Live data from Hacker News

Hepatitis C kills more Americans than all other infectious diseases combined

scopeblog.stanford.edu

181–190 of 276 posts

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#181
post #45

Earlier quoted context omitted.

Presumably, R&D costs should be shared across all countries rather than individual countries footing the bills. Alternatively a cost benefit from such R&D spending such that US R&D subsidies resulted in free drugs for the US market would be acceptable. Instead, the US both has the largest R&D subsides and the largest drug prices.

This requires some IP protection. Even if it's weaker than in America, at least some. Many nations adopt the stance that if it wasn't invented in their nation, screw the other guy, they're taking the IP. Many first-world nations, including Europe and Canada, do this and use the threat thereof to force down prices because their socialized medicine does not provide sufficient funds.

IP protection isn't a big deal for countries sort out to give equal ownership for split funding. We even have every major country from the US,Canada,Europe,India,China, and Russia all working the first full-scale cold fusion reactor via the multi-billion dollar ITER project built in France.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#182

Earlier quoted context omitted.

>If we - a I personally think we should - attach a social caveat to capitalism that requires we do what we can for people less fortunate, it fails miserably because we lack a mechanism for fostering unfettered profit In the case of intellectual property/technology you are mistaken. Patents have an expiration. Capitalists are provided a time limited monopoly for the sake of extracting rent in exchange for development…

You're operating on a false dichotomy, though. Why is this the only environment you can envision wherein drugs can be developed?

Because the only alternative economic system, Communism, was a total failure at drug development compared to the system we have. We have an example of a working system and another, much less productive defunct competitor.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#183
post #85

Earlier quoted context omitted.

I didn’t read this as advocating for everyone to run to get tested immediately. This is more a call to healthcare professionals to advocate for this testing. One way this can roll out is when sexually active adults who are considered low risk for HepC hopefully do their regular STI screening, either they or their healthcare provider can request a HepC test.

Are "regular STI screenings" common in the general population (not sex workers) in absence of symptoms?

Some people won’t have unprotected sex with a new partner unless they’ve both been tested. Some people know they’re in a non sex worker risk group and get tested without symptoms.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#184

Earlier quoted context omitted.

Yes, I got it from a blood transfusion when I was a child. The Hepatitis C virus wasn't identified until 1989, and blood bank wasn't wide spread until early 1990s, so anyone who received a blood transfusion before then is at risk.

Completely out of curiosity: why did you need a blood transfusion as a child?

I have this genetic disorder called G6PD [0]. It's pretty common, with about 5% of human beings having it. Most people who have it go through life without ever finding out they have it, because it has almost no symptoms.

One of the symptoms though is that eating fava beans can kill you. I basically ate a bunch of these beans and soon went into shock. I was rushed to the hospital but the doctors couldn't make an accurate diagnoses. It was kinda like an episode of House, except with just regular doctors. They knew I had acute hemolysis but didn't know what was causing it. Then a nurse suggested that a blood transfusion can fight the hemolysis even without knowing the root cause; that blood transfusion saved my life. It was much later that the doctors found the G6PD; turns out my great-grandmother had it too.

That's another thing: your doctor should be informed of every major medical issue that your genetically-related family members has, since it could potentially help their diagnoses. From genetic conditions, to even common stuff like high blood pressure and diabetes.

[0] https://en.wikipedia.org/wiki/Glucose-6-phosphate_dehydrogen...

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#185
post #140

I’m working on direct-to-consumer STD testing in JasonHealth.com . Some thoughts on Hep C testing: Hep C Antibody is a very inexpensive test. We charge $25 for it. It takes a long time for the body to produce the antibodies after infection. This test is only 90% sensitive after 12 weeks ( https://www.hepatitisc.uw.edu/go/screening-diagnosis/acute-d... ). Testing shortly after possible infection with this test is not…

Nice. It would be really great if you guys were to partner with other helping infrastructure, such as recovery centers, salvation army, homeless shelters etc... Getting more people tested for treatments on all levels is a good thing, IMO

Absolutely - but inexpensive testing may not help much when the cost of treatment is in the tens of thousands of dollars[1].

1: https://www.medicalnewstoday.com/articles/323767.php#drug-ty...

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#186
post #83

Earlier quoted context omitted.

From a public health perspective, recommendations and guidelines like this drive insurance company policies and government funding priorities. Or in other words, the things that actually move the needle when you're trying to get something done for an appreciable percentage of citizens. There's no ability and need to test everyone today, but this is a sign that we should move to more regular screening of higher percen…

>There's no ability and need to test everyone today, but this is a sign that we should move to more regular screening of higher percentages of the population. Signs of Hepatitis C, along with most liver diseases, can be caught with the standard liver enzyme tests that's available in pretty much every lab in the developed world. To be specific, if you see your doctor and it's been more than 6 month since your last vis…

Forgive a non-bio major, but these tests can generally be segregated into cultured (pcr) / non-cultured, no? And I'm guessing as an enzyme test, this would fall into the later category?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#187
post #85

Earlier quoted context omitted.

Are "regular STI screenings" common in the general population (not sex workers) in absence of symptoms?

I'm not sure about the general population, but this seems to be quite common in the homosexual population, especially among males. The big risk there continues to be HIV, but if you're going to get screened regularly anyway, might as well check for everything else. (Source: I am a homosexual male.) I'm not sure there should be all that much stigma attached to it honestly. There are enough non-STI ways to contract som…

> There are enough non-STI ways to contract some of these diseases that I think it makes sense for even married, faithful, and generally low risk partners to get a round of testing every once in a while.

Really? Chlamydia, gonorrhea, syphilis? How can you get those without having sex?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#188

Earlier quoted context omitted.

I think it's the "right" price, you want to incentivize companies to try to develop drugs that will do the maximal amount of good. Like, you could imagine a system where you don't have a free market at all, the government would directly fund both medical treatment (like in Europe) and medical research (like nowhere right now, but you could imagine nationalizing the drug companies). So then, before the hepatitis-c dru…

> I think it's the "right" price, you want to incentivize companies to try to develop drugs that will do the maximal amount of good. So the only incentive to do maximal good is more money. And people wonder why I laugh when it's claimed that we live in a civilized society.

How much drug research have you personally done? Is your time more valuable than that of others?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#189

Earlier quoted context omitted.

or go to India now and be treated for $1k [1]? [1] https://www.medicaltourismmag.com/article/hepatitis-c-treatm...

It’s basically to the point where it’s: > Go to and be treated for

As an American, how does that work in practice? I know I can go to Vietnam and be treated for a small amount (I was in a Vietnamese hospital for a couple of days due to a really bad strep infection and dehydration as I was unable/unwilling to swallow, and in a separate incident, also had a round of rabies shots after being bitten by a dog there). I figured it was cheap because everything is cheap there and no one there could afford it otherwise, not because of government insurance. But if I go to Australia, Canada, UK, or any other country, how do I get access to this cheap healthcare without becoming a citizen or paying taxes? Do I qualify just by nature of being there with a valid visa?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#190
post #83

Earlier quoted context omitted.

From a public health perspective, recommendations and guidelines like this drive insurance company policies and government funding priorities. Or in other words, the things that actually move the needle when you're trying to get something done for an appreciable percentage of citizens. There's no ability and need to test everyone today, but this is a sign that we should move to more regular screening of higher percen…

The blocker is generally the cost associated with false positives. If you are low risk for hep C and you get a positive test result it is more likely than not a false positive

This associated cost is what, the price of another, perhaps more expensive, test? That doesn't seem like a big deal...
Post reply on HN