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A summary of the history of implementation for the Hepatitis C Initiative is available in a PDF format ( PDF File: 64.2KB).
A description of the history and development of the Hepatitis C State Workgroup is available in a PDF format ( PDF File: 53.5kb).
In 1998, the Texas Department of State Health Services (DSHS) formed the Hepatitis C State Workgroup to involve key stakeholders in addressing the emerging hepatitis C epidemic in Texas. In 1999, the workgroup helped develop hepatitis C-related legislation. Currently, the workgroup serves as a forum for hepatitis C-related issues and works toward reducing duplication of efforts and resources across the state.
The workgroup comprises more than 150 members, and includes representatives from the Texas Legislature, advocacy groups, the Texas Medical Association, the Texas Nurses Association, the Texas Dental Association, the blood and tissue centers, local health departments, nonprofit clinics, the Veterans Administration hospitals, pharmaceutical companies, and various other state agencies. In addition, the workgroup includes patients, support group leaders, private physicians, local health department staff, registered nurses, physician's assistants, church and religious medical ministry leaders, health educators, street outreach workers, and counselors. Workgroup attendance has remained high (30% or more) throughout the last five years.
The workgroup is a particularly good example of the solid and well-developed infrastructure of the Hepatitis C Initiative. This workgroup enabled DSHS to address emerging hepatitis C issues efficiently and effectively. The workgroup meetings enable those with a strong interest in hepatitis C-related issues to become involved at the ground level of planning. These stakeholders are both individuals and organizations that have either a professional or personal interest in the state's plans for addressing the hepatitis C epidemic. These stakeholders provide expertise in various ways since they are individuals infected with the virus, staff who provide services to those infected or at risk, or persons who work in surveillance, education, and training. This expertise has enabled the initiative to expand rapidly and efficiently due to the close relationships that have developed among the key stakeholders.
The workgroup first met in the spring of 1998 when epidemiologists at the Travis County Health and Human Services Department invited staff from the DSHS Infectious Disease, Epidemiology, & Surveillance Division to meet with them and a few other local government officials to discuss the burgeoning epidemic. DSHS staff then broadened the invitation list and assumed responsibility to maintain the workgroup membership. The stakeholders examined the problems and issues, gathered and analyzed information related to the trends, and developed strategies to address the spread of the virus in Texas.
In fall 1998, the workgroup drafted a white paper to document data, demonstrate the public health need, and recommend a public health response. The recommendations included specific actions needed to enhance the state's public health infrastructure. The white paper also provided information on epidemiology, testing, cost estimates for screening and counseling, and emerging treatments on the market for hepatitis C. The white paper was shared with Texas Rep. Glen Maxey (D-Austin), who used the white paper to draft House Bill (HB) 1652. He presented HB 1652 to the 76 th Texas Legislature, which passed the bill in the spring of 1999 and appropriated approximately $3 million for the next biennium for implementation.
In June 1999, the informal group of stakeholders became a formal workgroup, which met regularly to advise DSHS staff on implementation of the legislation. Two working subcommittees were formed in the spring of 2000: the General Public Education Subcommittee and the Professional Education Subcommittee. They resolve issues brought forth by the larger workgroup, research issues for the larger workgroup, and plan and review the proposed projects. The DSHS staff coordinates the workgroup and subcommittees, facilitates meetings, and serves as a liaison for the workgroup members.
Once implementation of HB 1652 was well underway, the focus of the workgroup shifted once more. Currently, the workgroup serves to keep members abreast of and involved in statewide activities and related issues. Speakers provide expertise on hepatitis C-related issues. The workgroup meetings also provide opportunities for networking and developing partnerships for projects.
The workgroup has been particularly helpful in identifying issues. Some examples in which the workgroup has addressed emerging issues include addressing the disparity of minority populations affected with hepatitis C. The workgroup assisted in the campaigns developed to reach out to Hispanic adult males in an effort to encourage testing for those at risk and to help prevent transmission within families. The workgroup also assisted in the development of public service announcements targeting prevention messages among young African-American males. The workgroup has also discussed issues such as transplants, co-infections, Medicaid, IV drug use, prevention among youths, and services for veterans with hepatitis C.
The continued participation of the workgroup hinges on the members' abilities to stay invested in the issues and their willingness to cooperate on developing responses to new and emerging issues. Their opinions and informed viewpoints will help in the continued development of strategic plans. The workgroup has played, and will continue to play, an important role in expanding the infrastructure of the initiative's response to the health needs of the hepatitis C community and preventing new cases in the state.
Hepatitis C State Workgroup Meeting
Held October 28, 2003, 1-5 p.m. Texas Department of State Health Services (DSHS) Central Offices
K-100 (Auditorium)
Attendees:
David Barker, Sales Director, GlaxoSmithKline Vaccines San Antonio; Tom Betz, MD MPH, Director; DSHS Infectious Disease, Epidemiology & Surveillance (IDEAS) Division; Ginger Busboom PA, President of the Board, Liver Foundation of Central Texas; Jane Conner-Hill RN, Texas Department of State Health Services and Human Services; Cheryl Cunningham, Special Projects Coordinator, City of Houston Health Department; Paula Dickerson, Group Member, Alvin Liver Coalition; Dave Erickson, PhD, Director of Public Health and Education, Texas Liver Coalition of St. Luke's Episcopal Hospital in Houston; Gary Heseltine, MD MPH, Senior Epidemiologist, DSHS IDEAS Division; Kitten Holloway, Director of Policy and Planning, DSHS Associateship for Disease Control and Prevention; Sharon Melville MD, Director; DSHS HIV/STD Epidemiology Division; Ron Moore, Hepatology Specialist, Roche Laboratories, Inc.; Karen Mueller RN, Hepatitis C Coordinator, Austin/Travis County Health and Human Services Department; Beth Null, GlaxoSmithKline Austin; Donna Ochiltree, Group Member, Alvin Liver Coalition; Gladys Olsen, Director of Operations, Latino Organization for Liver Awareness (LOLA); Sharon Phillips, President, Hep C Advocate Network (HepCAN); Dan Rawlins, Statewide HIV Coordinator, Texas Commission on Alcohol and Drug Abuse; Joyce Rayzer, President and CEO, Integrated Systems Management; Eric Roland, Director of Education, Montrose Clinic in Houston; Sharilyn Stanley MD, Associate Commissioner, DSHS Associateship for Disease Control and Prevention; Alma Lydia Thompson, HCV Program Specialist, DSHS IDEAS Division; Barbara Veres, Publisher, Hepatitis Magazine; Jeffrey Wagers, Trainer, DSHS Bureau of HIV/STD Prevention; and Calvin White, Clinic Coordinator, UT Southwestern Medical Center in Dallas.
Welcome:
A welcome was extended to all attendees by Alma Thompson, Hepatitis C State Workgroup coordinator and facilitator.
Tom Betz MD MPH:
Alma Thompson introduced Dr. Tom Betz as the new DSHS IDEAS Division Director. Tom Betz MD MPH spoke briefly to the attendees about his years working in public health, and his experience working in hepatitis C.
Dr. Betz received his medical degree from the University of Michigan Medical School, did his residency in Family and Community Medicine at the University of Arizona Health Sciences Center, and holds a Masters in Public Health from the University of Texas School of Public Health at Houston. He is board certified in General Preventive Medicine and Public Health.
Dr. Betz has served at all levels of government: local, state, federal, and international. His Centers for Disease Control and Prevention (CDC)- related activities include serving as medical director at the Parasitology Unit, San Juan Labs, in San Juan Puerto Rico; serving in Epidemic Intelligence Service (EIS) Field Services in Texas; and serving as a CDC Consultant to the Peru Field Epidemiology Training Program, in Lima, Peru.
Dr. Betz has previously worked at the Texas Department of State Health Services for many years in different positions. His positions have included: director, Infectious Disease Epidemiology Division; chief, Bureau of Communicable Disease Control and Epidemiology; State Epidemiologist; and most recently as acting regional director, Public Health Region 1.
Dr. Betz has also worked as the Austin/Travis County Health Department:
Medical Director in Communicable Disease Prevention Services for many years.
His international activities include serving as professor of microbiology and parasitology, at the University of Eastern Venezuela Medical School. For the Pan American Health Organization, he also performed post-hurricane disease prevention and surveillance assessments of epidemiologic capacity and infrastructure development for the Ministry of Health in Belize.
Dave Erickson, PhD, Director of Public Health and Education, Texas Liver Coalition of St. Luke's Episcopal Hospital in Houston
Dave began his presentation by explaining that the set of services at the Texas Liver Coalition at St. Luke's has changed due to funding changes and new opportunities available in concert with a large institution like St. Luke's.
He explained that the first support group was established in Hermann Hospital in 1995. Today, the Liver Coalition has approximately 32 support groups throughout the state.
The Liver Coalition is currently focused on community outreach, mostly conducting these efforts through mail outs. These mail outs include information to answer the public's basic questions of "what is hepatitis?" and "what is cirrhosis?" The coalition is sending out about 100 of these brochures per week, many via e-mail.
Research and treatment are being done conducted at the hospital for a limited number of patients. For this endeavor, the hospital has hired Dr. S. Chris Pappas, who is a renowned hepatologist. The hospital also has hepatologists Dr. Joe Galati, Dr. Howard Monsour, Dr. Victor Ankoma-Sey, and Dr. Alan Glombicki on staff. Dave also mentioned the liver transplantation work of surgeons R. Pat Wood, Claire Ozaki, and Omar Barakat.
Dr. S. Chris Pappas has also been working on helping St. Luke's research through conducting clinical trials and the process of working with the Federal Drug Administration (FDA).
The 4 th Annual update on hepatitis C from Dr. Victor Ankoma-Sey, a conference for medical professionals, will be held at the Houstonian Hotel on November 21 and 22, 2003. (Call Bonnie McCausland at 713 500 5126 to register.)
St. Luke's currently provides outpatient and inpatient services. St. Luke's is working on research protocols and establishing e-doc online, continuing education for physicians. St. Luke's is also committed to developing a "Center for Excellence for Liver Diseases" similar to the Texas Heart Institute for cardiac care.
He also mentioned that the need for liver transplants would quintuple from 5,157 in 2003 to 27,229 in 2015 and the rate of organ donations has stayed stable, which means the rate of deaths due to lack of available organs for transplantation will go up.
Dave explained that he used to work as an epidemiologist and discussed the process used for rate projections. For example, he said the number of deaths from HIV is currently 8,000 annually nationwide and, by 2015, there will be 11 times more deaths from liver-related disease than from HIV. In Houston, these deaths are attributed to two things: hepatitis C and alcohol use. These deaths will increase, assuming these current projections. He continued to explain other data extrapolated from the NHANES study, noting that the NHANES data did not include prisoners, persons in facilities for the mentally ill, and the homeless-missing the populations with the highest rates of hepatitis C.
Dave also discussed steatosis (fatty liver disease) and its potential impact on youths living sedentary lives and the probability of shortened live expectancies in the obese.
He then discussed their current research, studies, and professional education programs:
Institute Studies:
• current 16 week of Peglyated Interferon alfa 2a and Ribavirin in treatment naïve chronic hep C positive patients with genotype 2 and 3
• use of growth factor of red blood cell in naïve patients chronic hep C positive genotype 1 (Amgen)
• Telbivudine in patients with compensated chronic hep B
Genotype 2 or 3 Study
16 wk study
• Genotype 2, 3
• 18 and older
• platelets > 90,000
• hemoglobin > 12
• no sign of heart or kidney disease
• no autoimmune disease
• no sign of psychiatric disorders
Growth Factor Study
• genotype 1
• 18-80 years old
• liver biopsy within past year
• hemoglobin 12-16
• eligible for pegylated Interferon-Ribavirin therapy
• no blood disorders
Hep B Study
• ages 16-70 years
• chronic hep B in live biopsy
• hep B e antigen positive or negative viral count
• HBV DNA>61og 10
• abnormal ALT
Education
• e-liver online physician newsletter
• guest hepatitis journal club
• international exchange-cultural exchange event where physicians from other countries interact with St. Luke's staff
• speakers bureau, worksite health promotion, health professional CEUs and public ed programs
St. Luke's also conducts community outreach, including the new "in-house" patient ed and support programs. These activities offer resources, such as support groups in 32 locations. Annual attendance at these support groups is approximately 8,000 annually.
The Texas Liver Coalition Web site is: www.texasliver.org
Their toll-free line is: 1-800-72-LIVER
Dave concluded his presentation by providing some chronological data on antiviral treatments and sustained viral responses (SVR):
In the 1990s
24 weeks
8-12% SVR
In the late 1990s
48 weeks
15-22% SVR
2000
Pegylated Interferon
48 weeks
25-39% SVR
1998
IFN/Fixed RBV
48 weeks
41% SVR
2000
Peg IFN/RBV
(long acting oral effect)
54-56% SVR
2002
RBV weight-based dosing
61%
With attention, dedication, and better side effect management from nurse practitioners and physician's assistants, at some institutions the SVR for more than six months is 98.5%, and what is normally 68% SVR for genotype 2 or 3 is up to 91%.
Gladys Olsen, Director of Operations, Latino Organization for Liver Awareness (L.O.L.A.)
Gladys gave her presentation by telephone conference from the Bronx in New York City. She gave an overview of L.O.L.A.'s mission and programs and indicated that Ms. Debbie Vega, President and Founder of L.O.L.A., would be coming to Texas for an upcoming workgroup meeting and would be presenting more detailed information to the workgroup
In 1992, Debbie was diagnosed with autoimmune chronic hepatitis and, in wanting to understand her illness and obtain support, L.O.L.A. was founded. In November 1995, Debbie received a liver transplant and, since then, L.O.L.A. has continued its goal. L.O.L.A. serves thousands of Spanish-speaking individuals regarding hepatitis. Their organization offers bilingual services and conducts community outreach presentations to community-based organizations, drug rehabilitation centers, hospitals/clinics, corporations, correctional facilities, and schools. Their program also includes one-on-one case management, a doctor referral service, and support group meetings. L.O.L.A has disseminated their bilingual information to more than 32 states and strongly encourages organ and tissue donation.
Sharon Phillips, President, HepCAN
HepCAN has been in operation for seven years. They are still an all-voluntary non-profit organization. However, due to growth on a national basis, they will possibly have a paid staff next year.
They work closely with other liver organizations such as the Texas Liver Coalition in Houston; Hepatitis Education Project in Seattle, Washington; American Liver Foundation (ALF); Hep C Alert; and others. In 2004, they are working with the Hepatitis Education Project in Seattle for a program, similar to the Texas Nurse to Nurse Education Program, to educate first responders nationwide in cooperation with firefighter unions and first emergency responders.
Three years ago, they joined with a Hepatitis C Challenge Organization in Portland, Oregon and networked with other Hep C non-profits, eventually becoming a part of the National Hepatitis C Advocacy Council, which is a national coalition of 23 member organizations from across the U.S. The council includes the American Liver Foundation, Hep C Connection, Hep C Alert, and groups nationwide. HepCAN chairs the government affairs committee. The council also has advisory groups. The National Association of State and Territorial AIDS Directors (NASTAD) is one advisory group and many HIV organizations are advisory groups. With the work they have done regarding public policy and awareness programs, they are all helping the members of the council understand and grow in HIV's footsteps and the lessons they have learned.
HepCAN has been working with more than 35 states' senators and representatives. They have also worked with U.S. Senate and congressional leaders as well.
In the last few months, they have been monitoring the status of S1143 of the 108 Congress, which would amend the Public Health Service Act to establish, promote, and support a comprehensive prevention, research, and medical management referral program for HCV infection. The title of the bill is the National Hepatitis C Epidemic Control and Prevention Act.
The bill is modeled after Texas' House Bill 1652 (passed in 1999). Many states have used this as a model bill. Most states have no money, but must address what is happening in their states. Later, Texas passed bills for nurses' education and training for licensed chemical dependency counselors (LCDCs), and eventually the bill for developing the state plan.
S1143 has 20 Senate co-sponsors. The lead co-sponsors are Senator Kennedy and Senator Hutchinson. The legislation has been stalled at this point. Senator Kennedy asked for a markup on the bill if possible. It will be on the table on January 21 when the Congress will be back. HepCAN and the council are continuing to work with the health committee staff. Members of Congress are interested in the bill and are dedicated to the issue.
Sharon encouraged the audience to visit the HepCAN website: www.hepcan.org and view and keep up with the bill.
Texas House members are ready to sign on as co-sponsors. It is truly a bipartisan bill. Both senators from Texas as well as both senators from Hawaii, South Dakota, and New York are co-sponsors.
Sharon also recounted several inspiring individuals, including Carey Graeber and her niece, Karly, whose mother, Christen Graeber Winter, lost her life to HCV. Carey Graeber is doing a documentary for PBS and other networks regarding the work on S1143 and its progress. A group of students-close to 150 from a Virginia High School DECA club-has taken up the Hepatitis C bill in Congress as a project. There will be a march, a press conference, and visits to all 535 Congressional members on December 4 by these high-schoolers and advocacy groups.
Sharon also mentioned two other bills that are currently moving in the House and now the Senate: H.R. 73, sponsored by Congressman Frelinghuysen, regarding Veteran's Care and Treatment of HCV; and H.R. 1993, sponsored by Congressman Ted Strickland and others, to amend the Public Health Service Act to establish an Office of Correctional Health regarding Hepatitis C.
Senate Bill 1143 will have an appropriations package of a projected $300 million, which would be provided in increments, supervised by the Health and Human Services, over the next three to four years to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The states would get this money first to set up infrastructure as has already been done in Texas.
There will be a meeting in Washington D.C. December 7-9 by the newly formed National Viral Hepatitis Roundtable, hosted by the CDC. The invitees on the roundtable include 150 groups involved in viral hepatitis and co-infections. It is based on the CDC's national roundtable for colorectal cancer and will include government agencies at all levels, academia, advocacy organizations and professional, medical and scientific organizations.
Its aim is to increase public awareness, influence public policy and education, and train health professionals in all areas of viral hepatitis.
Post-note from Sharon on November 18, 2003:
S1143 is about to be filed in the House by Congresswoman Heather Wilson from New Mexico and Congressman Edolphus Towns from New York. HepCAN should have the House Bill number late this week and everyone can check the HepCAN Web site for this information. HepCAN has an Action Alert on their Web site, so that interested individuals can know if something is moving or not. She said congressional district information is also on the HepCAN Web site.
If any workgroup member has questions, please e-mail Sharon at hepcan1@aol.com .
Post-note on November 21, 2003:
The Wilson-Towns Hepatitis C Epidemic Control and Prevention Act bill number is
H.R. 3539 and can be read at www.thomas.gov
Eric Roland, Director of Education, Montrose Clinic:
Eric began his presentation by stating that the Montrose Clinic has been testing for HCV since 2000. Testing was paid for initially with private funds in 2000 before availability of public funding. Testing first began in Houston for all who persons who came into the clinic to be tested for HIV. In late 2001, their HCV testing program was funded by DSHS, and they began testing only those clients who were at high-risk.
The clinic was very successful in integrating HCV counseling and testing into their existing clinic- and community-based HIV testing programs.
They are up to 8,000 HIV tests annually, and approximately 2,000 HCV tests annually. Testing of individuals is possible with very little advertising. Most persons who come in have found out about the clinic testing through word-of-mouth.
Once DSHS began funding the program in late 2001, the clinic was restricted to testing high-risk individuals, which also coincided with those who were coming into the clinic at that time.
The clinic had a high positivity rate of 18-19 percent, which has leveled off to 12 percent for a while and more recently dropped to about 6 percent.
Additional clinic services include Smart Step, which developed and implemented a three-hour workshop for HCV clients and their families.
The workshop covers:
• basic definitions and disease progression
• transmission factors and safety issues
• treatment recommendations and side effects
• potential complications
• nutritional factors
They also offer case management and referrals, including a full-time social worker for co-infected patients and a case manager for HCV-infected patients. (Referrals are made to the Harris County Hospital District or private physicians.) Later, case management has been for only Montrose clients who were diagnosed at Montrose.
The clinic also hosts weekly support groups, which are peer-led. These support groups meet in the clinic's building at no charge.
Private funds ended in January 2002, and DSHS funding will end December 31, 2003. If this funding ends without renewal, the Smart Step Program and case management will be cut completely due to no funds to offset the cost. The support groups will continue to meet at the clinic.
Eric then discussed how Montrose would continue with no funding.
The Houston Department of Health and Human Services (HDHHS) has offered to process blood specimens for HCV as part of its HIV contract. However, the same documentation is required, pre- and post-test counseling is still required, and they have no funding to cover supplies, phlebotomy, lab delivery, brochures, and more importantly, staff time. Staff time that is involved includes screenings for high-risk factors, which are more difficult to explain to clients because of the various factors involved and to explain that the risk could have taken place years ago. They also need staff time to educate clients about the different hepatitis viruses and help them distinguish between the different types. Staff time also includes promoting hepatitis A and B vaccinations and making appropriate referrals to the STD clinics for testing and vaccines.
Eric concluded his presentation by reiterating that the cuts in funding place a successful HCV prevention/education program in jeopardy. Fewer clients will know their HCV status and could potentially transmit the disease to others, creating a larger public health problem. Three years of funding has created a need for service, yet now there is less funding.
The clinic is committed, however, to continue screening for HCV in high-risk clients and will continue to seek funding to cover HCV counseling and testing. They may be forced to move to a fee-for-service system to offset the cost of supplies and staff time.
Montrose will continue to advocate for funding allocation at the state and federal levels.
Montrose also started offering OraQuick in March for a $60 fee and are now averaging about 100 rapid tests a month. Montrose believes more research and development should be done for a rapid hepatitis C test.
Ginger Busboom PA, President of the Board, Liver Foundation of Central Texas
Ginger explained that she began the Liver Foundation of Central Texas two years ago in response to a gap in hepatitis C treatment available for many hepatitis-C infected individuals in the community. These were all individuals who simply could not afford treatment. They included individuals who were above Medicaid requirements, but underinsured. She began to find individuals who could adopt the cause, donate time to the board, and help fund the liver foundation.
The foundation has no paid employees. The mission is to raise public awareness and help treat those persons without healthcare. They provide free hepatitis C screening and will be funding educational programs in schools. Currently, they operate solely in Travis County, but she hopes that other counties will be able to do the same.
The foundation receives private and corporate donations. Currently, they do not receive state or county funding to continue their services.
The board meets once a month and view their time as a true commitment to the cause. Some individuals involved with the foundation have had little or no involvement in hepatitis C until now, but committed to make a difference in the lives of these individuals. She said it helps that Austin is a very philanthropic community.
It took the foundation almost a year to raise enough funds to begin treating patients. The funds paid for doctor visits, lab work, and liver biopsies.
Patients are able to register online to be considered for assistance. They come in, complete income tax data to see if they qualify for assistance, and sign confidentiality agreements. The foundation follows definite protocols.
Many services are donated. For example, the foundation has been able to enlist the help of radiologists.
The foundation is hoping to run a screening and testing program in the spring in March-April. Counseling will be provided as well for those patients diagnosed as positive. Patients will also be provided with a list of doctors who are part of the Liver Foundation.
The educational program in the schools will center on the risks of sharing drug needles and tattoo needles.
Six-month therapy is approximately $1400 and, if a liver biopsy is done, then the cost is another $400. Forty-eight week therapy is $2700 per year. Physician assistants are providing patient care in gastroenterologists' offices. One of the larger laboratories is offering them lab testing at reduced costs.
So far, the foundation has assisted 18 individuals. They have an annual budget of $50,000-60,000, which is used solely on outreach and treatment. Assistance is provided to individuals on a first-come, first-served basis, unless they are already in an advanced stage of liver disease. At that time, the decision to treat is done on a case-by-case basis.
Sliding scales for payment were also discussed.
She also discussed their fundraising events, such as the HepFest at the Backyard and current planned events. She announced their upcoming event is December 16 here in Austin at the Texas Disposal Systems (TDS) Wildlife Ranch. Skeet will begin at 4:30 p.m.; dinner and dancing will follow with music provided by Kevin Fowler. She encouraged all to attend if possible.
Gary Heseltine MD MPH:
Gary began his presentation by explaining that DSHS and the Texas Department of Criminal Justice (TDCJ) had just applied for a Centers for Disease Control and Prevention (CDC) Viral Hepatitis Integration Project (VHIP) Grant, which would allow them to purchase hepatitis A and B vaccines to vaccinate all prisoners with HCV.
Gary defined chronic hepatitis and then presented a table showing national trends in cirrhosis morbidity, across years (1950-1995), for the different races and ethnicities. He also showed age-adjusted death rates for 2000 for the U.S. with Texas ranked as number nine in the nation for death rates due to chronic liver disease and cirrhosis.
He also explained that given Texas' population, the chronic viral hepatitis disease burden is estimated at 388,000 cases. For year 2000, chronic liver disease was the tenth leading cause of death in Texas.
In Texas, more than 110,000 reports of HCV diagnosed cases have now been received and soon will cross the threshold where more than 50 percent of the estimated people with HCV infection know their status.
Data of hepatitis deaths in 2001 show that it is concentrated mostly in males (2:1) not females, and in middle-age range of 40-55.
Deaths from chronic liver disease and cirrhosis are also disproportionately concentrated along the Texas/Mexico Border (1980-1998).
General Discussion:
Members introduced themselves and identified the organizations they represented. New members from the Alvin Liver Coalition and Joyce Rayzer of Integrated Management Systems were welcomed to the group.
Ron Moore of Roche mentioned that a number of HCV patient education related materials are now available from the Pegassist Patient Support Program. A number of these materials have been also translated into Spanish. These patient education pamphlets can be viewed at www.pegasys.com and are available by calling the Pegassist Support Program at 877-Pegasys.
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