn't my preferred style of argument.  Also, I do not discuss what I do and don't do in the name of advocacy for hcv or anything else.  In my family such matters are not spoken about with others and I can only imagine that if I did discuss anything of that nature on this board you would have turned it around to accuse me of  "relishing my victimhood."

IVDU WAS rampant in the 60's and 70's.  There are a significant number of people who got hcv from IVDU during vietnam.  I'm going to stand by my assertion that the larger numbers of documented new hcv cases we used to see due to our inability to make certain we had a blood supply that was free of hcv were FOR that reason.  Possibly the numbers were augmented by greater IVDU before cocaine was all the rage, since snorting coke isn't as effective a transfer method as IVDU, but I've never personally seen an expert who didn't say that the bulk of the problem was due to anything but the healthcare issue.

http://www.hhs.gov/asl/testify/t041214a.html

My THEORY is that we caught those new cases more quickly due to the ill health of a large number of the individuals involved.  (Which would lead to a quicker of counting of new cases then, and an undercounting of people who are primarily exposed in other ways now)  It is only a theory, and I would like to, but have not seen, retrospective studies on this particular issue - even though you have stated they are there.  I have not found retrospective studies specific to that topic.

With the surge in meth use I DO believe that our IVDU is enjoying a surge and if at some point you are interested in commenting on studies I have posted in response to previous points then I would be happy to argue with you further, and to post additional studies, but I am not going to take the time to look them up unless we are actually going to talk about the studies.

This quote from SAMHSA soliciting grant requests for HIV documents a couple of the points I was trying to make:

"Since the AIDS epidemic began, injection drug use (IDU) has accounted for more than one-third of AIDS cases in the United States.  Of the 43,517 new cases of AIDS reported in 2000, 25 percent were injection drug use (IDU)-associated1.  Racial/ethnic minorities in the U.S. are most heavily affected by IDU-associated AIDS.  In 2000, African American adults and adolescents accounted for 26 percent of IDU-associated AIDS cases and Hispanic adults and adolescents accounted for 31 percent, as compared to 19 percent of all IDU-associated AIDS cases among their white counterparts.  IDU-associated AIDS accounts for a larger proportion of cases among women than among men.  Fifty-seven (57) percent of all AIDS cases reported among women have been attributed to injection drug use or sex with partners who inject drugs as compared with 31 percent of cases among men."

Obviously, this is regarding HIV in the legal hispanic community.  It does, I believe, illustrate one of the avenues for risk to the undocumented community though. I understand, perhaps better than most since I work so much with that community, that undocumented workers who come here from Mexico and the surrounding areas do so to work, and they work hard when they get here.  I have also seen that over the years, as people settle into an area, they or members of their family pick up the bad habits of the people who are already living there.  And frequently, people don't move to a place where they already have family if they can.  There is also trafficking of illegal substances that occurs in those communities along the route from Mexico, taking advantage of the fact that there are now people in the area to move it - cocaine and marijuana.  IVDU is NOT a culturally accepted activity, but obviously, it does happen. And immigrants are more at risk if they live with family members who are already using.  If immigrants do become ill, there really isn't a good way for them to get medical service in most areas.  

On IVDU (overall, not in immigrant communities), in addition to meth, and cocaine, people are shooting up pills like dilaudid (sp?) that they buy at $25 a hit.  They get these from the folks who go to the pain clinics chiefly in order to sell their prescriptions.  The use of meth in the rural communities is astonishing.

Plenty of online info on substance abuse trends, but you don't have to go very far out in your community to spot trends in substance abuse.:

http://www.samhsa.gov/Grants/2008/sp_08_001.aspx
"In 2003, there were 237,000 substance abuse treatment admissions for injection drug use (13% of all admissions reported to SAMHSA's Treatment Episode Data Set [TEDS]).  Opiates accounted for 77% of admissions for injection drug use, followed by stimulants (16%) and cocaine (6%). Most substance abuse treatment admissions for injected opiates were self/individually referred to treatment (58%); while most admissions for injected stimulants were referred by the criminal justice system (44%)."

Again - my opinion - but I think that the idea that somehow hep c is on its way out is, lamentably, wishful thinking.  And I am NOT seeing a lot of research to show that it is going to exhaust itself in the next twenty years or so, despite the fact that there have been "diminshing" figures on new cases.  There is currently no good system that I have seen for counting new cases nationwide, or even statewide in most states.  There are some good models in some small areas.

Again, it is my OPINION, that the best thing that will happen to this disease is that when newer drugs that are better tolerated and more successful make their way to the market they will start closing up the gap from the top and that is the point at which we will start seeing the number of hcv cases diminish - or rather, that is the point at which the number of cases WILL actually begin to reduce.  Certainly it slowed when they started testing the blood supply, but I think that real progress on extiguishing it will begin from the top down instead of vice versa.  

If you are interested in commenting without hurling insults at me that's fine.  Otherwise, just please try to ignore me.  

[HCA]

Agreed-it is the rising mortality prospects among rhe extant HCV population that I think this thread kicked off with.It has strayed into a different domain
Indeed the revenue prospects of Vertex have the diminishing size of the patient base factored in.
As I mentioned in an earlier post the old canard about dying with it rather than from it has become rather reduntant now,

[Trish77]

Now YOU can have the last word..which you would have had, if I'd been a little faster to click Post.  I don't care to continue on this.  I'm disappointed completely in the tone you have chosen to take which, to me, was completely unnecessary and makes this conversation of no further interest.

[Trish77]

4,680 infections a year adds up, seems to me.  

As for this, "HCV has less of an impact on your healthcare system than the many in Canada who go to the doctor's every time they have a runny nose. That accounts for alot of the long waiting times there, and the extra cost burden on the system."

I agree that people run to the doctor far too easily here because they can.  One of the downsides to a universal health care system.  However, there have been various hepatologists and others paying alot of attention to the costs of HCV here lately and particularly that we don't have enough resources to handle the expected future costs.

I can actually get in to see my family physician quite fast.  Where the waiting times exist is to see any kind of specialist or testing and subsequent results.  That doesn't have alot to do with runny noses at the GP's office.  Cost burden to the healthcare system yes.. however, this doesn't negate the cost of HCV on the healthcare system, particularly as it's the leading cause of liver transplant here as well as the U.S. 1- 5% of that 4,680  HCV-infected persons a year coming into Canada  ending up dying from HCV and all the costs from those who have all the healthcare issues that go with HCV regardless if treating or not ain't going to help us a bit.

It really pisses me off that you suggest I made things up as if that was intentional and as if I have no interest in being factual. Misunderstanding you is not making things up. You're guilty of what you accuse of.  I did ask you for clarification repeatedly and you were arrogant about it.  When I first posted to you, it was not a challenge nor was it jumping on a bandwagon.  I was seriously interested in your response and open to what you had to say.  Your responses have been seriously offputting.

Trish

[Mr Liver]

As I've repeatedly stated--- in the US HCV is an epidemic that WAS. Need proof ? Here you go. Now, if you think this fits the profile of an epidemic please do not reply to me.


Incidence of hepatitis C, United States
Year Estimated Total New Infections
1982                 180,000
1983                 188,000
1984                 219,000
1985                 261,000
1986                 262,000
1987                 216,000
1988                 240,000
1989                 291,000
1990                 179,000
1991                 112,000
1992                   73,000
1993                   57,000
1994                   54,000
1995                   36,000
1996                   36,000
1997                   38,000
1998                   41,000
1999                   39,000
2000                   38,000
2001                   24,000
2002                   29,000
2003                   28,000
2004                   26,000
2005                   21,000
2006                   19,000

For 2008 they forecasted 18,000 new infections.

[Mr Liver]

"I disagree that the global impact is not of NO consideration."

I never said it wasn't. See, this is the problem here. You make up things that were never said. I've told you already what I said TWICE and you still get it wrong. Please review ALL of my posts and then show me where I said anything even close to that.

You are only talking about spreading HCV as a threat to national security, it seems, from your latest comment."

Where in the heck did that come from ? My assertion has been from the beginning that HCV does NOT pose a threat to our national security in the US ,Canada, or Europe.
I do not want to spend the time explaining how a disease like AIDS can actually threaten the security of a nation when the link I posted directly below my statement explains how this can happen, and gives plausible scenarios.  This is the THIRD time I am telling you this. When you understand how the threats could manifest and then try substituting HCV in the place of AIDS in those scenarios you will see how HCV is not, nor will it ever be, a threat to national security.  HCV has less of an impact on your healthcare system than the many in Canada who go to the doctor's every time they have a runny nose. That accounts for alot of the long waiting times there, and the extra cost burden on the system.

I looked this up..Canada allowed 260,000 immigrants to move to Canada permanently last year. 1.8% of that would be 4,680 infections and much less than that number would end up treating. I think even the overworked healthcare system in Canada can handle that without any resultant harm to your nat'l security. If the Canadian gov't thought a problem of that magnitude they would reduce or test the immigrants allowed to move there. Next year the Canadian gov't will allow 330,000 new immigrants to move there. That doesn't sound like the gov't is too concerned about any addt'l healthcare costs caused by immigration.

Anyway Trish I think I've provided enough accurate and up-to-date information to cover the points I have been trying to make. People can choose to reject them or refute them if they want. That's fine with me, as long as they don't attempt to refute fact with opinion.  What I really don't appreciate is people such as you and alagirl, and trinity making up things that I have never said. And to add to the insanity you and those others have gone on to attack those very words that I never uttered. That part is pretty funny to watch at first but it gets boring after awhile as I'm sure you can understand.
I am posting this again just for you. I know you are interested in the topic.

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030171&ct=1

Have the last word, please. I am done with this topic for now as I have made my points.

Mr Liver

And please don't worry about your nat'l security. Your friends to the south wouldn't let anything happen to y'all.

[Trish77]

True enough on that, Jim.  Just a matter of, as always, if one can tolerate waiting that ten years and risking that we might have to treat prior to that.  Some of us yes, some of us no.  

If you watch and wait, the wrinkles in the collar might settle out on their own...won't cost you a thing that way. ;->

[jmjm530]

Trish: With regards to your final statement here.... precisely, Jim.  Another one of MY considerations.  I wanted to treat while I was younger not older. Let go of my collar. :)
------------
Except that ten years from now, we have every reason to hope that the two years I lost will be just a few months, and possibly even without interferon. And sorry about the ruffled collar, I'll pay for the laundry bill :)

-- Jim

[Trish77]

ML:  "You said: "I do know that the immigrant population is now considered a risk factor all on it's own for HCV here in Canada and particularly if from one of the countries where it is  known to be more prevalent."  

Do you still stand by that ridiculous aasertion ? "

I'll have to give you this .. I didn't cut that fine enough.  Tattoos are a risk factor, it doesn't mean every person who gets a tattoo will get HCV.  While being an immigrant from the Middle East is a risk factor due to the higher incidence of HCV there, I'm not at all suggesting that being an immigrant alone is a risk factor.  My wording would suggest otherwise and I should have elaborated better than that.

"Since you have done an excellent job of nailing down the primary sources of infection in those countries you have helped me to prove my point. Or all of them going to start using IV drugs once they hit the Canadian shores ?
The only way these folks could present a health risk to Canada would be through IV drug use.That is the main transmission vector for HCV today by far and away over any other means of infection. No IV use, no threat. I assumed you had thought through the scenario completely before making a statement like the Sub-Saharan etc, population was considered to be a threat to Canada or Canadians ? My mistake"

I do think we are talking apples and oranges from your additional comments and if you had answered my question on what YOU mean by threat to national security, we could have saved alot of trouble here.

You are only talking about spreading HCV as a threat to national security, it seems, from your latest comment.  And while IVDU is the greatest factor and increasingly so on transmission of HCV - and I do agree with you on that and have said so in other discussion threads on tackling the stigma, for example - it's not the only method of transmission.  I agree that the threat of transmission is small but not without any impact at all.  You also ignore the fact that if they do not know they have HCV, there is a risk of transmission to their children in birth and to their spouses / sexual partners.  Small but not non-existent and not via IVDU.

Perhaps living in Canada with a universal healthcare system, I also consider the cost to treating persons with HCV a threat to national security. Everything that costs the healthcare system has a trickle-down effect and I've already explained that to you - the impact on waiting times, the fact that  the cost for treatment drugs are only supplemented for one round here due to the overall burden on a government funded healthcare system, the fact that funding is not supported for anyone below Stage 2 for the same reason... believe me, the cost to treating our own citizens for HCV is an issue here, let alone treating an additional 2% of the immigrant population.  You totally ignore this aspect of it.   I personally think this is a valid consideration and THAT is why I said I disagree that the global impact is not of NO consideration.  You can disagree.  I happen to think this is valid also.

Trish

[Trish77]

"Unlike Trish, I decided to treat somewhat late and looking back feel comfortable with my decision. My only regret was that my last biopsy showed significant liver damage, because if I didn't, then I would not have treated and would not have lost two years out of my life, including work and friends -- not to mention that I feel I aged ten years in the two years I treated. And the older you get, the more those ten years matter. "

With regards to your final statement here.... precisely, Jim.  Another one of MY considerations.  I wanted to treat while I was younger not older. Let go of my collar. :)

[Mr Liver]

"Where in anything I said, did you take me to imply that the persons from the countries I named specifically - the Middle East, SS Africa and SE Asia - have those higher HCV rates due to .. IVDU? "

You didn't. It was a hint but you obviously didn't pick up on it.

You said: "I do know that the immigrant population is now considered a risk factor all on it's own for HCV here in Canada and particularly if from one of the countries where it is  known to be more prevalent."  

Do you still stand by that ridiculous aasertion ? Since you have done an excellent job of nailing down the primary sources of infection in those countries you have helped me to prove my point. Or all of them going to start using IV drugs once they hit the Canadian shores ?
The only way these folks could present a health risk to Canada would be through IV drug use.That is the main transmission vector for HCV today by far and away over any other means of infection. No IV use, no threat. I assumed you had thought through the scenario completely before making a statement like the Sub-Saharan etc, population was considered to be a threat to Canada or Canadians ? My mistake.

Mr Liver

[Trish77]

I also feel comfortable with my decision, Jim. My life is not identical to your life, after all, hm?

I haven't pushed anyone in early Stage to go for treatment.  If you read my posts back, you'll see that I tell them they don't have to treat now, they need to educate themselves about what they're getting into and make a very well thought out decision.  It does upset me alot to see people told they need to treat now and scared into treatment and then the posts start popping up that say "my doc said this wouldn't be hard for me because of xyz!" or "my doctor didn't tell me that treatment could be like this".

Jim, if we were friends when I made my decision, I'd tell you I'm good with my decision as I HAVE thought long and hard about it....then I'd pry your hands from my collar.  :)  

Trish

[jmjm530]

Trish: I don't personally advocate early treatment, for the record.  I advocate choice.  
----------------
I will have to remember that one :)

Yes, I think just about everyone advocates *choice* but there's nothing wrong giving our opinions and where we come from, not that Trish suggested otherwise.

Unlike Trish, I decided to treat somewhat late and looking back feel comfortable with my decision. My only regret was that my last biopsy showed significant liver damage, because if I didn't, then I would not have treated and would not have lost two years out of my life, including work and friends -- not to mention that I feel I aged ten years in the two years I treated. And the older you get, the more those ten years matter.

If you're a 40 year old stage 1 genotype 1, I'd urge you to think long and hard before treating now. If you were a close friend, I'd grab you by the collar and try and shake some sense into you :)

Find yourself a good liver specialist and monitor your liver until better treatments come along. That's what I'd tell a friend, but of course, it's your choice :)

-- Jim

[Trish77]

There are more issues with having HCV than trying not to die from it.  It's also worthy to prevent getting to complications caused by it.  There are a number of extra-hepatic conditions caused by HCV.  When I was diagnosed, I was perfectly healthy (as far as I knew) in every other way.  Honestly, I didn't know about extra-hepatic complications when I made my decision, however if I did, it would have cemented further my decision to treat early in combination with the other factors.  I was apprehensive about the side effects and knew as much as one who has never treated can know about how difficult they can get.  I didn't approach this from an "out d@mn spot, out" point of view as in a kneejerk reaction.  Particularly when your doc says "are you ready for a year of hell?".

There is also the issue that you have no idea at what stage your liver will degenerate.  Yes, you can monitor, however if you are Stage 1, 40+ years old and have had it already for 20+ years, statistically you've already used up a fair bit of grace there.  If you are ready to treat now and you're not sure you'll be able to accommodate it in the future, well, then perhaps you opt for the "now" you know than the unknown future date you don't know and aren't sure you'll be in a position to accommodate treatment.  As someone said once, it's your OWN statistics that matter.

I don't personally advocate early treatment, for the record.  I advocate choice.  Perhaps I step in on early treatment's behalf as valid for some because, well, I'm treating early and didn't take the decision lightly.  

[BelB64]

The consensus is still in most places that most people WILL die with HCV rather than from it. Let's say those predictors who say 1-5% is the number of people who will die from HCV are wrong by 30%!  It still means 65% of those with HCV won't die from it.

I would like to know approximately how many people in the U.S. have tried to cure HCV by doing some type of interferon treatment. I bet of the 4,000,000 or so who have the disease a VERY small percentage has done it.

[Trish77]

I meant to elaborate on my perspective why I feel it is of SOME national concern rather than none that a particular percentage of the immigrant population arrives with HCV.  In MY country.   We already don't have enough treating GI's and accommodation for the currently known persons with HCV.  When I've been in discussions about efforts to identify those who haven't been tested, the discussion then turns to how they'll be treated if we identify them all.  Not that they shouldn't BE treated nor left unidentified.  But that once the move is made to identify them, the waiting times will increase even more than they already are.  I waited 10 months to get in to see the specialist.  Then two months more before I got any test results that confirmed I have active Hep C.  Harrybeads has been waiting I think five months to get the result of his six month PCR.  

To totally ignore the fact that the immigrant population arrives adding to this does NOT make it zero impact.  That is what I meant.  If that has nothing to do with your point, then simply explain why we're talking apples and oranges.  Still waiting for you to explain what you mean by national security rather than directing me to an article to do research on what YOU mean when that is best explained by you yourself rather than leaving it open to further misinterpretation.

Trish

[Trish77]

"There is no threat of widespread infection because a few immigrants have HCV. How many IVDU do you think there are in the Sahara desert ? The poorest people on the planet and you think they are injecting drugs. Sometimes I can't believe how far people will stretch to try and support the weak assertion they made."

Where in anything I said, did you take me to imply that the persons from the countries I named specifically - the Middle East, SS Africa and SE Asia - have those higher HCV rates due to .. IVDU?   I don't see it this way at ALL.  That's a total assumption on your part.  Look beyond IVDU and blood transfusions and look at the practices in those countries to determine where they're getting their HCV rates from.  I didn't decide the 4.3% figure for the Middle East, nor the 3.8% figure for SS Africa.  Why would YOU assume the only place HCV comes from in any country is IVDU?  I surely don't. I attribute these numbers due to improper sterilization procedures in those countries that are not yet where we are here in North America and in some parts of Europe - not all.  I didn't stretch anything.  YOU are the one stretching YOUR point here by attributing comments to me I didn't make and assuming I have some sort of agenda that I don't have.  I simply spoke up to you on the one point and your reaction to that is offensive.  While I used the word "misleading" regarding your assertion, I did NOT use the word "deceptive".  I am not saying that you are deluded and deluding, such as you attribute to me.  While I'm certainly new at this, I've been communicating with the local AIDS organization and I have been learning from them and we are learning together.  We've discussed how to properly support co-infected persons with regards to HCV treatment where they are at.  Does that sound like I'm pushing some kind of agenda to you?  On the whole I respect your knowledge and I learn alot from you.  On occasion though, you can be a pompous a$$.

""Alagirl:  The infection rate for AIDS throughout the entire world is 1 percent or less except in two countries, Sub-Saharan Africa and the Caribbean."

Mr. Liver: I'm not sure why you posted this. It is meaningless unless it is given in some sort of context."

Here's your context.  When immigrants from those countries come here, they will need to be treated and IF they are not TESTED for HCV, possibility of passing on HCV exists.  (Before you say it, I GET that it's not transmissible as easily as HIV. ) THAT is an issue, the same as the lifetime of HIV treatment that others need.  Not on the same scale at all by any means but, in my opinion, certainly doesn't equate to zero issue.  You can disagree and I'm okay with that.  You're the one that said NO impact.  I simply disagree and I said so.

For the record, I read the article you posted, didn't think I needed to, your statement of absolute zero impact seemed enough on it's own for me to comment to that.  I still don't know what YOU mean by threat to national security.  I've asked you and you refuse to answer, directing me to the article.  Which, btw, doesn't mention anything about global infection rates.

No, I didn't mean to put the decimal point in a different place.  I was simply showing the math that the "nearly two percent" came from.  You misunderstood, I wasn't clear...whatever.

Trish

[Mr Liver]

"Demonstrated that we know how quickly the IVDU community is growing and that we are successfully able to measure the incidence of new cases in that community. "

The numbers of IVDU in the US has been REDUCED by HALF since the 80's. Why don't you do a little research before you post ? You've stated repeatedly that IVDU use in the US is up. All studies say just the opposite.

"Another huge at risk group in the U.S. - undocumented workers"

HUGE ? Its that kind of statement that leads me to believe you do  not have much knowledge about HCV. Illegal immigrants do not have an IVDU problem. They come north to work. The vast majority of them could NEVER support a drug habit not to mention it is highly stigmatized in their society. Show some proof for these statements that you make. I have asked you several times before but apparently you think your opinions will substitute for fact.

"I didn't personally call it an epidemic.  But many doctors have (and pandemic as well), and I can see their point.  I do understand the numbers on this.  The slew of earlier cases increased by year, mostly due to transfusions, peaking somewhere in the mid two hundred thousands during the eighties."

You are not very knowledgable about HCV and related topics which is understandable as you are new to it. Your statement above about transfusions causing the explosive growth of HCV in the 70's and 80's is factually incorrect. You've stated this twice now so I thought I'd correct you before you make the same mistake again. It was primarily IV drug use that swelled the number of NEW infections , NOT transfusions.  

" we don't have the first clue as to how many new cases we truly have every year".

You might not have more than a clue--- but the scientific communities do and the estimates are very accurate. You seem to have no problem using estimates if you think it will further your point. Why do you trust those numbers ? They were arrived at the same way--statistical analysis. The science of statistical modelling is very complex and not easily understood by the average person. Every research paper includes a number which reflects the strength of the accuracy of the numbers used. You might want to look into that.

"I feel strongly that HCV needs more awareness and attention"

I believe I saw you say something similar months ago. So now months later I have to ask---what are you doing NOW to promote awareness and attention? And I'm not referring to telling the clerk at the store about it. Have you looked into volunteering or starting a support group, or arranged for  local media interviews, write editorials, letters to the editor etc, etc. ??  If you live near a city there are plenty of volunteer positions needed by the local support orgs. There are also heallth fairs which need volunteers. Have you ever even written your representatives in gov't from the local to the federal level ? How about community access television on cable ? It's free. I would love to hear what you have done to promote awareness and prevention.

You suggest things in your post that have been done long ago such as retrospective analysis concerning infection rates from the 70',80'90's. Its been done a hundred times by researchers and agencies.

You seem to have NO problem using infection rates when you think they are helping you prove a point.

If another penny wasn't spent on HCV it still would be virtually non-existent in the US in 20-25 years.
How do you figure?

This is information that you can go find for yourself. Let me lead you through it part way. Go find the projected IVDU in the US  for the next few years. Since it is trending downward since the SEVENTIES, you can safely assume it will continue to do so. But work with current number as I'm willing to give you the break. Then find out the projected number of HCV infected in 25 years. Of course this number will be almost exclusively represented by IVDU. Then come back and post the number and we'll discuss how much of a danger it poses to the average American citizen or our gov't.  I won't be holding my breath.

"I do think though, that the new infections are rising, or are just about to rise and a) that they are going to continue to increase and that b) this is due to IVDU's"

Where do you come up with this nonsense ? Incredible. You seem to have an endless supply of misinformation.

Look, I've given you facts, while you've given me opinions and factually incorrect statements. You do not corroborate anything you say, while I've furnished you with references for my assertions. I've answered your questions and you have not answered a single ONE of mine. For these reasons this discussion is now over.
ML

[Mr Liver]

"I wouldn't say that HCV poses NO threat to national security, if by that you mean the overall cost from the impact of the disease, either due to medical treatment costs or cost of transmitting the disease to others. "

When you made this comment it told me that you never read the article at the link I provided immediately below my statement. If you had, you would have known EXAVTLY what I meant and you might have gained some knowledge as to what types of problems a pandemic disease can create by every measure, not just financial and get a good understanding of how disease could threaten our nat'l security. And if you researched the subject further it would illuminate the potential problems that can be faced which could threaten our national security in other ways than those discussed in that ONE article.

IVDU which is the primary infection vector for HCV in the US Canada and Europe does not affect our national security in any way. IVDU usage has dropped by more than half since its peak.

" I'm saying I think it's misleading to say that HCV poses NO threat to the U.S. from a global influence. "

This is an example of not reading what someone has actually written. I said nothing close to what you just said I stated. Before telling someone that they are being deceptive you should determine what was actually said before making the accusation. There is no threat of widespread infection because a few immigrants have HCV. How many IVDU do you think there are in the Sahara desert ? The poorest people on the planet and you think they are injecting drugs. Sometimes I can't believe how far people will stretch to try and support the weak assertion they made.

"I do know that the immigrant population is now considered a risk factor all on it's own for HCV here in Canada and particularly if from one of the countries where it is  known to be more prevalent. "

AND

"  it was determined that nearly 2 out of every 100 immigrants come into our country with HCV (.018 to be precise).  

I'm going to assume you meant to put the decimal in a different place. It's supposed to be 1.8% which is the SAME infection rate for Europe, Canada, and the US so your point is meaningless. How can you say its more prevalent overall and then put down those numbers ? You don't know what the infection rate is in your own country ?

Mr Liver