Has the COVID-19 pandemic changed the perception of the HCV care cascade?
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Click here to read the Cover Story, "HCV care for people who inject drugs: ‘Bringing treatment to them’."
The COVID-19 pandemic has had a significant impact on medicine in the past 2-plus years.
We asked Nancy S. Reau, MD, Richard B. Capps Chair of Hepatology and professor in the department of internal medicine, division of digestive diseases and nutrition at Rush University, if it has changed the perception of the hepatitis C virus care cascade.
It will take months if not years to fully understand the impact of COVID-19 on the HCV care cascade. The global shutdown of essentially all health care services taxed an already fragile system, which especially impacted low-priority health services, like viral hepatitis.
COVID-19 eclipsed all other infections and most other health priorities. Screening for HCV came to a grinding halt, and even when routine health maintenance began to return, an HCV-positive individual identified through screening rarely made the next steps of staging the severity of liver injury and linkage to curative therapy. Yet, this health care curve ball has not changed the goal to eliminate viral hepatitis by 2030; it has only eliminated the conversation, resources and actions essential for the process.
Sadly, it doesn’t seem like this is likely to change soon. SARS-CoV-2 variants (and political commentary) continue to keep the focus on COVID-19 and divert public health efforts toward the pandemic. Not only does this dilute the time spent on preventive services, but it also contributes to stress and anxiety, which then increase alcohol and injection drug use. This is compounded by poor access to addiction and harm reduction services, which further increases the risk for HCV exposure.
Even before the pandemic, HCV was considered a “cured” virus. Highly effective, well-tolerated, easily accessible therapies distracted the community from the fact that most infected individuals had yet to be recognized. COVID-19 only compounded this perception. This lack of prioritization will ultimately result in health consequences that could have been avoided.
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