swann-hepatitis - Testing and Treatment for Hepatitis C...

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1 1 Testing and Treatment for Hepatitis C: When and Where Dr. Julie Swann Georgia Institute of Technology H. Milton Stewart School of Industrial and Systems Engineering Feb 2007 Joint work with Daniel Faissol (GT), Paul Griffin (GT), Susan Griffin (CDC), Eser Kirkizlar (GT) 2 Hepatitis C Background Liver disease caused by blood-borne Hepatitis C virus (HCV) Liver disease is 10 th leading cause of death among US adults Most infected people are asymptomatic for decades 3.9 million people in US are currently infected but many are unaware Treatments are somewhat effective (~ 50%) Behavior is important to progression and secondary infections
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2 Disease Taxonomy Behavior {Impacts transmission (1), Impacts morbidity (2), Has no effect (3)} Infectious {Communicable (1), Transmissible (2), Not Infectious (3)} Length {Chronic (1), Acute (2)} Morbidity {Small effect (1), Large effect (2), Leads to death (3)} Population {Targets specific groups (1), Differs by risk (2), No discrimination (3)} Symptoms {Brief time to symptoms (1), Long time to symptoms (2), Asymptomatic(3)} Treatment {Cure (1), Improves quality of life (2), None (3)} *Genetic linkages are not well understood **HPV can lead to a chronic state (e.g., cervical cancer) 1 3 1 1 2 1 2 Treatment 1 2 3 2 1 1 1 or 2 Symptoms 3 2 2 2 2 2 1 or 2* Population 2 2 and 3 1, 2, or 3 2 and 3 1 and 3 1 2 Morbidity 2 1 1 or 2** 1 2 2 1 Length 1 3 2 2 2 2 3 Infectious 3 2 1 1 and 2 3 1 2 Behavior Malaria Lung Cancer Human Papillomavirus Hepatitis C Flu Chlamydia Asthma 4 Screening for Disease Presence Identify populations (at-risk) to test for disease Evaluate cost-effectiveness Prevalence of disease Accuracy and cost of test Progression and cost of disease Cost reduction through disease awareness (e.g., treatment or behavioral change) (Sometimes) determine frequency or timing
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