Hep in the News 2016

Quick Shots
a round-up of under-reported-related stories from 2016
by Larry Buhl

It’s time for a 2016 desk clearing and to report some hepatitis-related stories that fell under the radar during the year.

USA-Vietnam_Veterans_MemorialVeterans Killed by Hep C Added to Vietnam Veterans Memorial
Not every veteran killed by war dies on the battlefield. In the case of soldiers like Jim McGough, transfusions that saved their lives can eventually kill them. McGough was an infantry soldier in 1971 when he was hit by a grenade near the Laos border. Surgery performed on him in Okinawa included a transfusion to replace lost blood.

Twenty years later he learned he had the hepatitis C virus (HCV), but he didn’t opt for treatment because he was asymptomatic. In 2014 he died of liver cancer, months before new, more effective drugs came onto the market. As he had no risk factors for HCV transmission, it was assumed that he contracted it from the transfusion in Japan. In 2016, McGough’s name was inscribed along with seven other names on the Vietnam Memorial “Wall.”

Nearly 400 names have been added to the wall since the memorial was completed in 1982. For a name to be added, the soldier’s death must have resulted from injuries sustained during the war in Vietnam or a defined combat zone.

Viral Hepatitis May Kill More Worldwide than HIV, Malaria or TB
The first study to systematically study the scope of viral hepatitis around the world, published in The Lancet in September, showed that hepatitis A, B, C, and E caused 1.5 million deaths in 2013, making it one of the leading causes of deaths worldwide.

The study also found deaths related to the liver-damaging disease have risen dramatically in the past two decades, even while deaths from other diseases are falling. Researchers estimated that there was a sixty-three percent increase in deaths from viral hepatitis between 1990 and 2013. In 1990, the disease was the 10th leading cause of death in the world. By 2013, it was the seventh leading cause, and its prevalence had surged in wealthy and poor countries alike. Many countries in Africa and Southeast Asia don’t have universal vaccination programs, and in some countries, like China, the new antiretroviral treatments are not available because they haven’t been tested.

More Prisoners Sue States Over Lack of Hep C Treatment
A&U has reported on the challenge facing correctional institutions in treating inmates with new and pricey antiretroviral drugs.

In 2016 lawsuits against state prisons became more common.

In December, the ACLU and the Roderick and Solange MacArthur Justice Center in St. Louis filed a federal lawsuit against the Missouri Department of Corrections alleging that inmates did not receive treatment for the hepatitis C virus. The lawsuit cites a survey published by the nonprofit Project HOPE, which found Missouri’s Corrections Department in January 2015 reported treating less than one percent of inmates with the illness.

In July, attorneys with the ACLU and other advocates sued the Tennessee Department of Correction, alleging officials knowingly denied inmates care for their hepatitis C, a neglect they charge is cruel and unusual punishment. This comes on the heels of an investigative report by the Nashville Tennessean earlier in 2016 that found that of nearly 3,500 inmates with hepatitis C in Tennessee prisons, only eight were receiving one-pill-a-day treatment that could cure them.

Correctional populations represent about one third of total U.S. HCV cases, according to the Hepatitis Education Project.

More than 1 Million Worldwide Treated With New Meds
In October, the World Health Organization (WHO) announced that more than one million people in low- and middle-income countries have been treated with direct acting antivirals (DAAs) since the drugs were released in 2014. The barrier to treating the estimated 80 million people with chronic hepatitis C worldwide remains the cost of the meds, which can be unaffordable even in high-income countries. The WHO points to the success of access strategies in bringing the new meds to low- and middle-income countries, including Argentina, Brazil, Egypt, Georgia, Indonesia, Morocco, Nigeria, Pakistan, Philippines, Romania, Rwanda, Thailand, and Ukraine. These strategies include competition from generic medicines through licensing agreements, local production and price negotiations, according to the WHO.

FDA Approves Pill to Treat All Forms of Hep C
In June the Food and Drug Administration approved the combination pill, Epclusa. Made by Gilead Sciences, Epclusa combines Sovaldi with a new drug that attacks the virus using a different mechanism to treat all six genetic subtypes of HCV. Clinical data reviewed by the FDA showed that the drug, when used in combination with ribavirin, cured ninety-five percent of patients in three months.

Larry Buhl is a radio news reporter, screenwriter, and novelist living in Los Angeles. Follow him on Twitter @LarryBuhl.