2023-09-28 14:46:10 +00:00
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abstract: 'The advent of highly effective antiviral regimens will make the
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eradication of hepatitis C in high-income countries such as the United
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States technically feasible. But eradicating hepatitis C will require
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escalating our response to the epidemic in key domains, including
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surveillance and epidemiology, prevention, screening, care and
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treatment, policy, research, and advocacy. Surveillance must be nimble
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enough to quickly assess the magnitude of new transmission patterns as
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they emerge. Basic prevention strategies - community-based outreach and
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education, testing and counseling, and access to sterile injection
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equipment and opioid substitution therapies - must be scaled up and
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adapted to target groups in which new epidemics are emerging. All adults
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should be screened for hepatitis C, but special efforts must focus on
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groups with increased prevalence through community outreach and rapid
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testing. Government, industry, and payers must work together to assure
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full access to health services and antiviral drugs for everyone who is
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infected. Access to the new regimens must not be compromised by
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excessively high prices or arbitrary payer restrictions. Partnerships
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must be forged between hepatitis providers and programs that serve
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people who inject illicit drugs. Healthcare providers and systems,
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especially primary care practitioners, need education and training in
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treating hepatitis C and caring for substance-using populations.
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Services must be provided to the disadvantaged and stigmatized members
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of society who bear a disproportionate burden of the epidemic.
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Environments must be created where people who use drugs can receive
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prevention and treatment services without shame or stigma. Action is
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needed to end the policy of mass incarceration of people who use drugs,
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reduce the stigma associated with substance use, support the human
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rights of people who use drugs, expand social safety net services for
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the poor and the homeless, remove the legal barriers to hepatitis C
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prevention, and build public health infrastructure to reach, engage, and
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serve marginalized populations. Governments must take action to bring
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about these changes. Public health agencies must work with penal
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institutions to provide prevention and treatment services, including
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antiviral therapy, to those in need in jails and prisons or on probation
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or parole. Research is needed to guide efforts in each of these domains.
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Strong and sustained political advocacy will be needed to build and
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sustain support for these measures. Leadership must be provided by
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physicians, scientists, and the public health community in partnership
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with community advocates and people living with or at risk for hepatitis
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C. Eliminating hepatitis C from the United States is possible, but will
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require a sustained national commitment to reach, test, treat, cure, and
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prevent every case. With strong political leadership, societal
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commitment, and community support, hepatitis C can be eradicated in the
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United States. If this is to happen in our lifetimes, the time for
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action is now. This article forms part of a symposium in Antiviral
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Research on ``Hepatitis C: next steps toward global eradication.{''''} (C)
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2014 Elsevier B.V. All rights reserved.'
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affiliation: 'Edlin, BR (Corresponding Author), Natl Dev \& Res Inst, 71 West 23rd
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St,4th Floor, New York, NY 10010 USA.
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Edlin, Brian R., Weill Cornell Med Coll, New York, NY 10065 USA.
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Winkelstein, Emily R., Natl Dev \& Res Inst, New York, NY 10010 USA.'
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author: Edlin, Brian R. and Winkelstein, Emily R.
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author-email: 'bredlin.nyc@gmail.com
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winkelstein@ndri.org'
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author_list:
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- family: Edlin
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given: Brian R.
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- family: Winkelstein
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given: Emily R.
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da: '2023-09-28'
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doi: 10.1016/j.antiviral.2014.07.015
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eissn: 1872-9096
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files: []
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issn: 0166-3542
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journal: ANTIVIRAL RESEARCH
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keywords: 'Hepatitis C; Disease eradication; Epidemiology; Prevention; Antiviral
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therapy; Social determinants of health'
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keywords-plus: 'INJECTION-DRUG USERS; NEW-YORK-CITY; HUMAN-IMMUNODEFICIENCY-VIRUS;
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SYRINGE EXCHANGE PROGRAMS; HEALTH-CARE-DELIVERY; INFECTIOUS-DISEASE;
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SAN-FRANCISCO; PUBLIC-HEALTH; HIV-INFECTION; CORRECTIONAL FACILITY'
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language: English
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month: OCT
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number-of-cited-references: '186'
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orcid-numbers: Edlin, Brian R/0000-0001-8172-8797
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pages: 79-93
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papis_id: 5ab2c1947d38f9ced15d5e8f99ba45ea
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ref: Edlin2014canhepatitis
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researcherid-numbers: Edlin, Brian R/F-2966-2018
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times-cited: '35'
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title: Can hepatitis C be eradicated in the United States?
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000343352600010
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usage-count-last-180-days: '1'
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usage-count-since-2013: '36'
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volume: '110'
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web-of-science-categories: Pharmacology \& Pharmacy; Virology
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year: '2014'
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