10 results on '"Wester, Carolyn"'
Search Results
2. Hepatitis C Virus Clearance Cascade--United States, 2013-2022
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Wester, Carolyn, Osinubi, Ademola, Kaufman, Harvey W., Symum, Hasan, Meyer, William A., III, Huang, Xiaohua, and Thompson, William W.
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Hepatitis C virus ,Infection ,Liver cancer ,Virus diseases ,Health - Abstract
Approximately 2.4 million adults were estimated to have hepatitis C virus (HCV) infection in the United States during 2013-2016 (1). Untreated, hepatitis C can lead to advanced liver disease, liver [...]
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- 2023
3. Advancing Diagnosis of Current Hepatitis C Virus Infection: A Key to Hepatitis C Elimination in the United States.
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Kamili, Saleem and Wester, Carolyn
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HEPATITIS C , *HEPATITIS C virus , *PREGNANT women , *DIAGNOSIS - Abstract
More than 2 million adults have hepatitis C virus (HCV) infection in the United States, and new infections continue to increase. Without treatment, HCV infection can lead to advanced liver disease and death. Treatment is recommended for nearly everyone with hepatitis C, resulting in a cure in >95% of people treated and raising the possibility of hepatitis C elimination. Testing is the first step to accessing life-saving treatment. The Centers for Disease Control and Prevention recommends hepatitis C screening for all adults, all pregnant persons, and anyone with risk; yet about one-third of people with hepatitis C remain unaware of their infection. Testing begins with a hepatitis C antibody test, followed, when reactive, by a nucleic acid test to detect HCV RNA. This antibody-first, 2-step testing strategy misses early infections and can result in incomplete diagnoses. Advancements in hepatitis C diagnostics and the US regulatory landscape have created an opportunity to include viral-first testing strategies and improve hepatitis C diagnosis. This journal supplement features 8 articles detailing challenges and opportunities for improving hepatitis C diagnostics in support of advancing hepatitis C elimination in the United States. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Vital Signs: Hepatitis C Treatment Among Insured Adults--United States, 2019-2020
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Thompson, William W., Symum, Hasan, Sandul, Amy, Gupta, Neil, Patel, Priti, Nelson, Noele, Mermin, Jonathan, and Wester, Carolyn
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Antiviral agents ,Medicaid ,Hepatitis C virus ,Infection -- Drug therapy ,RNA ,Adults ,African Americans ,Health - Abstract
On August 9, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Introduction Despite the availability of accurate diagnostic tests and an effective cure, [...]
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- 2022
5. Using Public Health Surveillance Data to Determine Hepatitis C Virus Exposure Among Live-Born Infants in Tennessee, 2013-2017.
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Wingate, Heather, Sizemore, Lindsey, Black, Jennifer, Heth, Zachary, Talley, Pamela, Patrick, Stephen W., and Wester, Carolyn
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HEPATITIS C transmission ,PUBLIC health surveillance ,MOTHERS ,PUBLIC health ,HEPATITIS viruses ,MOTHER-infant relationship ,LONGITUDINAL method - Abstract
Objective: Maternal hepatitis C virus (HCV) infection reported on birth certificates has been shown to underestimate HCV infection. We sought to determine the usefulness of HCV surveillance data for (1) quantifying the number of HCV-positive reproductive-aged women with a live birth, (2) comparing maternal HCV surveillance data with reported HCV infection status on birth certificates, and (3) delineating past versus current maternal infection to identify true perinatal exposures. Methods: We extracted data from January 1, 2013, through December 31, 2017, on birth certificate indication of HCV exposure from the Tennessee Birth Statistical File, and we ascertained indication of HCV exposure by using laboratory data from the Tennessee National Electronic Disease Surveillance System (NEDSS) Base System (NBS). We conducted a sensitivity analysis comparing birth certificate indication of HCV exposure with HCV laboratory data to determine whether true perinatal exposure had occurred. Results: During the study period, 6731 mothers with live births in Tennessee reported having HCV infection during pregnancy: 3295 (49.0%) had both laboratory and birth certificate indication of HCV infection, 2130 (31.6%) had indication of HCV infection on the laboratory report only, and 1306 (19.4%) had indication of HCV infection on the birth certificate only. Conclusions: Using data from a public health HCV surveillance system with birth certificate data may improve the identification of HCV-infected pregnant women and perinatally exposed infants. Surveillance systems that include complete reporting of all HCV RNA results can be used to distinguish past from present maternal HCV infection to focus limited public health resources on currently infected mothers and their exposed infants. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Cost-Effectiveness of Strategies to Identify Children with Perinatally Acquired Hepatitis C Infection.
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Hall, Eric W., Panagiotakopoulos, Lakshmi, Wester, Carolyn, Nelson, Noele, and Sandul, Amy L.
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- 2023
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7. Low hepatitis C antibody screening rates among an insured population of Tennessean Baby Boomers.
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Carlucci, James G., Farooq, Syeda A., Sizemore, Lindsey, Rickles, Michael, Cosley, Brandon, McCormack, Leigh, and Wester, Carolyn
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CHRONIC hepatitis C ,PUBLIC health ,MEDICAL microbiology ,LIVER disease etiology ,ANTIVIRAL agents ,CLINICAL trials ,THERAPEUTICS - Abstract
Introduction: Chronic Hepatitis C Virus (HCV) infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers") have relatively high prevalence of chronic HCV infection, prompting recommendations that all Baby Boomers be screened for HCV. If chronic HCV is confirmed, evaluation for antiviral treatment should be performed. Direct-acting antivirals can cure more than 90% of people with chronic HCV. This sequence of services can be referred to as the HCV "cascade of cure” (CoC). The Tennessee (TN) Department of Health (TDH) and a health insurer with presence in TN aimed to determine the proportion of Baby Boomers who access HCV screening services and appropriately navigate the HCV CoC in TN. Methods: TDH surveillance data and insurance claim records were queried to identify the cohort of Baby Boomers eligible for HCV testing. Billing codes and pharmacy records from 2013 through 2015 were used to determine whether HCV screening and other HCV-related services were provided. The proportion of individuals accessing HCV screening and other steps along the HCV CoC was determined. Multivariable analyses were performed to identify factors associated with HCV screening and treatment. Results: Among 501,388 insured Tennessean Baby Boomers, 7% were screened for HCV. Of the 40,019 who received any HCV-related service, 86% were screened with an HCV antibody test, 20% had a confirmatory HCV PCR, 9% were evaluated for treatment, and 4% were prescribed antivirals. Hispanics were more likely to be screened and treated for HCV than non-Hispanic whites. HCV screening was more likely to occur in the Nashville-Davidson region than in other regions of TN, but there were regional variations in HCV treatment. Conclusions: Many insured Tennessean Baby Boomers do not access HCV screening services, despite national recommendations. Demographic and regional differences in uptake along the HCV CoC should inform public health interventions aimed at mitigating the effects of chronic HCV. [ABSTRACT FROM AUTHOR]
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- 2017
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8. Timing of Positive Hepatitis C Virus Test Results During and 1 Year Before Pregnancy.
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Woodworth, Kate R., Newton, Suzanne M., Olsen, Emily O., Tannis, Ayzsa, Sizemore, Lindsey, Wingate, Heather, Orkis, Lauren, Reynolds, Bethany, Longcore, Nicole, Thomas, Nadia, Bocour, Angelica, Wills, Aprielle, Kim, Shin Y., Panagiotakopoulos, Lakshmi, Wester, Carolyn, Delman Meaney, Dana, Gilboa, Suzanne M., and Tong, Van T.
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HEPATITIS C virus , *HEPATITIS C , *PREGNANCY - Abstract
The incidence of hepatitis C virus (HCV) infection in reproductive-aged adults quadrupled during the past decade. Hepatitis C can progress to advanced liver disease and be transmitted perinatally. Highly effective curative hepatitis C treatment is available but is not recommended in pregnancy. Using the Surveillance for Emerging Threats to Mothers and Babies Network, we describe timing of positive RNA testing among pregnant people with HCV (HCV RNA detected during or within one year prior to pregnancy). Four US jurisdictions reported 1161 pregnancies during 2018-2021 among people with hepatitis C: 75.9% were multiparous; and 21.4% had their first peri-pregnancy HCV RNA detected prior to pregnancy, indicating potential missed treatment opportunities to improve maternal health and prevent perinatal transmission. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic.
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Kaufman, Harvey W., Bull-Otterson, Lara, Meyer III, William A., Huang, Xiaohua, Doshani, Mona, Thompson, William W., Osinubi, Ademola, Khan, Mohammed A., Harris, Aaron M., Gupta, Neil, Van Handel, Michelle, Wester, Carolyn, Mermin, Jonathan, Nelson, Noele P., and Meyer, William A 3rd
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HEPATITIS C , *COVID-19 pandemic , *COVID-19 treatment , *HEPATITIS C virus , *ANTIBODY titer , *VIRAL antibodies - Abstract
Introduction: The COVID-19 pandemic has disrupted healthcare services, reducing opportunities to conduct routine hepatitis C virus antibody screening, clinical care, and treatment. Therefore, people living with undiagnosed hepatitis C virus during the pandemic may later become identified at more advanced stages of the disease, leading to higher morbidity and mortality rates. Further, unidentified hepatitis C virus-infected individuals may continue to unknowingly transmit the virus to others.Methods: To assess the impact of the COVID-19 pandemic, data were evaluated from a large national reference clinical laboratory and from national estimates of dispensed prescriptions for hepatitis C virus treatment. Investigators estimated the average number of hepatitis C virus antibody tests, hepatitis C virus antibody-positive test results, and hepatitis C virus RNA-positive test results by month in January-July for 2018 and 2019, compared with the same months in 2020. To assess the impact of hepatitis C virus treatment, dispensed hepatitis C virus direct-acting antiretroviral medications were examined for the same time periods. Statistical analyses of trends were performed using negative binomial models.Results: Compared with the 2018 and 2019 months, hepatitis C virus antibody testing volume decreased 59% during April 2020 and rebounded to a 6% reduction in July 2020. The number of hepatitis C virus RNA-positive results fell by 62% in March 2020 and remained 39% below the baseline by July 2020. For hepatitis C virus treatment, prescriptions decreased 43% in May, 37% in June, and 38% in July relative to the corresponding months in 2018 and 2019.Conclusions: During the COVID-19 pandemic, continued public health messaging, interventions and outreach programs to restore hepatitis C virus testing and treatment to prepandemic levels, and maintenance of public health efforts to eliminate hepatitis C infections remain important. [ABSTRACT FROM AUTHOR]- Published
- 2021
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10. Hepatitis C Virus Testing During Pregnancy After Universal Screening Recommendations.
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Kaufman, Harvey W., Osinubi, Ademola, Meyer III, William A., Khan, Mohammed, Huang, Xiaohua, Panagiotakopoulos, Lakshmi, Thompson, William W., Nelson, Noele, Wester, Carolyn, and Meyer, William A 3rd
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HEPATITIS C virus , *PREGNANCY tests , *HEALTH insurance , *MEDICAL screening , *TASK forces - Abstract
The study evaluates the effect of the 2020 Centers for Disease Control and Prevention and U.S. Preventive Services Task Force recommendations on hepatitis C virus (HCV) screening among pregnant persons nationally and by health insurance type. The study included 5,048,428 pregnant persons aged 15-44 years with either Medicaid or commercial health insurance who had obstetric panel testing performed by Quest Diagnostics, January 2011-June 2021. Antibody screening for HCV infection increased before and accelerated after the updated recommendations in early 2020. Disparities in HCV testing by health insurance status were substantial over the entire study period. Despite substantial progress in the proportion of pregnant persons screened for HCV infection, current testing rates fall short of universal recommendations. [ABSTRACT FROM AUTHOR]
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- 2022
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