This interview was originally published on our sister site, HCPLive.
In an interview at the recent American Association for the Study of Liver Diseases (AASLD) 2023 Liver Conference, Tatyana Kushner, MD, MS, associate professor of medicine in the Division of Hepatology at the Icahn School of Medicine at Mount Sinai, discussed the Biden administration’s hepatitis C Elimination programs, the role of clinicians in addressing this issue, and disparities among patients affected by hepatitis C.
“Our goal is to develop a national plan dedicated to eliminating hepatitis C, and there are specific aspects that need to be addressed in that proposed plan,” Kushner explained.
Components of this goal include providing easier access to medicines, improving the process from testing to treatment, and emphasizing the need for research, particularly related to the development of a hepatitis C vaccine. In addition to these elements, Kushner described the role clinicians must play in eliminating HCV and emphasized the need for screening.
“If you see patients, whether in primary care or any other medical setting, you need to screen them for hepatitis C. That’s very, very important. Even if you’re not someone who sees a lot of patients with hepatitis C, you need to Get screened, it’s an important part of your health care maintenance,” Kushner said.
The difficulty in addressing the growing epidemic of hepatitis C virus is that clinicians are unable to treat difficult populations. Kushner explained that easy-to-treat populations are not a problem, but more attention and resources must be directed to communities considered difficult to treat, including “the homeless, people who inject drugs, people who use drugs “. “Unscheduled access to the health care system.” In addition to special attention to challenging populations, Kushner emphasized the importance of “the entire cascade of care,” from initial screening to treatment and follow-up.
“There are inherent disparities in access to health care and we need to really work to make sure that in addition to the disparities, we also make sure that stigma is addressed so that people feel safe accessing health care. If you’re in a stigma-ridden environment and they If people are unwilling to even receive health care, then it’s impossible to solve the problem of hepatitis C in this population,” Kushner explained.
Looking at HCV from a gender-based perspective, women who inject drugs are at greater risk for HCV than men, for reasons Kushner described as “multifactorial,” including engaging in high-risk injecting behavior, injecting more frequently, and surrounding pursuits. Stigma and harm reduction services. Screening and treatment during pregnancy may provide new opportunities for female patients to receive care they would not otherwise seek.
“During pregnancy, women will come to you, they’ll be in care, and they’ve had all these tests, so this is our opportunity to screen them and make sure they’re relevant for treatment. The issue of treatment during pregnancy is still being studied . In fact, the data at this meeting suggest that treatments in the second and third trimesters look promising,” Kushner said. “Obviously, there are important interactions between liver disease and pregnancy and pregnancy outcomes, so I do think that does become part of what we’re doing, and I think our first-ever guidance goes some way to demonstrating that. at this point”.