Hepatitis C virus (HCV) infection is a global health problem affecting two to four million people in the United States and 71 million people worldwide. Hepatitis C causes more deaths in the United States than 60 other infectious diseases combined, including human immunodeficiency virus (HIV) and tuberculosis.
With the recent availability of new antiviral drugs, individuals with hepatitis C can achieve cure of their disease. Several organizations, including the National Academy of Medicine and the World Health Organization, are considering the possibility of hepatitis C elimination as a public health threat, but several barriers exist. These include lack of effective screening policies, exorbitant costs associated with scaling-up screening and treatment to a large portion of the population, and the rising incidence of hepatitis C, especially among young people who inject drugs.
Supported by the Directorates for Engineering and Computer and Information Science and Engineering through the Smart and Connected Health initiative, the National Science Foundation has awarded a $1.2 million grant over four years to a team of researchers to study the elimination of hepatitis C in the United States. The interdisciplinary research team is comprised of Turgay Ayer, George Family Foundation assistant professor at the Georgia Institute of Technology’s H. Milton Stewart School of Industrial and Systems Engineering; Jagpreet Chhatwal, decision scientist at Massachusetts General Hospital and assistant professor at Harvard Medical School; and Anne Spaulding, associate professor of epidemiology at Emory University’s Rollins School of Public Health and an infectious disease physician in the Department of Medicine, Emory School of Medicine.
This collaborative research aims to use innovative methods from operations research to answer policy-relevant questions that could lead to hepatitis C elimination in the United States. The research will address questions such as: How should state Medicaid programs expand hepatitis C screening and treatment under their constrained budgets; what kind of screening policy should be implemented for the general population; and how would investments in high-risk groups such as people in prisons reduce hepatitis C transmission.
The interdisciplinary team will also develop practical decision-support tools for implementation and use by the stakeholders. To facilitate implementation, the researchers will partner with the Department of Health and Human Services, state and county health departments, and prison policymakers, who are the potential stakeholders of the proposed solutions and tools.
Ultimately, this innovative project has the potential to substantially reduce HCV disease burden, eventually leading to its elimination by 2030.
“NSF is pleased to support innovative, multidisciplinary research teams as they address key national challenges, such as control over debilitating diseases like hepatitis C,” said Georgia-Ann Klutke, National Science Foundation Program Director for Operations Engineering, which funds the research. “While highly successful antiviral treatments are available, eliminating the disease requires a cost-effective allocation of resources for screening and treatment.”
“Many of the pressing healthcare problems faced today are too complicated for a single academic discipline to consider and tackle,” said Ayer. “This is an exemplary interdisciplinary collaborative research effort drawing upon the expertise from several disciplines, including mathematical modeling and data analytics, public health and policy, hepatology, and correctional health; and with the holistic and innovative perspective we take, our hope is to facilitate and improve decision-making in managing the hepatitis C epidemic worldwide.”
Describing the impact of the research, Chhatwal said, “By providing decision-support tools, we believe the proposed research can aid policymakers in making policy decisions that will bring us closer to hepatitis C elimination in the United States.”
“I have been taking care of patients with hepatitis C for two decades, in both correctional facilities and the community,” added Spaulding. “We can study how addressing hepatitis C in each setting contributes to eliminating this curable disease.”
This material is based upon work supported by the National Science Foundation under Grants No. 1722614, 1722665, and 1722906.