The dollars and sense of chronic hepatitis C infection management.

Abstract

SUMMARY We have observed major advances in opportunities for HCV treatment in the recent years; however, there are a number of economic and prac-tical challenges to reducing the burden of HCV infection in Canadians. As an infectious diseases community, we will need to advocate on behalf of HCV-infected patients for access to optimal therapies to cure their infection. Due to focus of care in subspecialized clinics in many cases, infectious diseases specialists at large in Canada, with a few exceptions, have traditionally had a limited role in the management of HCV-infected patients. Given the prevalence of HCV infection and current availability of highly effective therapies, we believe that HCV manage-ment can no longer be considered to be a ‘subspecialty’ within infectious diseases. The onus is on all adult infectious diseases specialists to actively contribute to reducing the burden of HCV infection in Canada. REFERENCES 1. Myers RP, Shah H, Burak KW, Cooper C, Feld JJ. An update on the management of chronic hepatitis C: 2015 Consensus guidelines from the Canadian Association for the Study of the Liver. Can J Gastroenterol Hepatol 2015;29:19-34.2. Hull M, Shafran S, Tseng A, Giguere P, Klein MB, Cooper C. CIHR Canadian HIV Trials Network Co-Infection and Concurrent Diseases Core: Updated Canadian guidelines for the treatment of hepatitis C infection in HIV-hepatitis C coinfected adults. Can J Infect Dis Med Microbiol 2014;25:311-20.3. Myers RP, Krajden M, Bilodeau M, et al. Burden of disease and cost of chronic hepatitis C infection in Canada. Can J Gastroenterol Hepatol 2014;28:243-50.4. Kwong JC, Ratnasingham S, Campitelli MA, et al. The impact of infection on population health: Results of the Ontario burden of infectious diseases study. PLoS One 2012;7:e44103.5. Klein MB, Rollet-Kurhajec KC, Moodie EE, et al. Mortality in HIV-hepatitis C co-infected patients in Canada compared to the general Canadian population (2003-2013). AIDS 2014;28:1957-65.6. Hernandez MD, Sherman KE. HIV/hepatitis C coinfection natural history and disease progression. Curr Opin HIV AIDS 2011;6:478-82.7. Lee MH, Yang HI, Yuan Y, L’Italien G, Chen CJ. Epidemiology and natural history of hepatitis C virus infection. World J Gastroenterol 2014;20:9270-80.8. Rosen HR. Clinical practice. Chronic hepatitis C infection. N Engl J Med 2011;364:2429-38.9. Pawlotsky JM, Feld JJ, Zeuzem S, Hoofnagle JH. From non-A, non-B hepatitis to hepatitis C virus cure. J Hepatol 2015;62(1S):S87-S99.10. Hoofnagle JH, Mullen KD, Jones DB, et al. Treatment of chronic non-A, non-B hepatitis with recombinant human alpha interferon. A preliminary report. N Engl J Med 1986;315:1575-8.