Dear Viral Hepatitis Advocate:
Congressman Hank Johnson, one of our strongest champions for viral hepatitis screening, care and treatment, is asking his colleagues to sign onto a letter to the CDC asking for the speedy release of new screening guidelines for the Hepatitis C virus. The proposed age-based screening guidelines will identify many more Americans with Hepatitis C and enable them to access care and treatment, thereby reducing deaths and health care costs.
We urge you to help Congressman Johnson by calling YOUR member of Congress today to ask him or her to sign on to the letter (below and attached). You can reach your Representative by calling the Capitol Switchboard at 1-202-224-3121 or google their website for a direct office number. Sign on to the letter closes on Thursday, COB, so please call today!
Here’s a sample call script:
“My name is ____________ , I live in (city, state), and I care about viral hepatitis. Hepatitis is a serious health problem in the U.S., in my District, and is a very important issue to me. I urge Representative _____________ to show leadership in the fight against hepatitis and liver cancer by signing Congressman Hank Johnson’s Congressional sign on letter to the CDC regarding hepatitis C screening guidelines.”
If there is time, tell them why this issue is important to you. You will probably only have time for 2-3 sentences. Members of Congress and their staff pay attention to their constituents. They need to hear how viral hepatitis affects you, the people you care for, your friends, family, and co-workers. Our lawmakers are unaware of viral hepatitis and how it impacts people in their Districts so they really need to hear from you!
Begin forwarded letter:
Dr. Thomas R. Frieden
Director
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333
RE: Release of Screening Guidelines for Hepatitis C
Dear Director Frieden:
We are writing to express our full support for the timely release of the Centers for Disease Control and Prevention’s (“CDC”) revised screening guidelines for the Hepatitis C virus (“HCV”). In particular, we urge the CDC to adopt new guidelines that would recommend a one-time screening for all Americans born between 1945 and 1965, the “baby boomer generation.” Existing risk-based screening is not effectively targeting a patient population where baby boomers account for 80 percent of all Americans infected with chronic HCV.[1]
HCV infection is the most common long-term blood-borne infection in the United States.[2] There are four million Americans currently infected with HCV, but 75% of these individuals are unaware of their condition.[3] Additionally, the incidences of chronic infection are disproportionately higher in minority populations. For example, HCV is twice as prevalent among African Americans as among Caucasians.[4]
Chronic HCV can result in long-term health problems, and is the leading cause of liver cancer and the most common reason for liver transplantation in the United States.[5] Despite new treatment options that can cure the disease, the mortality rate associated with HCV has now surpassed HIV/AIDS with 15, 106 deaths attributable to the virus in 2007 alone.[6]
These are devastating numbers and that is why it is so important for the CDC to take action and release new age-based screening guidelines that will more effectively address this serious issue. Age-based screening may help to identify these HCV-infected patients prior to the onset of liver failure or liver cancer, allowing them to be adequately monitored and potentially treated.[7] Furthermore, by increasing efforts to detect HCV infection, screening may assist in reducing further transmission of the virus.
Recent studies offer evidence that this is sound public policy that will also save lives. An article in The Annals of Internal Medicine, authored by the CDC, provides a glimpse into the type of effect new guidelines could have. The article found that compared with the status quo, age-based screening would identify 808,580 additional cases of chronic HCV infection and, when followed by treatment, would reduce the number of deaths by 121,000. If implemented, this could be a transformative development given the study’s other finding that deaths from HCV are forecasted to increase to 35,000 annually by 2030.[8]
A similar peer-reviewed article on the cost-effectiveness of age-based screening was recently published in Hepatology. The study’s authors found that compared to the current strategy of risk-based screening, birth cohort screening followed by treatment reduced deaths by 78,000 compared to risk-based screening at a cost of $37,700 per quality-adjusted life year (QALY) gained. The study also found that birth cohort screening resulted in 84,000 fewer cases of cirrhosis, 46,000 fewer cases of liver cancer, and 10,000 fewer liver transplants.[9]
Deaths attributable to HCV are increasing, leading to a sense of urgency around the need to take action. We believe that the lessons from the HIV epidemic are applicable to combating HCV, that hepatitis C deaths can be prevented through promoting testing, early diagnosis & linkage to care. The CDC is to be commended for identifying the magnitude of the problem, but it is now imperative that it take further steps towards helping the millions of patients unaware of their condition to get screened and linked to care.
New CDC draft guidelines could offer an effective approach to reaching populations where the disease is most prevalent. We once again offer our full support for new HCV age-based screening guidelines, and urge the CDC to finalize their recommendations as soon as possible.
Sincerely,
Cc: The Honorable Kathleen Sebelius, Secretary, Department of Health and Human Services
Cc: Dr. Howard Koh, Assistant Secretary for Health, Department of Health and Human Services
Martha Saly
Director
National Viral Hepatitis Roundtable
Phone: 707-242-3333
Cell: 707-480-0596
The National Viral Hepatitis Roundtable is a coalition of public, private and voluntary organizations dedicated to reducing the incidence of infection, morbidity and mortality from viral hepatitis in the United States. NVHR is a project of the Task Force for Global Health (www.taskforce.org).
[1] “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C,” at 1. Institute of Medicine, July 27, 2011
[2] McHutchison, J.G. & Bacon, B.R. Chronic hepatitis C: an age wave of disease burden. Am J Manag Care 11, S286-295; quiz S307-211 (2005).
[4] Armstrong GL, et al. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144(10):705-714; 3.
[6] “The Growing Burden of Mortality Associated with Viral Hepatitis in the United States, 1999-2007,” S.D. Holmberg, K.N. Ly., et.al, AASLD Abstract, November 5-8, 2011.
[7] Srocynski G, Esteban E, Conrads-Frank A, Schwarzer R, et. al. Long-term effectiveness and cost-effectiveness of screening for Hepatitis C virus infection. European Journal of Public Health, Vol. 19, No. 3, 245-253. February 2009.
[8] “The Cost Effectiveness of Birth-Cohort Screening for Hepatitis C Antibody in US Primary Care Settings,” D. Rein, B. Smith, et. al, The Annals of Internal Medicine, February 2012.
