Hepatitis c north carolina

OBJECTIVES: Hospitalizations for drug use-associated infective endocarditis (DUA-IE) have risen sharply across the United States over the past decade. The sex composition of DUA-IE remains less clear, and studies have indicated a possible shift to more females. We aimed to compare more recent statewide hospitalization rates for DUA-IE in females versus males and contextualize them among other drug-related harms in North Carolina (NC). METHODS: This study was a retrospective analysis using public health datasets of all NC hospital discharges for infective endocarditis from 2016 to 2020...

Per- and polyfluoroalkyl substances (PFAS) have emerged as high priority contaminants due to their ubiquity and pervasiveness in the environment. Numerous PFAS co-occur across sources of drinking water, including areas of North Carolina (NC) with some detected concentrations above the Environmental Protection Agency's health advisory levels. While evidence demonstrates PFAS exposure induces harmful effects in the liver, the involvement of extracellular vesicles (EVs) as potential mediators of these effects has yet to be evaluated...

BACKGROUND: Widespread outbreaks of person-to-person transmission of hepatitis A virus (HAV), particularly among people who inject drugs (PWID), continue across the United States and globally. However, the herd immunity threshold and vaccination coverage required to prevent outbreaks is unknown. We aimed to use surveillance data and dynamic modeling to estimate herd immunity thresholds among PWID in 16 U.S. states. METHODS: We used a previously published dynamic transmission model of HAV transmission, calibrated to surveillance data from outbreaks involving PWID in 16 states...

Central North Carolina (NC) is highly contaminated with per- and polyfluoroalkyl substances (PFAS), in part due to local fluorochemical production. Little is known about the exposure profiles and long-term health impacts for humans and animals that live in nearby communities. In this study, serum PFAS concentrations were determined using liquid chromatography high-resolution mass spectrometry and diagnostic clinical chemistry endpoints were assessed for 31 dogs and 32 horses that reside in Gray's Creek NC at households with documented PFAS contamination in their drinking water...

Poor access to care has made western North Carolina vulnerable to an outbreak of hepatitis C viral infection (HCV), particularly among persons who inject drugs (PWID). As substance use disorder (SUD) treatment providers could potentially improve linkage to HCV testing and treatment, we sought to understand SUD providers, clinic and client characteristics; referral patterns; HCV knowledge; willingness to participate in additional trainings; and local linkage-to-care pathways for treatment of substance use and HCV...

OBJECTIVES: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are significant public health concerns, especially given the risks for disease interactions. Rates of HCV and HIV are increasing, especially in rural areas. Local health departments (LHDs) play an important role in rural health care, offering screening, testing, and treatment for HCV and HIV. Gaps persist in LHD resources for meeting these demands, especially in Appalachia and the US South. METHODS: To explore HCV/HIV screening, testing, and treatment approaches and perspectives in south-central Appalachian North Carolina, structured telephone questionnaires were administered to communicable disease nurses and other health department staff directly involved in screening and testing...

Hepatitis C virus (HCV) is a chronic infection that can lead to severe liver damage if left untreated. With increased availability and affordability of curative treatments, screening for HCV has become an important first step in reducing morbidity and mortality. At a rural federally qualified health center in North Carolina, two quality improvement initiatives-an electronic health record (EHR) prompt and educational flyers-were implemented to improve HCV screening rates. We compared the proportion of eligible patients born from 1945 to 1965 who received HCV screening before, during, and after the initiatives...

BACKGROUND: Pharmacists are among the most accessible healthcare providers in the United States and uniquely positioned to provide harm reduction services. The availability of pharmacy-based harm reduction services and pharmacist attitudes toward delivering these services have been understudied to date. We examine North Carolina (NC) pharmacists' experiences with and attitudes about harm reduction services and explore differences between rural and urban pharmacists. METHODS: A convenience sample of NC pharmacists participated in an anonymous, online survey regarding harm reduction services: non-prescription syringe sales; naloxone dispensing; and human immunodeficiency virus (HIV) and hepatitis C virus (HCV) screening...

An estimated one-fourth of people with HIV in the U.S. are coinfected with hepatitis C virus (HCV). We examined patient-related correlates of HCV screening and treatment in a convenience sample of 1,853 HIV-positive adults in Connecticut, Louisiana, New York, North Carolina, Pennsylvania, and Texas. Overall, 85.1% reported being screened for HCV, and 30.8% reported ever being offered treatment. In multivariate logistic regressions, greater HCV knowledge, lower HCV-related medical mistrust, older age, and prior substance use treatment were associated with higher screening and treatment likelihoods...

BACKGROUND: Hepatitis C virus (HCV) infection remains underdiagnosed and undertreated, but treatment advances may allow primary care providers to address gaps in care by delivering HCV treatment themselves. OBJECTIVE: The objective of this study was to evaluate results of an HCV treatment program at a federally qualified health center (FQHC) in rural North Carolina and assess the extent to which program success depends upon ongoing consultative support from specialists...

PURPOSE: An institutional workflow developed by clinical pharmacists for initiation of directing-acting antiviral (DAA) therapy for patients who receive solid organ transplants from hepatitis C (HCV)-positive donors is described; programmatic challenges in providing pharmaceutical care to these patients are reviewed. SUMMARY: In recent years the introduction of new oral DAAs, coupled with faster screening of donor organs for HCV infection through use of a nucleic acid test (NAT), has facilitated transplants of organs from HCV-seropositive donors to HCV-seronegative recipients...

Objectives. To assess and control a potential outbreak of HIV among people who inject drugs in Western North Carolina. Methods. Disease intervention specialists offered testing for hepatitis B and hepatitis C, harm reduction materials, and linkage to care to 7 linked people recently diagnosed with HIV who also injected drugs. Contacts were offered the same services and HIV testing. HIV genotype analysis was used to characterize HIV spread. We assessed testing and care outcomes by using state surveillance information...

The prevalence of opioid misuse by people living with HIV (PLWH) during the current US opioid epidemic has not been fully described. Among a cohort of persons engaged in HIV care in North Carolina, we examined the prevalence of and risk factors for opioid misuse, defined as self-reported "street" opioid use (e.g., heroin) or nonmedical prescription opioid use on a patient reported outcomes survey. Recent (past three-month) opioid misuse among 1,440 PLWH in care 2012-2017 was 2% (95% CI 2-3%) and lifetime misuse 15% (13-16%)...

PURPOSE: To characterize how health care providers in western North Carolina (NC) manage patients with substance use disorders and to inform strategies for preventing injection drug use (IDU)-associated outbreaks of bloodborne infectious diseases. METHODS: We collected data on practice characteristics, provider sociodemographics, and attitudes and beliefs about hepatitis C virus (HCV), human immunodeficiency virus (HIV), opioid use, and IDU via online survey. Providers in 8 counties of western NC were invited to participate by email...

OBJECTIVES: To identify the level of provision of reproductive and sexual health (RSH) services to reproductive-age women enrolled in opioid treatment programs (OTPs) in 2017, and to understand provider-perceived barriers to integration of services. METHODS: A web-based survey was sent to medical or program directors at all OTPs (n = 48) in North Carolina (NC). Data were collected regarding program characteristics, demographic information about female patient populations, provision of RSH services, and provider-perceived barriers to service integration into OTPs...

Prisoners in the United States are disproportionately affected by hepatitis C. Addressing the disease behind bars is crucial for curtailing the epidemic in the greater population. Effective strategies for testing and treatment are elucidated here. Recommendations for changes in hepatitis C health care policy in North Carolina prisons are also described.

BACKGROUND Like the rest of the nation, North Carolina is experiencing the worst drug crisis in United States history, as deaths related to medication and drug overdoses are at an all-time high. Although the absolute numbers of deaths are highest among white populations, American Indians (AIs) experience disproportionally high rates. METHOD Using death certificate data, death rates due to unintentional medication and drug overdose were calculated for various races and ethnicities. Acute hepatitis B (HBV) and acute hepatitis C (HCV) rates were also calculated across racial and ethnic groups using data from the North Carolina Electronic Disease Surveillance System...

Syringe exchange programs became legal in North Carolina on July 11, 2016. A combination of forces led to this progressive public health measure, including advocacy of the State Health Official, in a state characterized by a conservative political climate. Data collected by the division of public health were a key contributor to the initiative. Nearly 5 North Carolinians died each day from unintentional medication or drug overdose. High rates of coinfection including hepatitis B and C, human immunodeficiency virus, and endocarditis were shown to have substantial economic consequences...

BACKGROUND: With some Medicaid state programs still restricting patient access to hepatitis C (HCV) treatment, it is important to demonstrate how states could expand treatment access to a broader Medicaid population and balance short-term budget concerns. METHODS: We used the HCV Transmission and Progression (TaP) Markov model to quantify the impact of removing restrictions to HCV treatment access on the infected populations, expenditures, and net social value for the North Carolina (NC), Oregon (OR), and Wisconsin (WI) Medicaid programs...

Importance: Infection with hepatitis C virus (HCV) is a major cause of morbidity and mortality in the United States, and incidence has increased rapidly in recent years, likely owing to increased injection drug use. Current estimates of prevalence at the state level are needed to guide prevention and care efforts but are not available through existing disease surveillance systems. Objective: To estimate the prevalence of current HCV infection among adults in each US state and the District of Columbia during the years 2013 to 2016...