The first estimates of active Hepatitis C viral (HCV) infections have been released as part of the End Hep C SF consortium in San Francisco. The estimates, which comprise the first ever estimate of its kind, indicate higher than average HCV in the city overall and identify some expected, some unexpected high-risk populations.
What Hep C Is and Why Ending It Matters
Hepatitis C is a viral infection that affects the liver. In early stages, many people are asymptomatic. If left untreated, however, the virus damages the liver, often contributing to the development of cirrhosis and cancer. HCV-caused liver damage and failure is preventable; unfortunately, without the awareness of the infection or access to treatment, people die. The larger population also pays heavily for costly treatment for advanced-stage liver disease treatment.
Overview and High-Risk Populations
Estimates were calculated based on the 2015 population of 860,000. The End Hep C SF study found 26,000 San Francisco residents have HCV antibodies, which is nearly double the national average.
Based on the estimates that 20% of those with HCV antibodies will clear the infection without treatment and others will seek treatment once symptoms present, San Francisco has an estimated 13,000 residents with active HCV infections.
HCV does not affect the population equally or at random. The study identified the following high-risk groups:
- Injection drug users—3% of the population but 70% of HCV infection cases
- Baby boomers
- Gay and bisexual men
- Transgender women
There is some overlap between high-risk populations for HCV and HIV/AIDS. In San Francisco, gay and bisexual men account for 90% of HIV cases, and an estimated 75% of them also have HCV infections.
Prognosis and Next Steps
The study and estimates of active HCV infections is just a first step for End Hep C SF. By estimating the number of people needing treatment and identifying groups for targeted education, prevention and screening, End Hep C SF can begin to more effectively strategize how to eradicate active HCV infections.
Initiatives will likely include making current treatments more accessible to individuals with HCV infections. Unlike older treatments that were limited in effectiveness and often had severe side effects, newer treatments have a 95% cure rate. However, they are cost-prohibitive to many, including many of those in the identified high-risk populations.
Implications for New Mexico
End Hep C SF provides insight into the incidence of HCV in other locations…like New Mexico. With a population near 900,000, San Francisco is comparable in size to Albuquerque. Because injection drug use presents the highest risk for HCV infection and statistics for injection drug use for Albuquerque (and the state) show a high incidence of use, overdose and fatal overdose, our state may well have more than 10,000 residents with active HCV infections, too. In other words, it may be time for New Mexico to consider a similar initiative to raise awareness about and increase accessibility to treatment for HCV.
In the meantime, individuals who fall into any of the high-risk populations, including members of the LGBTQ community, should get screened for HCV infection. UNM Truman Health Services can provide HCV screening and refer you to other medical resources (if necessary) for additional testing and treatment. Contact us to learn more.