NATIONAL ADVOCACY GROUPS HOST FREE FORUM TO DISCUSS CRITICAL INFORMATION REGARDING HEPATITIS C AND HIV/HEPATITIS C COINFECTION

Forum to Provide the Latest Medical and Epidemiological Information to Patients, Caregivers and Local Health Community

BRONX, NY (March 5, 2003) - The National AIDS Treatment Advocacy Project (NATAP), in partnership with the Latino Organization for Liver Awareness (LOLA) and the Citiwide Harm Reduction Coalition will convene a panel of medical experts to provide the latest information regarding HIV/hepatitis C (HCV) co-infection. The meeting, which will be held on March 5, 2003 at Montefiore Hospital in the Bronx, is open to patients, medical providers and city and state officials. The panel will include Jules Levin, executive director/founder of NATAP, Debbie Delgado-Vega, executive director/founder of LOLA, Daliah Heller, executive director/founder of Citiwide Harm Reduction and local co-infection physician specialists.

HCV and HIV are the two most prevalent blood-borne infections in the United States. Chronic hepatitis C affects approximately four million Americans and HIV almost one million. Nationally, it is estimated that 30 percent of HIV-infected individuals are co-infected with HCV. It is also estimated that 60-90 percent of individuals infected with HIV through intravenous drugs use have HCV. In total, it is estimated that 300,000 individuals in the United States have co-infection. The leading cause for transmission of HCV is intravenous drug use, and so in New York City the numbers of individuals with HCV/HIV co-infection and the prevalence rates are higher. In a published study from the New York Hospital HIV Clinic, 86 percent of patients who contracted HIV through IV drug use had HCV, with similar rates of co-infection found at Johns Hopkins Medical Center's HIV Clinic. David Thomas, MD, of Johns Hopkins Medical Center's HIV clinic, will be present at the March 5 forum to address this and other findings.

HCV disproportionately affects both the Latino and African-American communities in the U.S., as 2.5 percent of Hispanics and 3.2 percent of African-Americans, compared to 1.5 percent of non-Hispanic whites, are infected. According to LOLA founder Debbie Delgado-Vega, "Latinos and African-Americans are significantly affected by co-infection with HIV and HCV not only in prevalence, but because they often lack the information and resources they need to make educated health decisions. With this forum, our aim is to provide these communities everything they need to know about these diseases."

"At the end of the day, our aim is to empower patients to make educated treatment decisions by providing them access to resources and most importantly, experts on the front lines who have the most up-to-date information," says Jules Levin, executive director of NATAP. "As someone who is co-infected myself, I understand just how critical it is to ensure patients, physicians and caregivers have access to the critically important information they need to manage this often under-served patient population."

A recent study published in Clinical Infectious Diseases reported that the leading cause of death in HIV patients co-infected with HCV was end-stage liver disease. With HIV/HCV co-infection there are a number of special considerations that need to be addressed. These include understanding how each virus is affected by the other, balancing the risks and benefits of treating each of these viral infections, deciding on the order and timing of treatment, and understanding how medication toxicity may be modified in patients with co-infection.

"Although health and longevity may have improved for patients with HIV with newer and better treatments, HCV has emerged as a leading cause of death in co-infected individuals," says Alain Litwin, M.D., M.P.H. at the Albert Einstein College of Medicine and medical director of a Methadone Maintenance Treatment clinic. "It is vital that patients who are co-infected with HIV/HCV work closely with their physician to address both diseases."

Hepatitis C (HCV)

Hepatitis C virus is the most prevalent blood-borne disease in the United States with an estimated four million Americans chronically infected with HCV. HCV is transmitted through the exchange of body fluids (primarily blood, and very rarely with semen and saliva) with an infected person. Receipt of blood during a surgical procedure before screening became widespread in the early 1990s is a common source of infection. Sharing needles during intravenous drug use is another common route of transmission. Razor blades, nail clippers, barber's scissors, body piercing, tattooing and acupuncture needles, and even toothbrushes that have been in contact with the blood of a person with HCV have also been identified as theoretically possible transmitters of the virus. While additional research is needed to determine if HCV can be contracted through sexual activities, some experts recommend using a condom during intercourse with an infected person. Perinatal transmission is also a possibility that is being further investigated. In many cases, the mode of transmission is unknown. Unfortunately, many people infected with HCV are unaware of it because it takes 20 to 30 years for symptoms to develop. It is estimated that less than 30 percent of all cases are diagnosed.

HIV

Approximately one million people in the U.S. are infected with HIV, with up to 50,000 people newly infected each year. HIV belongs to a group of viruses called retroviruses, which destroy the white blood cells called T helper cells or CD4 cells. Those white blood cells are the core of the body's immune system, and as a result, normally non-threatening organisms can become life-threatening to people living with HIV.

Co-infection

Co-infection of HIV and HCV is a high priority concern for medical professionals, as results from a number of studies have shown HIV may accelerate HCV progression two- to six- fold, suggesting co-infected patients may develop cirrhosis or end stage liver disease more quickly. Treatment for these patients is complicated, as caregivers and patients must understand how the natural history of each virus is affected by the other, balance the risks and benefits of treating each of these viral infections, decide on the order and timing of treatment, and understand how medication toxicity may be modified in patients who are co-infected. Liver disease has emerged as a major cause of mortality and morbidity in co-infected patients, thus it is vital that co-infected patients be treated for HCV.

About NATAP

NATAP is a New York State non-profit corporation with 501(c) 3 Federal tax-exempt status. NATAP's mission is to educate individuals about HIV and Hepatitis treatments and to advocate on the behalf of all people living with HIV/AIDS and HCV. Efforts in these areas are conducted on local, national, and international levels.

Locally, NATAP collaborates with other organizations as well as city and state agencies. Nationally, NATAP works with Federal agencies such as the Food and Drug Administration and the National Institute of Health and advocates on policy and treatment issues. Jules Levin, Executive Director, is a community representative to the AIDS Clinical Trials Group (ACTG) and the HIV Disease Research Agenda Committee (RAC) of the ACTG, where the Federal government conducts its HIV research.

The treatment information that NATAP provides reaches medical professionals, allied professionals, patients, caregivers, under-served communities, and other interested parties in over 40 countries. NATAP is one of the leaders in providing hepatitis treatment education and advocacy in New York City.

About LOLA

Founded in 1994, LOLA is the first national bilingual/ bicultural organization dedicated to raising awareness of liver disease and liver transplantation through informational materials, treatment, prevention and educational community outreach programs, referral services and support groups to the Latino and American communities and other under-served populations who suffer from liver disease or are in need of a liver transplant in the United States. In 1998, LOLA also created the first bilingual HCV educational campaign and HCV initiatives focusing on NYS Correctional Facilities and Drug Rehabilitation Centers.

LOLA operates primarily in New York City and works closely with city, state and federal government agencies, medical professionals and many other nationwide organizations. LOLA is also an acting member of New York Organ Donor Network, the Hispanic Federation, the National Alliance for Hispanic Health, and the National Coalition on Organ Donation. LOLA also strongly advocates on a local and state level to all elected officials on behalf of Latinos and Americans, most recently with the National Latino Elected Officials (NALEO) Organization.

About Citiwide Harm Reduction

CitiWide Harm Reduction is a safe and supportive participant-led community, providing outreach and direct services that promote bio-psycho-social wellness in a respectful and nonjudgmental manner. Serving as a catalyst for self-empowerment through advocacy and education, we challenge stigmas related to drug use, HIV/AIDS and homelessness. Citiwide Harm Reduction values the collaboration between participants and staff to facilitate pro-active strategies and innovative responses where the promise is hope.

This co-operative effort is sponsored by Bronx HIV Care Network, Bronx Lebanon Hospital, Citiwide Harm Reduction, LOLA, Montfiore Medical Center, NATAP and Promesa Systems.