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264121 tn?1313033056

U.S. Morbidity

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.
72 Responses
Avatar universal
Yes,the profile and prognosis has changed.
Some years ago it was accepted wisdom that only one in five would develop cirrhosis.
As the baby boomer Hep C has aged it looks more likely that the majority(if not the vast majority) will be cirrhotic by around age 65.This is thought to be due to weakenimg age related immunity
We are also learning that it is not the virus per se that causes progression but our own altered auto-immune response to chronic infection.
264121 tn?1313033056
We are also learning that it is not the virus per se that causes progression but our own altered auto-immune response to chronic infection.
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Of course, I was an acute, newly infected patient with a 1b genotype, so my best shot at clearing was to treat immediately (and I did).  But if I had been chronic when I found out I had hep c, I probably would have treated quickly anyway for the exact reason you mention.  My autoimmune issues have wreaked havoc on my body my entire life, and I would have been very afraid that in responding to the hep c, my own system would eat me alive.
151263 tn?1243377877
The thing is, is that many more die of secondary issues triggered and/or exacerbated by hep C. And yet the cause of death is listed as diabetes, cancer, alcoholism etc, instead of what originally caused or greatly contributed to the actual direct reason of death. Also, hepatitis C undoubtably has and continues to make at least some impact on suicide rates. How many is not known, but hep C definitely takes a significant psychological toll on many. Based on my own experiences, I'm quite certain it has been much more than the straw that broke the camel's back on many who have died by their own hand. HCV's total toll on humanity is incalculable.
Avatar universal
That's why I think it's so important to treat early on.  In my case, probably had this disease over 30 years and didn't know it.  Working, raising kids, not eating as healtly as I should,  drinking a bit too much at times over the course of my life and at 55 years old I find out I have hepc with Stage 3 liver disease.  Had I known, wouldn't I have done things differently.  Many of us find out after the damage has been done and it's harder to treat and cure.  That's where a large percent of those with hepc are right now.  Advanced liver disease with very few options.  I'm glad there is a heightened awareness of this disease now so more will treat before it's too late.
Avatar universal
That's exactly what I was thinking when I was reading the drug inserts for Int and Riba... all the sides were saying "up to and including death" from that particular "complication" or additional new "disease". Or "up to and including acting on those thoughts".

Today I was wondering if anybody's doctor ever reminded them about disinfecting their OWN manicure or personal care items, during or after treatment. And those who didn't, could that patient have been re-infected accidentally by their own hand, and then been diagnosed as a "relapser"?  

Can you tell me the protocol on razors, or other items? Throw away sooner? Bleach them? How often?  I would die if I thought there was a chance that I actually spaced out and re-infected my own self.  Can you tell that I'm close to my start date for treatment?  I wake up nights with an OMG out of the clear blue sky.

Thank you for the list Alagirl, I was surprised to see Alzheimers at sixth.

cathy
151263 tn?1243377877
"Can you tell me the protocol on razors, or other items? Throw away sooner? Bleach them? How often?  I would die if I thought there was a chance that I actually spaced out and re-infected my own self."

I'm certainly no expert on "the protocol" for disinfecting things. But concentrated bleach is widely thought to be about as effective as it gets as a disinfectant both for viruses and bacteria (and Dr Dieterich on this forum did say that bleach was the best antiviral). I do recall some post/reference in the past where someone had "evidence" that even bleach in one form or another wasn't 100.00% effective at sterilizing something that might be contaminated with HCV. But I think it's safe to say that if the concentration of the bleach/water solution is high enough (especially if it's hot), it will do a very good job of sterilizing anything with contaminated blood on it. The catch is to give the bleach some time to do the job. For instance, don't just dip an earring in bleach water and then insert it right into your ear. Let it soak or allow the strong bleach solution to stay on whatever it is you want disinfected. Preferably for a couple days if you can. Normally hep C cannot survive outside of the human body for more than a few days. So to be on the safe side I would sterilize with strong bleach solution, leaving the solution in contact with the contaminated item for several days, and if possible a week (or even more). Better safe than sorry I always say.

But really, in practical terms, what I did in terms of razors etc was to simply throw them away as I progressed through treatment. As long as I was on the antiviral drugs I didn't really worry about being reinfected. Simply throw the razors away (assuming they are disposable) as you progress through treatment. And especially at the end of treatment you want to swap out your razors more regularly. And think carefully about any pointy objects (like scissors etc) that have been around you during treatment. But again, even if any of the objects did have contaminated blood on them, simply being outside of the body for more than a week at a time will kill the virus.

Lastly, as an added measure of protection, we have a certain limited form of immunity after successfully treating, especially from the genotype we once had. Our body has antibodies and "remembers" the virus that once swarmed in our blood, Its defenses will remain up for that particular genotype, and it probably makes us less likely to be re-infected by our old genotype, especially that found in our own old blood. It's not a foolproof form of protection, we can still be reinfected. But studies have shown that we do have a sort of limited, partial immunity (compared to a person who has never been infected with HCV). That partial immunity should make it even less likely to be reinfected by ourselves in the very unlikely event you would come into contact with your own infected blood before the effects of the antiviral drugs wear off.

In short, just use common sense! Good luck on your upcoming treatment...
Avatar universal
every week before my shot I would use my toothbrush and then discard, take a shower use razor and then discard that too.  
I'm 5 weeks post tx now and still throw em out weekly.

Toothbrushes are cheap-you can get 5 in a pack
for a buck at Walgreens or the dollar store.

Disposable razors are a bit more expensive,
but I believe worth using a new one (after shot) each week on tx.

I bought cheap manicure kits at Walgreens and the dollar store.
I threw them out as well.  Better safe than sorry.
Avatar universal
Similar to what I did on tx except never used the same razor twice.
Avatar universal
You being a guy (even though our profile pics look the same  LOL) didn't shave as much as us females. I have a hard time believing the 4 day rule for the survival of HCV outside the body.  Remember (years ago) when someone posted that it "could" live up to 21 days in the right enviroment?...
Anyway-best to be safe.
Avatar universal
"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."

It should be a rising number. New infections peaked in the mid to late '80s at around 260,000 new infections per year. That is 260,000 !

The study which reclassifies deaths has been posted here before several times.
http://www.news-medical.net/?id=36630s.

When you go through death certificates and you use incomplete medical histories of those included in the study of HCV mortality, the numbers become very questionable. Using the author's criteria new mortality numbers could be added if: A car driver crashes and bleeds to death before help arrives and upon autopsy they discover HCV and SLIGHTLY lower than normal platelets. In this study HCV would be listed as a contributing factor. But, was it really ? Let's say a person drinks themselves to death (which still represents almost half of all liver transplants) and is discovered to have HCV upon death. When was the HCV contracted ? It will be listed as an underlying cause or a contributing factor. But, was it really ?

This study above uses extremely flawed subjective methodologies that I wouldn't trust in a million years.

"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!!???) "

No, it does not floor me, nor should it floor anyone, because you are basing your statement using incomplete data. HCV does not pose a FRACTION of the potential harm HIV/AIDS could bring to this country.

To wit: Appx 4 million infected with HCV in the US, even using the 'bloated' figures above would only put the HCV mortality rate yearly at appx 5%. There are 900,000 appx infect with HIV/AIDS. Using the numbers you gave of appx 15,000 deaths per year would represent a 14% mortality rate. 5% vs 16%--its obvious which one poses the greatest threat to the country. The new infection rates of HCV are expected to be below 18,000 next year. HIV/AIDS will be over 55,000. Which one poses the greatest threat to our country is self-evident.. Funding is commensurate with the threat posed.

From the CDC:

"HIV Incidence Estimate

Incidence is the number of new HIV infections that occur during a given year.

In 2008, CDC estimated that approximately 56,300 people were newly infected with HIV in 2006 (the most recent year that data are available). Over half (53%) of these new infections occurred in gay and bisexual men. African American men and women were also strongly affected and were estimated to have an incidence rate than was 7 times greater than the incidence rate among whites. "

So here we have new infections of 56,000 this year for HIV vs appx 20,000 new infections for HCV and this number will rapidly decline in a few years).

So again, which poses the most threat to our country ?

HCV is NOT an epidemic. It is an epidemic that WAS.

"Liver disease was in the top fifteen causes of death in the US in 2006.  Actually, I think it was in the top twelve."  

HCV as the cause of death wouldn't even make the top 40. Liver disease includes all cancers, alcoholic hepatitis deaths, poisonings, along with a myriad of others liver diseases.

If you have HCV and smoke you should be much more concerned with this:
"Health Effects of Smoking

Each year, a staggering 440,000 people die in the US from tobacco use. Nearly 1 of every 5 deaths is related to smoking. Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined. "

When dealing with these types of numbers you have to ask yourself  is the figure being expressed as a percentage of the population as a whole ,or is it just a number with no context ?

Mr Liver
mathmetician


Avatar universal
Thanks for the perspective. As suggested, I would imagine that alcoholism and heavy drinking factor significantly into these results, as well as probably the fact that many of these people didn't even know they had Hep C -- therefore no monitoring or choice of being treated.

One inference --- that one should treat early -- doesn't follow, at least for me. I certainly think people should treat whenever they want to, but I see "watchful waiting" as a very reasonable strategy as long as one monitors the liver carefully and makes appropriate lifestyle choices.

-- Jim
568322 tn?1370169040

The 14,627 deaths is the CDC's estimate.  But the "Death Totals by State including the District of Columbia Compiled from each State's Department of Public Health" is only 10,472.  And most states reported huge decreases in yearly deaths.  

http://fairfoundation.org/states/hiv-aids_deaths_by_state.htm


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

Thanks to the success of HIV meds, HIV patients now have a NORMAL life expectancy.....that's 77.8 years.   We can't say the same for Hep C patients.

There are 3,538 clinical trials for HIV/Aids.....but only 571 for Hepatitis C (many involving HIV/HCV co-infection).

The NIH is spending $3,052 on each citizen estimated as having HIV/AIDS....but they  spend only $20 on each HCV patient.  

Let's not spend it all in the same place.



Source:
http://fairfoundation.org/news_letter/2008/02june/000newsletter.htm
320078 tn?1278348320
wait i didnt know that i should be throwing away razors and toothbrushes while tx.  i use my toothbrush for about amonth and then get a new one, i use disposable razors and used them about three times aweek and then throw them away.  Am i doing something wrong?

peace
rita
Avatar universal
I don't think so rita, I've never been advised to do so.  It's isn't listed on any of the websites such as janis7hepc.com and my doctor hasn't mentioned anything about it either.  I think there are those that just take extra precautions for vaious reasons of their own. I've heard many say you can never be too careful, but I can't preoccupy myself with those kinds of things.  If it were absolutely necessary, it would be well documented and strongly advised by the "renowned specialists" across the country.  If we could ever get on the expert forum, it would be a great question to ask.
Trinity
Avatar universal
You are not going to reinfect your self using the same razor or tooth brush during Tx.
1. You are taking a strong anti hcv drug which will kill it even if you did reinfect yourself
2. This could only be an issue when you are close to UND and then re infect yourself after you became UND.
3. The virus doesnt live long enough outside the body to do that
4. You are taking IFN for a long time after you become UND.
5. no one would svr if this was the case.

CS
Avatar universal
"Thanks to the success of HIV meds, HIV patients now have a NORMAL life expectancy.....that's 77.8 years.   We can't say the same for Hep C patients. "

This is not factually correct. HIV patients have a shorter than average lifespan. Much depends on age, time of infection, start of antiretroviral therapy, and means of acquisiton.This just came out in Lancet:

"Life expectancy for HIV positive people is still not normal. Even under the best scenarios, he wrote "about 10 years is shaved off a normal lifespan," and starting treatment after severe immune deficiency has set in shaves off an extra 10-20 years. "--
Another reason why more money is given to HIV/AIDS research.
http://www.cdc.gov/hiv/topics/surveillance/basic.htm#incidence

Perhaps you can tell me what the life expectancy is for someone with HCV since you brought it up ?

The fact that people with HIV in the US live longer now only increases the burden of the healthcare costs associated with the treatment, care, and housing for those infected. They take expensive meds and never stop until they die. They are presumed to be disabled upon diagnosis and most will have to rely on government funds for their medical care, prescription costs, and housing. Thus the cost to society in dollars is getting larger the longer they live. But this pales in comparison to what we could lose if the global HIV/AIDS rates do not start coming down. Yet another reason for higher funding for HIV/AIDS.

"There are 3,538 clinical trials for HIV/Aids.....but only 571 for Hepatitis C (many involving HIV/HCV co-infection). "

This is nonsense and intellectually dishonest. How come you point out that many HCV studies are co-infection studies and not disclose that many more HIV/AIDS trials are for co-infections, as well ? Go through that list and delete all HIV trials that are completed,terminated,not recruiting, suspended,ancillary studies, and for co-infection and you won't have that many trials for HIV/AIDS left. And if you go through the remainder and delete all that are not trials for new drugs there will only be a handful left.

Because of its global prevalence and ease of infection  HIV/AIDS poses a potentially serious national security issue. HCV poses no threat to our national security at all nor will it as a result of global infections (which will follow a similar decline as the US) . Let's face it-HCV is hard to get. HIV/AIDS by comparison has many more transmisson vectors which make the spread of the disease harder to control. Furthermore, funding in the US for HIV/AIDS research is not just based on the needs of HIV/AIDS patients in the US, but the ENTIRE WORLD, as  the genesis of any threat to our national security would undoubtedly be a result of the pandemic nature of HCV, not as a result of US infections. We face no such danger from HCV. Another reason for the higher funding of HIV/AIDS research.
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030171&ct=1

The number of new HCV infections (in the US ) are expected to be below 18,000 next year. HIV/AIDS will be over 55,000. Which one poses the greatest threat to our country is self-evident.. Funding is commensurate with the threat posed, and this is reflected in research dollars.  http://www.cdc.gov/hiv/topics/surveillance/basic.htm#incidence



"The 14,627 deaths is the CDC's estimate.  But the "Death Totals by State including the District of Columbia Compiled from each State's Department of Public Health" is only 10,472. "

Only ? OK, let's use 10,472 instead of the CDC's estimate of appx 15,000  HIV/AIDS deaths during a year's time. With appx 1 million infected HIV/AIDS individuals in the US this would be about a 10% mortality rate. HCV has only an appx mortality rate of 1%-5%  This would seem to run counter to the point I think you are trying to make.(*However,If you look closely at the data you cited you will see that the totals by state  are not all reported in the SAME year ). I think with a mortality rate 3X higher than HCV it would be obvious which one demands the most diligence, and research dollars, on the part of the government.

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

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

"The NIH is spending $3,052 on each citizen estimated as having HIV/AIDS....but they  spend only $20 on each HCV patient. "

This should be expected and illustrates my point about which disease poses the greatest threat to the US. Again you make it sound as if these research dollars were soley for the benefit of infected US citizens which is not true. It is for the benefit of ALL US citizens when viewed from a standpoint of national security.
Contracting HCV is HARD compared to HIV/AIDS. New infections of HIV/AIDS continue to rise globally while new infections of HCV continue to plummet (and for HCV this trend will continue.)  " In 2008, CDC estimated that approximately 56,300 people were newly infected with HIV in 2006 ." New infections of HCV in the same year was less than 30,000.
http://www.cdc.gov/hiv/topics/surveillance/basic.htm#incidence

If another penny wasn't spent on HCV it still would be virtually non-existent in the US in 20-25 years. And I mean not one red cent for research, prevention, or tx.  If you did the same to HIV/AIDS, it would eventually decimate this country. Just one more reason for the increased funding as this illustrates how much more HIV/AIDS is a threat over HCV due to its virulent nature.

In the mid-80's new HCV infections peaked at appx 240,000 per year. Last year there were appx 25,000 new infections. Why someone would expect the gov't to invest large sums of taxpayers dollars for a disease that is going away through attrition is beyond me.

Mr Liver
mathmetician and dissecter of half-truths
568322 tn?1370169040
Besides a "mathmetician", you wouldn't happen to be an Aids advocate, would you?
264121 tn?1313033056
Not to split hairs, but I think that most of the data I've seen states that overall about 4 million Americans have HCV antibodies, with about 2.7 to 3.2 million chronic HCV patients.  I presume the others are those who had acute HCV and cleared on their own.  What I'm not at all sure of is where they put the SVR's, or if the SVR's are supposed to be included in that numbers difference also.

I do see what you're saying about HIV patients having a larger percentage of deaths for their overall population, but I don't think that the HCV patients have an inconsequential number comparitively.  And some of the trends in HCV deaths in the past few years (like the fact that they have risen in the age 45 - 54, and disproportionately among men), are a little disturbing.

Also, I think there has been a surge in substance abuse among all populations.  College students are using hard drugs in really significant numbers.  And while I don't know that we'll get back to the transmission levels we had when HCV was transmitted via transfusions, I am afraid that there are a lot of people, many of them teenagers, who are going to be infecting themselves over the next few years, causing the new infection rate to go up.  At the same time, this is about the time that we are going to see a lot more deaths from people who were infected tens of years ago.

http://www.medicalnewstoday.com/articles/65347.php

I don't really have a problem with classifying a death in which Hepatitis C was a contributing factor as a hep c death (or with the fact that it might sit on both the HCV and the HIV lists).  If HCV has hastened the premature nature of someone's death, then I think its fair to add that death to the HCV list - because if that person was not suffering from HCV, they would have died on a later date.  Even in the case of an alcoholic, his liver would have lasted longer if not so compromised by HCV.  If it cannot be established that HCV was a contributing factor in actually CAUSING the death, then I think it shouldn't go on the HCV list.  And of course even then we have so many people who die without an autopsy and also without ever knowing they were HCV positive and that HCV was a contributing factor to their death, that it seems to me that we really are underestimating the number of HCV deaths in all probability.

As meds for HIV continue to become more refined, we are going to see more and more of what we are seeing now, co-infected HIV/HCV folks who actually die more from complications brought on by HCV than from the actual HIV (except in that the HIV weakened their immune system to the point that they were more susceptible to the ravages of HCV).  Again though, for me, the decision on whether HCV also receives attribution for the death depends on how clearly it can be determined whether or not HCV contributed to the death.

http://www.medpagetoday.com/InfectiousDisease/Hepatitis/tb/8890

"Death certificates mentioning hepatitis C as either the underlying cause of death or as a contributing cause of death were compared to medical records with hepatitis C listed as a discharge diagnosis, as a part of the patient's history, or as a positive laboratory test. Using MCOD data alone would have only captured 18% of the total number of estimated deaths.[26] Another study utilizing Kaiser Permanente Medical Care Program data for 2000 also found hepatitis C to be underreported on death certificates. Only 64% of deaths attributed to hepatitis C in the Kaiser database listed hepatitis C as a cause of death on the corresponding death certificate.[27] Applying results of these validation studies to data from 2004 suggests that between 12,000 and 41,000 hepatitis C-related deaths occurred, consistent with other published estimates.[2]

An important but infrequently recognized complexity in the analysis of MCOD data pertains to the translation of entity axis codes to record axis codes and may result in an underestimation of cause-specific mortality. Although HIV and hepatitis C are often both listed in the entity axis, they are frequently combined into a single code for HIV disease in the record axis. For example, it is possible for ICD-10 codes K74.6 (other and unspecified cirrhosis of liver), B24 (unspecified HIV disease), and B18.2 (chronic viral hepatitis C) to be listed separately in the entity axis. After processing and translating the entity axis codes, the record axis may only contain B20.3 (HIV disease resulting in other viral infections) and K74.6, with B20.3 listed as the underlying cause of death. This phenomenon could have lead to the exclusion of numerous deaths strongly related to hepatitis C if ICD codes in the entity axis had not been taken into account."

264121 tn?1313033056
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?
Avatar universal
This is what ticks me off...
(I've posted this before-the bill was initially turned down I believe in 2002)

July 30, 2008
President Bush Signs H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008--

This bill will help us combat the diseases that complicate HIV/AIDS.

It commits $4 billion to fight tuberculosis --
which is the leading killer of Africans living with HIV.

The bill also pledges an additional $5 billion to our Malaria Initiative. Through this Initiative, we've provided malaria treatment and prevention services to more than 25 million people. We've dramatically reduced malaria in many parts of Africa.

The additional funds in this bill will help us save even more lives.

http://www.whitehouse.gov/news/releases/2008/07/20080730-12.html

This is billions of dollars we're talking here...
What about HCV?  I just don't get it.  
I guess we need to help Africa before we help the people of the US or
help people sticken with Hepatitis.  In another decade the SH!T will hit the fan.
264121 tn?1313033056
Truly, I would LOVE to believe that HCV would no longer be a going and spreading concern in 20 years.  But I don't see how its possible, and I haven't read any research to that effect - if you have some, I would be interested in it though.

HIV also puts on the lists of its deaths, people who are coinfected and died at the time they did largely due to the contributing factors of HCV.  So I guess I still feel kind of valid in saying that we have a serious health problem.

And honestly, the HIV community and physicians aren't just a little bit worried about HCV, they are VERY worried about HCV.  This is NOT an either/or situation here.  HCV needs more money for treatment and research for the sake of both communities.  HCV contributes prominently to the death toll of those with HIV.

http://www.thebody.com/content/art12281.html#kills

Additionally, I hardly think that only 1 - 5% of those with HCV will die.  It is higher than that.  1 - 5% will have liver cancer.  A percentage will have liver failure, a percentage will have kidney failure.  All of those percentages don't add up to 1 - 5%

I don't understand, honestly, why your tendency is to minimize this when there are doctors and researchers both here in the U.S., and in several other countries calling it an epidemic.  Personally, I think if the U.S. is going to get it under control, this is the time to do it.
Avatar universal

I am not minimizing anything. I am speaking factually. I have HCV, am on the tp list, and suffer from decompensation. I have no reason in the world to minimize HCV or its impact. I speak to facts. Many people have a hard time accepting the truth especially when they haven't heard it before. There are tons of epidemiological studies that chronicle the rise and  fall of HCV in the US. It is on its way out. The doctors and researchers that you mentioned are a handful who are misapplying the word "epidemic". They should refer to the rising deaths and cancer as a surge , and completely expected. A breakout widespread infection is an epidemic. In the mid-80's new HCV infections peaked at appx 240,000 per year. THAT was an epidemic. Last year there were appx 25,000 new infections. You call that an epidemic ? Funny, but I always thought in an epidemic the numbers went UP, not DOWN.

"Additionally, I hardly think that only 1 - 5% of those with HCV will die.  It is higher than that.  1 - 5% will have liver cancer.  A percentage will have liver failure, a percentage will have kidney failure.  All of those percentages don't add up to 1 - 5% "
First off, not everybody dies from HCC who gets it. In appx 20% of the cases the patient lives. If someone dies of kidney failure due to liver disease, trust me the doctors can put two and two together and figure it out. HCV has been listed for over a decade as the cause of death if the disease caused other manifestations that eventually killed the patient. They wouldn't list the death as 'kidney failure". So, tell me just what those percentages add up to ?
Please back with a reference.

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

This is to be expected as well. I covered this already.The epidemiology of HCV is an open book. References, articles, and studies all detail the course HCV will run in the US, and WHY. Those numbers above don't mean anything more than the cycling through of those who primarily contracted this disease in the 70's and 80's via IVDU -and transfusions to a much lesser degree. More people infected during a time period will be reflected by more deaths as they age. Nothing unusual about that and points to the coming day when IVDU will be the primary source of new infections in this country.

" Personally, I think if the U.S. is going to get it under control, this is the time to do it. "

What does 240,000 new infections in the mid-80's vs. 18,000 new infections today mean to you ? To most people it would be very apparent in light of those facts that we DO have it under control as a nation.


"And honestly, the HIV community and physicians aren't just a little bit worried about HCV, they are VERY worried about HCV.  This is NOT an either/or situation here.  HCV needs more money for treatment and research for the sake of both communities.  HCV contributes prominently to the death toll of those with HIV".

You are overstating the case. Co-infection has much more meaning when it comes to tx. But failing HCV tx doesn't mean you are going to die if you have HIV. Please provide a reference to back up your assertion that HCV plays a prominent role in HIV mortality rates. I assume you have one to make that statement.--ML

"However, multivariate analyses adjusting for baseline CD4+ cell count and number of weeks on HAART showed no statistically significant difference in survival time between HCV/HIV co-infected and HIV only patients (p= 0.56). Baseline CD4+ cells and length of time on HAART were both significant predictors of survival.CONCLUSIONS: In a multivariate analysis correcting for baseline CD4+ cell count and HAART use, survival times between HIV patients with and without HCV co-infection were found to be comparable. HAART was the strongest predictor of survival, suggesting treatment is more important to survival than co-infection with HCV"--http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102263696.html

"HIV also puts on the lists of its deaths, people who are coinfected and died at the time they did largely due to the contributing factors of HCV." --- I would love to see this list you refer to. Please provide a reference.

"A percentage will have liver failure, a percentage will have kidney failure.  All of those percentages don't add up to 1 - 5% "

So, if a patient has fulminant liver disease, or failing kidneys you don't think the doctors or medical examiners can figure out what the cause of death was ? C'mon you can't be serious.

It would benefit you to actually read all the way through the references I posted. Everything that you have brought up is addressed in those studies.

Mr Liver
Avatar universal
"Besides a "mathmetician", you wouldn't happen to be an Aids advocate, would you?"

Why would posting facts make me an AIDS activist ?  I like the truth, don't you ? Actually, an AIDS advocate would never go where I went in these postings.

I'm an advocate for HCV and I'm proud to say I've done alot of work in our city and state as one. When I give a speech or presentation it's for HCV, not AIDS. That said, I do have a good relationship with local and nat'l AIDS orgs which works to the benefit of everyone with HCV. I'm sure you have noticed that AIDS orgs are well organized . Besides great organizational skills, they have great expertise in fundraising, awareness, and most importantly for HCV, great connections in the public relations department. They have established worldwide networks that were started from the grass roots level. It would be foolish not to tap into those type of resources and expertise. Even before co-infection was an issue the AIDS orgs helped the local HCV orgs to obtain grants, help put various support systems in place, and helped immensely with fundraising. So, well I have worked closely with those with HIV/AIDS I have been, and will continue to be, an advocate for HCV.

In the US new HCV infections have dropped precipitously since 1990. This trend continues and will do so even more in the future. However, there is still a need for HCV advocacy in our prisons, awareness programs for IVDU, and testing.  It doesn't have to be an epidemic to care for someone with HCV.

Mr Liver
Avatar universal
i posted a similar chart concerning death statistics about a year ago.
i  compiled it in this   'deaths per day'    format as all the statistics are
difficult to compare and this was easiest for me to understand.
i didnt compare it exactly with alagirls chart  but at a quick glance they look very similar and of course the numbers vary from year to year and from source to source.

DEATHS PER DAY IN AMERICA

    DISEASES

heart        2000
cancer       1000
stroke       400
lung         350
                 250              accidents etc. (see below)              
diabetes         200
alzheimers        200
flu                 200

kidneys      150                
blood        100   (bacterial septicemia)

liver      70   all liver problems  (alcohol, viral, auto immune, toxicity
liver      45           all hepatitis,  (a b c d e f g)
liver      25    hep c only  

high blood pressure        60
aids                       45 this number may be lower now


ACCIDENTS ETC.  (250  total)

motor vehicles  115
suicide   80
murder    50
fire      13

on the job    10
drownings  9
iraq war   3
ladders    1


the funny thing is, i interpreted it exactly the opposite as alagirl.
why do we so feverishly destroy ourselves with combo therapy
but fail to stay up on our flu vaccines?  (much greater chance of death) why do we endure deadly chemotherapy but continue to smoke? (decidedly deadlier)  why do we jump at the chance for a crappy 50% cure from hep c but at the same time continue to overeat and be sedentary? (leading to far deadlier problems) not to mention the fact that if logic was applied none of us treaters would ever get in a car again!!!!!!!!!!
i dont know the answer to these questions but i looked at those death statistics last year in the middle of my treatment and was very much happy to see that hepc wasnt nearly as deadly as i had
imagined it to be.  the priorities that we assign to the efforts of avoiding death are far out of line with the real world statistical chances
for those deaths in my opinion.  

i am glad i treated now that its over but i presently put much more effort in avoidance or preventative measures on the items at the top of the list than i ever did before.

yea, all of this is all an oversimplfied
'drive by' picture of this issue but still good food for thought.


"now lets go have a beer"

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