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Opioid epidemic leads to new threat: Hep C infection and deaths

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Calling it a "hidden epidemic," county health officials are lauding a new strategy by Gov. Andrew Cuomo to increase screening and treatment for the Hepatitis C virus.

Cuomo last week announced new strategies to eliminate Hep C, piggybacking on a previous effort to tackle HIV in New York. The new effort aims to stop the spread of the Hep C virus by increasing access to medications that can cure the disease and by expanding programs to connect New Yorkers in high-risk communities with wrap-around services for prevention, screening and treatment.

Dr. Gale Burstein, Erie County health commissioner, said many people don't realize Hep C has made a major comeback, and just how deadly it can be.

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"The problem is, Hep C is the most deadly disease in the United States, causing more deaths than HIV. And because it causes permanent liver damage and cirrosis, it's also the No. 1 cause of liver cancer," she said. "However, if it's diagnosed early, Hep C can be treated on an outpatient basis."

Burstein also serves on Cuomo's AIDS Task Force, which has a goal of eliminating HIV/AIDS in New York by 2020.

Last year, there were 573 confirmed cases of chronic and acute Hep C infection across New York. For Western New York, the state reported an infection rate of 89.9 per 100,000 population, compared to a statewide rate of 73.9 cases per 100,000.

The incidence of Hep C has been growing along with opioid addiction that leads to heroin use, especially among young people 20 to 40. Acute cases reported have risen by 75 precent, and over 80 percent of those were among young people. Half of cases were women, and nearly 86 percent of those infected reported a history of injection drug use. Worse, Burstein says, many of those women are of reproductive age.

"So we have to worry not only about infection among those women, but we have to worry about vertical transmission during pregnancy and how to manage those newborns," she said.

Gov. Cuomo's plan calls for increasing funding for Hep C prevention, testing and treatment programs, such as education, patient navigation and HCV prevention programs in primary care and other settings. The administration has also expanded an HIV/AIDS rental assistance program, which will cap income contributions toward rental costs at 30 percent. That also helps with Hep C, since one in five people with HIV are co-infected with Hep C.

Getting physicians and hospitals to encourage younger people to be screened is important too, along with revised recommendation from the U.S. Preventive Services Task Force, which has traditionally recommended universal screening only for baby boomers. Because most people don't have symptoms until they're very sick, they just don't know to ask.

"We really want to make sure that people who are at-risk are identified as infected, similar to HIV," she said. "People who are infected don't have symptoms for a very long time, but there's still a lot of inflammation to their liver causing damage and leading to development of liver cancer, but it will kill if not treated."