The HCV-related mortality rate in New York State surpassed the HIV-related mortality rate in 2012, indicating the severity of disease burden and the urgency for wider treatment availability.
NYSDOH AI guidelines are developed by committees of clinical experts through a consensus-driven process.
The NYSDOH AI Hepatitis C Virus Infection Guideline Committee was charged with developing evidence-based clinical recommendations for primary care providers in NYS who treat patients with chronic HCV infection.
The resulting recommendations are based on an extensive review of the medical literature and reflect consensus among this panel of HCV experts.
Each recommendation is rated for strength and for quality of the evidence (see Recommendation Rating Scheme, below).
Recommendation Rating Scheme: Hepatitis C Virus Infection Guideline Committee, July 2017 More than 50% of people with chronic hepatitis C virus (HCV) infection may not be aware of their infection .
Because approximately 75% of cases are among persons born between 19 [1-3], age-cohort screening of asymptomatic adults with no recognized risk factors is thought to increase identification and treatment for these patients.
The Centers for Disease Control and Prevention (CDC) reported 162,863 cases of chronic HCV infection (past or present) nationwide in 2015 .
The number of reported cases in New York State (excluding New York City) and New York City for 2015 are provided in Box 1.
This guideline covers screening, diagnosis, pretreatment assessment, treatment, and post-treatment monitoring for primary care providers treating patients with chronic HCV infection.
In terms of HCV treatment, the guideline includes recommendations for initial HCV treatment in patients with and without cirrhosis and for retreatment in patients with and without cirrhosis who have failed previous DAA and non-DAA regimens.
From 1999 through 2013, deaths from primary liver cancer in the United States increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer .