Last year the National AIDS Treatment Advocacy Project (NATAP) began organizing a nationwide group of advocates, doctors, and people co-infected with HIV and hepatitis C to push for more education, care and services to address HIV/hepatitis C co-infection. This group is called the National HIV/Hepatitis C Co-infection Coalition.
Some quick facts about co-infection:
- Between a quarter and a third of people with HIV in the United States are co-infected with hepatitis C. This adds up to between about 250,000 and 300,000 people -- about a tenth of all people with chronic hepatitis C infection.
- Up to 90% of all people who became HIV+ through drug injection also have hepatitis C. When we talk about co-infection, we're talking largely (though by no means exclusively) about current and former drug injectors.
- HIV worsens and accelerates hepatitis C disease progression, putting co-infected people at greater risk of cirrhosis and end-stage liver disease. Liver disease resulting from hepatitis C has become a leading cause of death in people with HIV.
- Co-infection affects treatment for both viruses. Hepatitis C co-infection increases the risk of liver toxicity from HIV medications. HIV co-infection decreases the chances of clearing hepatitis C during interferon/ribavirin treatment.
The National HIV/Hepatitis C Co-Infection Coalition sent a sign-on letter (PDF version here) outlining these issues to all members of Congress, endorsed by dozens of individuals and groups (including numerous harm reduction and needle exchange advocates). A cover letter made three specific requests:
- Support the 2005 reauthorization of the Ryan White CARE Act (federal legislation funding HIV care and related support services, such as case management and treatment education)
- Support full funding of AIDS Drug Assistance Programs (ADAPs -- state-based programs that pay for HIV medications for people who can't afford them. Because of budget constraints, only 9 state ADAPs currently cover hepatitis C treatment, and many states are having trouble covering basic HIV medications for everyone who needs them)
- Support the Hepatitis C Epidemic Control and Prevention Act (legislation introduced in the House and Senate to "establish, promote, and support a comprehensive prevention, research, and medical management referral program for hepatitis C virus infection")
[See the links below for more background on these issues]
Co-infection Coalition members will be meeting with key legislators in April to discuss these issues. To get involved, contact NATAP's Saidia McLaughlin by email or by calling (212) 219-0106. You can also visit the coalition's advocacy website for more information.
Background on the Ryan White CARE Act from the National Minority AIDS Council (NMAC) available here. See also the CAEAR ( Communities Advocating Emergency AIDS Relief) Coalition website and resource center. See also the U.S. Health Resources and Services Administration's Ryan White section from their HIV/AIDS Bureau website. To get involved in planning how to incorporate hepatitis C co-infection into Ryan White-funded services on a local level, contact your local Ryan White Planning Council (scroll to the bottom of the page for a list of local Title I planning council websites).
Background on the ADAP crisis from the Save ADAP Committee of the AIDS Treatment Activists Coalition (ATAC) available here. To get involved with Save ADAP email Ryan Clary from Project Inform. See also the National ADAP Monitoring Project on the website of the AIDS Treatment Data Network (ATDN) here. The National Association of State and Territorial AIDS Directors (NASTAD) released an ADAP Funding Watch in January documenting waiting lists, restrictions on medications, and funding gaps (2 page PDF file).
Background on the Hepatitis C Epidemic Control and Prevention Act from the National Hepatitis C Advocacy Council (NHCAC): text of the Senate bill (PDF version), text of the House bill (PDF version), community support letter. Click here for contact information to find out how you can support this legislation.