Why it is time to wage war on HCV

[Mugwump]

There can be no doubt now that HCV can be effectively controlled because it can be cured. Now is the time to eradicate it for good the way we have with polio and other diseases that need a unified concerted public outcry to deal with.

This does not mean that all work on finding an effective vaccine against the virus is no longer a goal that is worth the effort. Michael Houghton would agree with this analysis I am certain.

Currently the costs associated with viral load testing are one of the greatest hurdles in the way of effectively eliminating HCV from the general population. This unfortunate situation needs addressing as does easy access to accurate HCV testing the way other conditions have become inexpensive to accurately test. The other hurdle that must be overcome is greed on the part of the pharmaceutical companies and a complete lack of commitment from governments when it comes to recognizing the significance and socio-economic implications of letting things stand the way they are regarding the treatment and costs of dealing with this virus.

Let us consider first the economic productivity years lost to this virus. A few forward thinking people and organizations have but governments including their health departments seem to have their collective head in the sands regarding HCV and the real problems it has created for humankind!
http://www.rand.org/content/dam/rand/pubs/technical_reports/TR1300/TR1307/RAND_TR1307.pdf

A paper done on costs of HCV on the Spanish and European economy also delves into this aspect of the burdens caused by this disease

"Our model shows total productivity losses attributable to HCV infection of 1054.7 million euros over the period analysed."

All of these non-biased findings clearly indicate that HCV will be a financial burden of war like proportions if not effectively dealt with by our health care systems. Perhaps this is ironic in one sense because it seems very possible that HCV itself was only recently made wide spread by battlefield surgery and blood transfusion practice during and after wars, starting in the second world war and perhaps including the Spanish Civil war.

This slow but insidious spread of HCV went on all the way to recent conflicts in the middle east and most likely peaked during the Vietnam war.

Although HCV was then spread to the general population first by contaminated blood products and inadequate decontamination of syringes and surgical equipment, it also got into the street drug using populations and then spread by other means largely with the re-use of drug paraphernalia.

It is clear that unless we passionately attack HCV and make it a social goal to enable free treatment of this condition on a global scale it will continue to invade our society and make war upon us. A war that we cannot afford to ignore and fight with all the resources we would use to fight if we went to war with each other again.
 

[Mugwump]

In the US there are no relevant studies that I can find which have been done past 1997 as the progression of the number of known infected individuals with HCV increases.

So instead one would have to take the 1997 study and apply the method then to the chronic infection rate data curve past that date all the way to the current time.

It seems that in some ways the treatment and study of HCV is being put on the back burner of our health care system. Even the treatment and disease information recommendations indicated by the key CDC documents are out dated and are not currently being updated with reference to new DAA treatments.

This blatant foot dragging is happening for a reason and I suspect it is because the general public will not be very happy when the real reasons why HCV became an epidemic in the first place become public information.

[elias]

I'm reading much lately about the peak of the current HCV epidemic having occurred
during the Vietnam war on account of mass inoculations. This would explain the high rate among baby boomers especially those among them who served in that war.

Has the VA not owned up to this yet?

There's also the factor of substandard health care and poor infection control and  even in the domestic arena. Especially back then

Here's short clip of Senator Bernie Sanders-back in 2015-  addressing the high cost of Sovaldi and its effect on veterans:

https://www.youtube.com/watch?v=QKi_nP9TDiI

[Mugwump]

The disease seems to have begun to spread even before the Vietnam conflict. The inoculations with gun devices were done to more than just soldiers. And the general methods of blood transfusion seems to have increased the spread of this virus earlier on all the way back to the second world war.

At the same time the use of injectable drugs sharing needles increased on the street essentially creating a double whammy.

Unfortunately at first the VA blamed drug use as the cause of the huge numbers of vets that turned out to be infected. In fact it became a gospel to write off HCV as an SIW or "self inflicted wound". The unfortunate fact is that this attitude still holds sway in some military minds because it became the norm to associate drug use with those who have this disease.

However the VA has relented somewhat and all a vet has to do is say that they did not use drugs and they will get treatment. Still a bullcrap kind of situation but at least a first step in the right direction for now.

However you will not see anyone admitting yet that the disease most likely started to gain traction during the second world war with tainted vaccine as documented in the very history of military medicine. http://history.amedd.army.mil/booksdocs/wwii/communicablediseasesV5/chapter17.htm

THE SERUM HEPATITIS EPIDEMIC OF 1942It was only a few months after the declaration of war in December 1941 that the most extensive outbreak of serum hepatitis ever to be recorded in military history broke out among U.S. troops both in the United States and abroad. This outbreak of "jaundice" in the Army, which began in February 1942, was the cause of great concern to the Medical Department and particularly to the Preventive Medicine Service, Office of the Surgeon General. Not the least of its disconcerting features was the fact that it was so unexpected, and also that some 4 or 5 weeks elapsed before there was general acceptance of the fact that it was actually homologous serum jaundice following vaccination for yellow fever and perhaps not due to attenuated yellow fever virus.¹⁸In brief, the events were as follows: In February 1942, an increased incidence of jaundice in the Army of the United States was reported to the Preventive Medicine Service of the Office of the Surgeon General. By March it was evident that a widespread epidemic was imminent, and it was soon apparent that the epidemic was not limited to the continental United States but was occurring simultaneously in troops in such widely separated regions as Hawaii, the Southwest Pacific, Alaska, Iceland, and England. For 4 or 5 weeks, the nature of this outbreak was in doubt, but data submitted by a team of the Army Epidemiological Board seemed conclusively to exclude toxic agents or contacts with infected civilians as causes and established statistically a causal relationship between the administration of certain lots of yellow fever vaccine which had been given 2 or 3 months previously. On the basis of this information and an analysis of reports from various affected units, The Surgeon General, on 15 April 1942, discontinued the administration of serum-containing yellow fever vaccine. At that time it seemed possible that an icterogenic agent, perhaps the unknown cause of infectious hepatitis, had been introduced into the vaccine by way of the human serum used in its preparation. Subsequently, this was abundantly proved. A serum-free vaccine was substituted in April 1942, and no jaundice that was proved to be associated with yellow fever vaccination, per se, developed subsequently in recipients of this vaccine.

This rash of cases of rapid onset of serum hepatitis seems to have a difference to how HCV is known to infect in some respects. But if one extrapolates that the disease does rapidly infect a small portion of the population and leaves a much greater population symptom free then an explanation of what occurred becomes more understandable. It is highly likely that many thousands of soldiers were infected but showed no signs and thus went on to return to the civilian population. At the time the only known difference between strains of the disease were the understood differences between infectious and "serum" hepatitis. The b strain was not known but was simply grouped into the "serum". 

This military outbreak has not been studied for the exact strain of the disease, perhaps it was both b and c. This information can be discovered but it seems that the government and the military wants to pretend it never happened!
Here is hoping that the US where the disease first took hold in huge numbers finally has the guts to get its collective head out of the sand and deal with this plague now that it is becoming possible.

[Lynn K]

Well we could take a page from the AIDS advocates from the 80's

Out of the closets and into the streets.
Actup
Fight back
Fight Hep C

We too are hiding in closets of our own making. It matters not how we got hep c. Some will never know. But whether or not it was through misfortune or behavioral we all have or had hep c and we need to fight together for all.