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Strategies for the Elimination of Hepatitis C Virus Infection as a Public Health Threat in the United States

  • Hepatitis C (A Aronsohn and H Vargas, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Direct-acting antiviral regimens for chronic hepatitis C virus (HCV) infection became available in 2014, and these highly curative therapies have the potential to reduce HCV-associated morbidity and mortality, decrease HCV transmission, and eliminate HCV infection as a public health problem. This review summarizes the recommendations by the National Academies of Sciences, Engineering, and Medicine for a US strategy for HCV elimination.

Recent Findings

To achieve proposed targets of reducing HCV incidence by 90% and decreasing HCV-related mortality by 60% by 2030, there is a critical need to improve HCV diagnosis and linkage to care, reduce HCV-related disease by antiviral treatment scale-up, reduce HCV incidence, and strengthen HCV surveillance to determine achievement of HCV elimination targets over time.

Summary

While HCV elimination is feasible, success of this national effort will require ongoing collaboration and critical resource investment by key stakeholders, including medical and public health communities, legislators, community organizers, and patient advocates.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Denniston MM, Jiles RB, Drobeniuc J, Klevens RM, Ward JW, McQuillan GM, et al. Chronic hepatitis C virus infection in the United States, national health and nutrition examination survey 2003 to 2010. Ann Intern Med. 2014;160(5):293–300. https://doi.org/10.7326/M13-1133.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(1 Suppl):S58–68. https://doi.org/10.1016/j.jhep.2014.07.012.

    Article  PubMed  Google Scholar 

  3. Ly KN, Hughes EM, Jiles RB, Holmberg SD. Rising mortality associated with hepatitis C virus in the United States, 2003–2013. Clin Infect Dis. 2016;62(10):1287–8. https://doi.org/10.1093/cid/ciw111.

    Article  PubMed  Google Scholar 

  4. • Pawlotsky JM. New hepatitis C therapies: the toolbox, strategies, and challenges. Gastroenterology. 2014;146(5):1176–92. https://doi.org/10.1053/j.gastro.2014.03.003. Important initial review summarizing the development of direct-acting antiviral agents and interferon-sparing treatment strategies for chronic HCV infection.

    Article  CAS  PubMed  Google Scholar 

  5. Lok AS, Chung RT, Vargas HE, Kim AY, Naggie S, Powderly WG. Benefits of direct-acting antivirals for hepatitis C. Ann Intern Med. 2017;167:812–3. https://doi.org/10.7326/M17-1876.

    Article  PubMed  Google Scholar 

  6. World Health Organization. Combating hepatitis B and C to reach elimination by 2030. http://apps.who.int/iris/bitstream/10665/206453/1/WHO_HIV_2016.04_eng.pdf?ua=1. Accessed 24 Oct 2017.

  7. Department of Health and Human Services. The U.S. national viral hepatitis action plan for 2017–2020. https://www.hhs.gov/sites/default/files/National%20Viral%20Hepatitis%20Action%20Plan%202017-2020.pdf. Accessed 24 Oct 2017.

  8. •• National Academies of Sciences Engineering, and Medicine. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase one report, Washington (DC): The National Academies Press; 2016. Formative Phase One report published by the National Academies to first evaluate and describe the feasibility of a national strategy for the elimination of HCV in the US.

  9. •• National Academies of Sciences EaM. In: Strom BL, Buckley GJ, editors. A National Strategy for the elimination of hepatitis B and C: phase two report. Washington (DC): The National Academies Press; 2017. Seminal phase two report published by the National Academies that provides clear recommendations for achievement of US HCV elimination targets by 2030.

  10. Smith BD, Morgan RL, Beckett GA, Falck-Ytter Y, Holtzman D, Teo CG, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR Recomm Rep. 2012;61(RR-4):1–32.

    PubMed  Google Scholar 

  11. Moyer VA, USPSTF. Screening for hepatitis C virus infection in adults: U.S. preventive services task force (USPSTF) recommendation statement. Ann Intern Med. 2013;159(5):349–57. https://doi.org/10.7326/0003-4819-159-5-201309030-00672.

    Article  PubMed  Google Scholar 

  12. • Yehia BR, Schranz AJ, Umscheid CA, Lo Re V 3rd. The treatment cascade for chronic hepatitis C virus infection in the United States: a systematic review and meta-analysis. PLoS One. 2014;9(7):e101554. https://doi.org/10.1371/journal.pone.0101554. Important systematic review that depicts the care continuum for HCV infection in the US.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Southern WN, Drainoni ML, Smith BD, Koppelman E, McKee MD, Christiansen CL, et al. Physician nonadherence with a hepatitis C screening program. Qual Manag Health Care. 2014;23(1):1–9. https://doi.org/10.1097/QMH.0000000000000007.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Almario CV, Vega M, Trooskin SB, Navarro VJ. Examining hepatitis C virus testing practices in primary care clinics. J Viral Hepat. 2012;19(2):e163–9. https://doi.org/10.1111/j.1365-2893.2011.01539.x.

    Article  CAS  PubMed  Google Scholar 

  15. White DA, Anderson ES, Pfeil SK, Trivedi TK, Alter HJ. Results of a rapid hepatitis C virus screening and diagnostic testing program in an urban emergency department. Ann Emerg Med. 2016;67(1):119–28. https://doi.org/10.1016/j.annemergmed.2015.06.023.

    Article  PubMed  Google Scholar 

  16. Hsieh YH, Rothman RE, Laeyendecker OB, Kelen GD, Avornu A, Patel EU, et al. Evaluation of the Centers for Disease Control and Prevention recommendations for hepatitis C virus testing in an urban emergency department. Clin Infect Dis. 2016;62(9):1059–65. https://doi.org/10.1093/cid/ciw074.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Blackburn NA, Patel RC, Zibbell JE. Improving screening methods for hepatitis C among people who inject drugs: findings from the HepTLC initiative, 2012–2014. Public Health Rep. 2016;131(Suppl 2):91–7. https://doi.org/10.1177/00333549161310S214.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Trooskin SB, Poceta J, Towey CM, Yolken A, Rose JS, Luqman NL, et al. Results from a geographically focused, community-based HCV screening, linkage-to-care and patient navigation program. J Gen Intern Med. 2015;30(7):950–7. https://doi.org/10.1007/s11606-015-3209-6.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Irvin R, McAdams-Mahmoud A, Hickman D, Wilson J, Fenwick W, Chen I, et al. Building a community—academic partnership to enhance hepatitis C virus screening. J Community Med Health Educ. 2016;6(3) https://doi.org/10.4172/2161-0711.1000431.

  20. Centers for Disease Control and Prevention. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR Recomm Rep. 1998;47(RR-19):1–39.

    Google Scholar 

  21. Jewett A, Garg A, Meyer K, Wagner LD, Krauskopf K, Brown KA, et al. Hepatitis C virus testing perspectives among primary care physicians in four large primary care settings. Health Promot Pract. 2015;16(2):256–63. https://doi.org/10.1177/1524839914532291.

    Article  PubMed  Google Scholar 

  22. Centers for Disease Control and Prevention. Locations and reasons for initial testing for hepatitis C infection—chronic hepatitis cohort study, United States, 2006–2010. MMWR Morb Mortal Wkly Rep. 2013;62(32):645–8.

    Google Scholar 

  23. Centers for Disease Control and Prevention. Guidelines for viral hepatitis surveillance and case management. Atlanta, GA. 2005. https://www.cdc.gov/hepatitis/pdfs/2005guidlines-surv-casemngmt.pdf. Accessed 31 July 2017.

  24. Centers for Disease Control and Prevention. Epidemiology and laboratory capacity for infectious diseases (ELC) cooperative agreement. https://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html. Accessed 22 Oct 2017.

  25. Klompas M, Murphy M, Lankiewicz J, McVetta J, Lazarus R, Eggleston E, et al. Harnessing electronic health records for public health surveillance. Online J Public Health Inform. 2011;3(3) https://doi.org/10.5210/ojphi.v3i3.3794.

  26. Pawlotsky JM, Feld JJ, Zeuzem S, Hoofnagle JH. From non-a, non-B hepatitis to hepatitis C virus cure. J Hepatol. 2015;62(1 Suppl):S87–99. https://doi.org/10.1016/j.jhep.2015.02.006.

    Article  CAS  PubMed  Google Scholar 

  27. Mitruka K, Thornton K, Cusick S, Orme C, Moore A, Manch RA, et al. Expanding primary care capacity to treat hepatitis C virus infection through an evidence-based care model—Arizona and Utah, 2012–2014. MMWR Morb Mortal Wkly Rep. 2014;63(18):393–8.

    PubMed  PubMed Central  Google Scholar 

  28. Laraque F, Varma JK. A public health approach to hepatitis C in an urban setting. Am J Public Health. 2017;107(6):922–6. https://doi.org/10.2105/AJPH.2017.303718.

    Article  PubMed  Google Scholar 

  29. Yoo ER, Perumpail RB, Cholankeril G, Jayasekera CR, Ahmed A. Expanding treatment access for chronic hepatitis C with task-shifting in the era of direct-acting antivirals. J Clin Transl Hepatol. 2017;5(2):130–3. https://doi.org/10.14218/JCTH.2016.00059.

    PubMed  PubMed Central  Google Scholar 

  30. Weinbaum C, Lyerla R, Margolis HS, Centers for Disease Control and Prevention. Prevention and control of infections with hepatitis viruses in correctional settings. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2003;52(RR-1):1–36. quiz CE1–4

    PubMed  Google Scholar 

  31. Beckman AL, Bilinski A, Boyko R, Camp GM, Wall AT, Lim JK, et al. New hepatitis C drugs are very costly and unavailable to many state prisoners. Health Aff. 2016;35(10):1893–901. https://doi.org/10.1377/hlthaff.2016.0296.

    Article  Google Scholar 

  32. Maurer KG, Gondles EF. Hepatitis C in correctional settings: challenges and opportunities. Coalition of Correctional Health Authorities and American Correctional Association 2015;2(1):1–15.

  33. Liu S, Watcha D, Holodniy M, Goldhaber-Fiebert JD. Sofosbuvir-based treatment regimens for chronic, genotype 1 hepatitis C virus infection in U.S. incarcerated populations: a cost-effectiveness analysis. Ann Intern Med. 2014;161(8):546–53. https://doi.org/10.7326/M14-0602.

    Article  PubMed  PubMed Central  Google Scholar 

  34. He T, Li K, Roberts MS, Spaulding AC, Ayer T, Grefenstette JJ, et al. Prevention of hepatitis C by screening and treatment in U.S. prisons. Ann Intern Med. 2016;164(2):84–92. https://doi.org/10.7326/M15-0617.

    Article  PubMed  Google Scholar 

  35. Cahill SR, Mayer KH, Boswell SL. The Ryan white HIV/AIDS program in the age of health care reform. Am J Public Health. 2015;105(6):1078–85. https://doi.org/10.2105/AJPH.2014.302442.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sood N, Juday T, Vanderpuye-Orgle J, Rosenblatt L, Romley JA, Peneva D, et al. HIV care providers emphasize the importance of the Ryan White Program for access to and quality of care. Health Aff. 2014;33(3):394–400. https://doi.org/10.1377/hlthaff.2013.1297.

    Article  Google Scholar 

  37. Wills T, Friedrich M, Beal J, Somboonwit C, Mcintosh S, Bork A et al. Implementing hepatitis C treatment programs in comprehensive HIV clinics: the Health Resources and Services Administration (HRSA) special projects of national significance hepatitis C treatment exapnsion initiative. ID Week 2014; October 10, 2014; Philadelphia. [Abstract PA2014].

  38. Trooskin SB, Reynolds H, Kostman JR. Access to costly new hepatitis C drugs: medicine, money, and advocacy. Clin Infect Dis. 2015;61(12):1825–30. https://doi.org/10.1093/cid/civ677.

    Article  PubMed  Google Scholar 

  39. Simon RE, Pearson SD, Hur C, Chung RT. Tackling the hepatitis C cost problem: a test case for tomorrow's cures. Hepatology. 2015;62(5):1334–6. https://doi.org/10.1002/hep.28157.

    Article  PubMed  Google Scholar 

  40. Grebely J, Haire B, Taylor LE, Macneill P, Litwin AH, Swan T, et al. Excluding people who use drugs or alcohol from access to hepatitis C treatments—is this fair, given the available data? J Hepatol. 2015;63(4):779–82. https://doi.org/10.1016/j.jhep.2015.06.014.

    Article  PubMed  Google Scholar 

  41. Barua S, Greenwald R, Grebely J, Dore GJ, Swan T, Taylor LE. Restrictions for Medicaid reimbursement of sofosbuvir for the treatment of hepatitis C virus infection in the United States. Ann Intern Med. 2015;163(3):215–23. https://doi.org/10.7326/M15-0406.

    Article  PubMed  Google Scholar 

  42. Canary LA, Klevens RM, Holmberg SD. Limited access to new hepatitis C virus treatment under state Medicaid programs. Ann Intern Med. 2015;163(3):226–8. https://doi.org/10.7326/M15-0320.

    Article  PubMed  Google Scholar 

  43. Ooka K, Connolly JJ, Lim JK. Medicaid reimbursement for oral direct antiviral agents for the treatment of chronic hepatitis C. Am J Gastroenterol. 2017;112(6):828–32. https://doi.org/10.1038/ajg.2017.87.

    Article  PubMed  Google Scholar 

  44. Lo Re V 3rd, Gowda C, Urick PN, Halladay JT, Binkley A, Carbonari DM, et al. Disparities in absolute denial of modern hepatitis C therapy by type of insurance. Clin Gastroenterol Hepatol. 2016;14(7):1035–43. https://doi.org/10.1016/j.cgh.2016.03.040.

    Article  PubMed  Google Scholar 

  45. Younossi ZM, Bacon BR, Dieterich DT, Flamm SL, Kowdley K, Milligan S, et al. Disparate access to treatment regimens in chronic hepatitis C patients: data from the TRIO network. J Viral Hepat. 2016;23(6):447–54. https://doi.org/10.1111/jvh.12506.

    Article  CAS  PubMed  Google Scholar 

  46. •• American Association for the Study of Liver Diseases/Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed 10 Aug 2017. Important evidence-based consensus guidelines issued by major specialty societies providing guidance for clinicians on up-to-date care and management of chronic HCV infection.

  47. Negro F, Forton D, Craxi A, Sulkowski MS, Feld JJ, Manns MP. Extrahepatic morbidity and mortality of chronic hepatitis C. Gastroenterology. 2015;149(6):1345–60. https://doi.org/10.1053/j.gastro.2015.08.035.

    Article  PubMed  Google Scholar 

  48. Soriano V, Berenguer J. Extrahepatic comorbidities associated with hepatitis C virus in HIV-infected patients. Curr Opin HIV AIDS. 2015;10(5):309–15. https://doi.org/10.1097/COH.0000000000000175.

    Article  CAS  PubMed  Google Scholar 

  49. Harris RJ, Martin NK, Rand E, Mandal S, Mutimer D, Vickerman P, et al. New treatments for hepatitis C virus (HCV): scope for preventing liver disease and HCV transmission in England. J Viral Hepat. 2016;23(8):631–43. https://doi.org/10.1111/jvh.12529.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Martin NK, Thornton A, Hickman M, Sabin C, Nelson M, Cooke GS, et al. Can hepatitis C virus (HCV) direct-acting antiviral treatment as prevention reverse the HCV epidemic among men who have sex with men in the United Kingdom? Epidemiological and modeling insights. Clin Infect Dis. 2016;62(9):1072–80. https://doi.org/10.1093/cid/ciw075.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Backus LI, Belperio PS, Shahoumian TA, Mole LA. Impact of sustained virologic response with direct-acting antiviral treatment on mortality in patients with advanced liver disease. Hepatology. 2017; https://doi.org/10.1002/hep.29408.

  52. Mahale P, Engels EA, Li R, Torres HA, Hwang LY, Brown EL, et al. The effect of sustained virological response on the risk of extrahepatic manifestations of hepatitis C virus infection. Gut. 2017;67:553–61. https://doi.org/10.1136/gutjnl-2017-313983.

    Article  PubMed  Google Scholar 

  53. van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA. 2012;308(24):2584–93. https://doi.org/10.1001/jama.2012.144878.

    Article  PubMed  Google Scholar 

  54. Najafzadeh M, Andersson K, Shrank WH, Krumme AA, Matlin OS, Brennan T, et al. Cost-effectiveness of novel regimens for the treatment of hepatitis C virus. Ann Intern Med. 2015;162(6):407–19. https://doi.org/10.7326/M14-1152.

    Article  PubMed  Google Scholar 

  55. Rein DB, Wittenborn JS, Smith BD, Liffmann DK, Ward JW. The cost-effectiveness, health benefits, and financial costs of new antiviral treatments for hepatitis C virus. Clin Infect Dis. 2015;61(2):157–68. https://doi.org/10.1093/cid/civ220.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Chahal HS, Marseille EA, Tice JA, Pearson SD, Ollendorf DA, Fox RK, et al. Comparative clinical effectiveness and value of novel interferon-free combination therapy for hepatitis C genotype 1: summary of California technology assessment forum report. JAMA Intern Med. 2015;175(9):1559–60. https://doi.org/10.1001/jamainternmed.2015.3348.

    Article  PubMed  Google Scholar 

  57. Allison MA, O'Leary ST, Lindley MC, Crane LA, Hurley LP, Beaty BL, et al. Financing of vaccine delivery in primary care practices. Acad Pediatr. 2017;17:770–7. https://doi.org/10.1016/j.acap.2017.06.001.

    Article  PubMed  Google Scholar 

  58. Huff-Rousselle M. The logical underpinnings and benefits of pooled pharmaceutical procurement: a pragmatic role for our public institutions? Soc Sci Med. 2012;75(9):1572–80. https://doi.org/10.1016/j.socscimed.2012.05.044.

    Article  PubMed  Google Scholar 

  59. Health Resources and Services Administration (HRSA). 340B drug pricing program http://www.hrsa.gov/opa. Accessed 10 Aug 2017.

  60. • Grebely J, Dore GJ, Morin S, Rockstroh JK, Klein MB. Elimination of HCV as a public health concern among people who inject drugs by 2030—what will it take to get there? J Int AIDS Soc. 2017;20(1):1–8. https://doi.org/10.7448/IAS.20.1.22146. Important review describing specific challenges and proposed solutions to achieve HCV elimination among people who inject drugs (PWID), a group with the highest HCV prevalence.

    Article  Google Scholar 

  61. Perlman DC, Jordan AE, Uuskula A, Huong DT, Masson CL, Schackman BR, et al. An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: structural barriers and public health potential. Int J Drug Policy. 2015;26(11):1056–63. https://doi.org/10.1016/j.drugpo.2015.04.015.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Abdul-Quader AS, Feelemyer J, Modi S, Stein ES, Briceno A, Semaan S, et al. Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject drugs: a systematic review. AIDS Behav. 2013;17(9):2878–92. https://doi.org/10.1007/s10461-013-0593-y.

    Article  PubMed  Google Scholar 

  63. Fernandes RM, Cary M, Duarte G, Jesus G, Alarcao J, Torre C, et al. Effectiveness of needle and syringe Programmes in people who inject drugs—an overview of systematic reviews. BMC Public Health. 2017;17(1):309. https://doi.org/10.1186/s12889-017-4210-2.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Holtzman D, Barry V, Ouellet LJ, Des Jarlais DC, Vlahov D, Golub ET, et al. The influence of needle exchange programs on injection risk behaviors and infection with hepatitis C virus among young injection drug users in select cities in the United States, 1994–2004. Prev Med. 2009;49(1):68–73. https://doi.org/10.1016/j.ypmed.2009.04.014.

    Article  PubMed  Google Scholar 

  65. Huo D, Ouellet LJ. Needle exchange and injection-related risk behaviors in Chicago: a longitudinal study. J Acquir Immune Defic Syndr. 2007;45(1):108–14. https://doi.org/10.1097/QAI.0b013e318050d260.

    Article  PubMed  Google Scholar 

  66. Van Den Berg C, Smit C, Van Brussel G, Coutinho R, Prins M, Amsterdam C. Full participation in harm reduction programmes is associated with decreased risk for human immunodeficiency virus and hepatitis C virus: evidence from the Amsterdam cohort studies among drug users. Addiction. 2007;102(9):1454–62. https://doi.org/10.1111/j.1360-0443.2007.01912.x.

    Article  Google Scholar 

  67. Jones L, Pickering L, Sumnall H, McVeigh J, Bellis MA. Optimal provision of needle and syringe programmes for injecting drug users: a systematic review. Int J Drug Policy. 2010;21(5):335–42. https://doi.org/10.1016/j.drugpo.2010.02.001.

    Article  PubMed  Google Scholar 

  68. Centers for Disease Control and Prevention. Syringe exchange programs—United States, 2008. MMWR Morb Mortal Wkly Rep. 2010;59(45):1488–91.

    Google Scholar 

  69. Des Jarlais DC, McKnight C, Goldblatt C, Purchase D. Doing harm reduction better: syringe exchange in the United States. Addiction. 2009;104(9):1441–6. https://doi.org/10.1111/j.1360-0443.2008.02465.x.

    Article  PubMed  Google Scholar 

  70. Oramasionwu CU, Johnson TL, Zule WA, Carda-Auten J, Golin CE. Using pharmacies in a structural intervention to distribute low dead space syringes to reduce HIV and HCV transmission in people who inject drugs. Am J Public Health. 2015;105(6):1066–71. https://doi.org/10.2105/AJPH.2015.302581.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Islam N, Krajden M, Shoveller J, Gustafson P, Gilbert M, Buxton JA, et al. Incidence, risk factors, and prevention of hepatitis C reinfection: a population-based cohort study. Lancet Gastroenterol Hepatol. 2017;2(3):200–10. https://doi.org/10.1016/S2468-1253(16)30182-0.

    Article  PubMed  Google Scholar 

  72. Midgard H, Hajarizadeh B, Cunningham EB, Conway B, Backmund M, Bruggmann P, et al. Changes in risk behaviours during and following treatment for hepatitis C virus infection among people who inject drugs: the ACTIVATE study. Int J Drug Policy. 2017;47:230–8. https://doi.org/10.1016/j.drugpo.2017.05.040.

    Article  PubMed  Google Scholar 

  73. Turner KM, Hutchinson S, Vickerman P, Hope V, Craine N, Palmateer N, et al. The impact of needle and syringe provision and opiate substitution therapy on the incidence of hepatitis C virus in injecting drug users: pooling of UK evidence. Addiction. 2011;106(11):1978–88. https://doi.org/10.1111/j.1360-0443.2011.03515.x.

    Article  PubMed  Google Scholar 

  74. Palmateer NE, Taylor A, Goldberg DJ, Munro A, Aitken C, Shepherd SJ, et al. Rapid decline in HCV incidence among people who inject drugs associated with national scale-up in coverage of a combination of harm reduction interventions. PLoS One. 2014;9(8):e104515. https://doi.org/10.1371/journal.pone.0104515.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Ayanga D, Shorter D, Kosten TR. Update on pharmacotherapy for treatment of opioid use disorder. Expert Opin Pharmacother. 2016;17(17):2307–18. https://doi.org/10.1080/14656566.2016.1244529.

    Article  CAS  PubMed  Google Scholar 

  76. Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012;31(3):207–25. https://doi.org/10.1080/10550887.2012.694598.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Rosenblatt RA, Andrilla CH, Catlin M, Larson EH. Geographic and specialty distribution of US physicians trained to treat opioid use disorder. Ann Fam Med. 2015;13(1):23–6. https://doi.org/10.1370/afm.1735.

    Article  PubMed  PubMed Central  Google Scholar 

  78. DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA Jr. Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians. Rural Remote Health. 2015;15:3019.

    PubMed  Google Scholar 

  79. Jones EB. Medication-assisted opioid treatment prescribers in federally qualified health centers: capacity lags in rural areas. J Rural Health. 2017;34:14–22. https://doi.org/10.1111/jrh.12260.

    Article  PubMed  Google Scholar 

  80. Gonzalez SA, Fierer DS, Talal AH. Medical and behavioral approaches to engage people who inject drugs into care for hepatitis C virus infection. Addict Disord Their Treat. 2017;16(2 Suppl 1):S1–S23. https://doi.org/10.1097/ADT.0000000000000104.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Edlin BR, Eckhardt BJ, Shu MA, Holmberg SD, Swan T. Toward a more accurate estimate of the prevalence of hepatitis C in the United States. Hepatology. 2015;62(5):1353–63. https://doi.org/10.1002/hep.27978.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Office of National AIDS Policy. https://www.whitehouse.gov/onap. Accessed 23 Oct 2017.

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Authors and Affiliations

  1. Department of Pediatrics, The Ohio State College of Medicine, Columbus, OH, USA

    Charitha Gowda

  2. Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Charitha Gowda & Vincent Lo Re III

  3. Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Vincent Lo Re III

  4. Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA

    Vincent Lo Re III

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Correspondence to Vincent Lo Re III.

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Charitha Gowda declares no conflicts of interest.

Vincent Lo Re reports grants from AstraZeneca and reports having served on the committee convened by the National Academies of Sciences, Engineering, and Medicine to outline a national strategy for HCV elimination, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Gowda, C., Lo Re, V. Strategies for the Elimination of Hepatitis C Virus Infection as a Public Health Threat in the United States. Curr Hepatology Rep 17, 111–120 (2018). https://doi.org/10.1007/s11901-018-0394-x

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