The new issue brief from amfAR highlights a peculiar global health conundrum — people living with HIV, a disease for which no cure yet exists, survive with treatment only to die of a disease that can be cured. One example has long been tuberculosis. This brief puts the spotlight on Hepatitis C and HIV: Addressing the Dual Epidemic.
Prevalent in areas with high rates of HIV, and with heavy impact on those with the least access to adequate health services, including people who inject drugs, people who have had unsafe blood transfusions, and people receiving tattoos under unsafe conditions, the hepatitis C virus can be cured with a combination of injected and oral medicines over the course of six months or a year. Newer medicines may achieve a cure in as little as three months. Treatment also reduces the odds of transmitting the virus. Yet the prevalence of hepatitis C continues to rise, and death from liver disease caused by the virus is becoming a leading cause of death of people living with HIV, the brief notes. The reason? A course of treatment in the Asia-Pacific region where rates of HIV-hepatitis C coinfection are high, costs from $18,000 to $33,000, and is rarely covered by public health programs or private insurance.
The cost to health systems and society of inadequate treatment access are higher, though, the brief says, noting a 2009 study showing that people with hepatitis C visit emergency rooms and physicians, or are incapacitated from working with significantly higher frequency than those uninfected. The brief makes a particular case for investing in addressing treatment access in Asia, where the type of hepatitis circulating is easier to treat successfully, and where greater numbers of people are genetically likelier to be cured by treatment.