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HIV & HCV Excerpts from HHS/CDC 2017 Budget: ".....$17.5 billion on healthcare for people living with HIV in 2015"
About 50,000 people contract HIV each year, and while the estimated lifetime medical care and treatment costs for these individuals total up to $19 billion, prevention has significantly reduced the nation's HIV treatment costs.
federal government spent an estimated $17.5 billion on healthcare for people living with HIV in 2015.472
page 473:
Improvements in surveillance and monitoring are needed to rapidly detect and prevent new HCV infections, as well as to assure that HCV infected persons receive appropriate care and treatment to avoid premature death. For example, of persons with hepatitis C who do not receive needed care and treatment; approximately one million will die from HCV-related complications; unfortunately, at a time of safe and curative therapies for hepatitis C, up to 60% of the estimated 3 million Americans living with HCV do not know they are infected and even fewer are receiving appropriate care. To improve strategies for HCV testing and linkage to care which previously were based on the ascertainment of risks for infection, CDC recently expanded the recommendations to include routine one-time screening for all persons born during 1945-1965; this population has a five-fold greater prevalence of HCV infection than other adults.
This approach (in addition to risk-based screening) could reduce hepatitis C related deaths by 320,000.479
CDC provides technical assistance to states for improving viral hepatitis surveillance; however, only limited funding is provided to enable enhanced surveillance to obtain more complete demographic information on individuals with acute and chronic viral hepatitis infection. As a result, few states are able to conduct comprehensive follow-up activities of all persons with positive laboratory reports. Current funding recipients are Florida, Massachusetts, Michigan, New York, Washington, Philadelphia, and San Francisco. Although CDC did not meet targets in FY 2011 and FY 2012, CDC expanded the scope of this measure in FY 2013 to include chronic viral hepatitis. As a result, CDC met the FY 2013 target with seven states providing quality acute hepatitis data to be included in national reports (Measure 2.6.4).
Greater effort is needed to improve the quality of viral hepatitis surveillance data, particularly to track the burden of chronic infection and access to preventive services. The current volume of viral hepatitis testing overwhelms the existing surveillance capability of most state and local health departments. Adding to the challenges of surveillance, screening for the presence of HCV requires two tests: one test to detect a history of infection and if positive, a second test to determine current infection. State and local health departments have limited capacity to access the large volume of viral hepatitis laboratory data, process the incoming data (including sorting the multiple records that exist for persons living with hepatitis B or C given the complexity of hepatitis testing), ensure the quality of the data, investigate cases and obtain complete case information, and assure infected persons are linked to care and treatment. As a consequence, the number of cases reported to CDC underestimate the expected number of cases actually occurring, and do not always include sufficient information about the case. In 2013, over 31,000 reports of chronic hepatitis B and over 132,000 reports of chronic hepatitis C were submitted to CDC; however, sufficient information was only available for approximately 50% of the reports of chronic hepatitis B infection and 60% of the reports of chronic hepatitis C infection.
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