STUDY Abstract: THU-421 Screening for Neurocognitive Dysfunction in Non-Cirrhotic Chronic Hepatitis C Infection in an Irish Academic Unit – D. Ferguson, et al.
Study Aims and Results: This study investigated the prevalence of neurocognitive dysfunction in Irish HCV patients. Of 431 HCV-positive people, 48% had cognitive dysfunction.
Conclusions: This study’s investigators stressed the importance of screening for cognitive dysfunction in HCV patients, particularly the often overlooked non-cirrhotic patients.
Editorial Comments: This study is still in progress with future plans to release results on the potential reversibility of this neurocognitive dysfunction using exercise intervention or viral eradication.
STUDY Abstract: THU-395 Lower Risk of Multiple Sclerosis in Patients with Chronic Hepatitis – J. Söderholm, et al.
Study Aims and Results: The aim of the present study was to investigate the risk for multiple sclerosis (MS) in HCV patients. Data were collected from a nationwide population-based register from 2001–2013 in Sweden. The prevalence of MS was lower in those with HCV (0.087% or 37/42,522 subjects) compared with those without HCV (0.27% or 544/202,694 subjects).
Conclusions: This large study found that people with HCV were at a lower risk of developing MS compared with those without the virus.
Editorial Comments: It is nice to read some good news! I would love to see this study duplicated in the U.S.
STUDY Abstract: THU-113 Effectiveness of Hepatitis C Virus Screening Laws in United States: Evidence from Paid Claims Data from 2010 to 2016 – D. Mehta, et al.
Study Aims and Results: This study evaluated the effectiveness of HCV screening policies of 5 U.S. states (NY, CA, CT, MA, CO) beginning in 2014. The aim was to assess the U.S. progress in meeting the World Health Organization’s (WHO) goal of screening 90% of the world’s population for HCV infection by 2030. Researchers gathered data from a large claims database, from 2010-2016.
Compared to 2010, annual screening rates were increased by nearly 20% after 2014. In the states that passed screening laws, screening rates were increased by an additional 6%. Medicare enrollments, females, and the presence of comorbidities were associated with an increased likelihood of screening.
Projections of screening rates suggest that NY and 4 other states without screening laws were on track to reach the WHO target by 2030; 8 additional states are projected to reach the WHO target by 2040; 29 states would not attain this target by 2050.
Conclusions: Over 90% of states in the U.S. are still not on track to reach the WHO target by 2030.
Editorial Comments: As bad as this sounds, the projections may be even worse if we don’t solve the opioid crisis.
STUDY Abstract: THU-090 The Covert “C”; Prevalence: Risk Factors and Management of Hepatitis C in Psychiatric In-Patients – J. Ramachandran, et al.
Study Aims and Results: In the by-gone era of treating HCV patients with interferon, people with mental illness were underserved because of interferon’s high profile of psychiatric side effects. Now with the availability of direct-acting antivirals (DAAs), this Australian study of patients who were hospitalized with mental illness assessed: (1) HCV seroprevalence, (2) HCV risk factors, and (3) experience of treatment and follow-up. Of 241 patients (70% male with median age 43 years), the HCV risk factors were intravenous drug use (28%), exposure to custodial stay (20%), tattooing (63%), blood transfusion or organ transplantation (10%), sex workers (16%) and indigenous descent (8%). The prevalence of HCV antibody was 10%.
HCV RNA was negative in 11 of 25 patients with positive antibody, of which 5 had prior treatment and 6 had spontaneous clearance. In the remaining 14 patients with detectable HCV RNA, five were treated with DAAs. The remaining 9 untreated patients were difficult to engage with despite efforts by care teams.
Conclusions: These researchers concluded that psychiatric inpatients should be considered a high-risk population for HCV and routine screening should be considered. However, treating this patient population was challenging due to difficulties engaging.
Editorial Comments: This study had problems enrolling subjects, and thus is small. However, I agree that we should consider HCV screening for this population. I’d love to see a peer model approach, where peers with HCV talk about their HCV treatment experiences.