(Press-News.org) BOSTON (December 11, 2014) -- A new study from epidemiologists at Tufts University School of Medicine helps to identify communities with the greatest public health need in Massachusetts for resources relating to HIV/AIDS and hepatitis C. The study, published today in PLOS ONE, used geospatial techniques to identify hotspots for deaths related to HIV/AIDS and hepatitis C. The findings show large disparities in death rates exist across race and ethnicity in Massachusetts.
The HIV/AIDS and hepatitis C epidemics are challenging public health officials and clinicians in the United States. While HIV/AIDS mortality rates have decreased, hepatitis C infection rates have increased at a steep rate in younger populations. Co-infection is common among drug users. Public health officials are also increasingly concerned about long-standing and initially silent hepatitis C infections in baby boomers.
Studies of mortality frequently use only one cause of death, but these studies often miss the underlying cause of death. To get a fuller picture, the research team looked at the contributing or underlying causes of death, related to HIV/AIDS or hepatitis C, as documented on death certificates from 2002 to 2011 in the Commonwealth of Massachusetts.
Hispanic and black populations die at rates up to five times greater than white and Asian populations from HIV/AIDS or hepatitis C, particularly those aged 45-65. Springfield, Worcester, South Boston, the Merrimack Valley, and New Bedford had the highest rates of death from HIV/AIDS or hepatitis C and are identified as the communities in greatest need of resources for reducing disparities.
"Many neighborhoods and towns are affected by these intertwined epidemics, but some neighborhoods and municipalities have been hit particularly hard. While these specific communities are hardest hit now, hepatitis C has been increasing in young, nonurban, white, populations so preventing transmission - particularly because it often takes about 20 to 30 years for symptoms to show up - is paramount," said senior author Tom Stopka, Ph.D., assistant professor of public health and community medicine at Tufts University School of Medicine.
"Comprehensive prevention should include health education, enhanced counseling and testing, linkage to care, and increased access to sterile syringes through syringe exchange programs and pharmacies. Expanded treatment is also essential, for both HIV and hepatitis C, to decrease transmission risks in local communities," he continued.
The research team looked at all death certificates in Massachusetts from 2002 to 2011 that had HIV/AIDS or hepatitis C as an underlying or contributing cause of death. Using population estimates, they calculated mortality rates in each census tract across the state by race and age.
The researchers conducted geospatial and temporal hotspot analyses to see what areas had clusters of higher mortality rates for HIV/AIDS and hepatitis C compared to the rest of the state and portrayed the results in maps.
Detailed findings:
The research team found a total of 4,818 deaths associated
with HIV/AIDS and 2,913 deaths associated with hepatitis C
during the ten-year period.
While HIV/AIDS deaths decreased over the ten-year period,
hepatitis C deaths increased slightly.
Age-adjusted mortality rates for hepatitis C were 2.9 per
100,000 people for white populations while they were 10 and
10.4 for black and Hispanic populations respectively.
Age-adjusted mortality rates for HIV/AIDS were 1.6 per
100,000 people for white populations while they were 14.3 and
10.7 for black and Hispanic populations, respectively.
The largest hotspots of HIV deaths occurred in the Greater
Boston area, the Greater Worcester and Springfield areas, New
Bedford, and Provincetown.
The largest hotspots of hepatitis C deaths occurred in South
Boston/Dorchester, New Bedford, Lawrence/Merrimack Valley,
Springfield, Worcester, and Salem/Lynn/Peabody.
Significant coldspots of mortality were also found for both
hepatitis C and HIV/AIDS primarily in the metrowest region of
Boston but also in the southeast.
"I conducted this study to better highlight the enormous, yet preventable, disparities that exist in infectious disease mortality, especially in the case of AIDS and hepatitis C. By analyzing who is dying from these conditions, and where, we can figure out the best ways to organize a targeted response to improve health equity," said first author, David Meyers, M.P.H. Meyers conducted the study as part of his MPH degree program at Tufts University School of Medicine. He is currently an analyst at the Harvard School of Public Health.
While anyone can get hepatitis C, more than 75% of adults infected are baby boomers, perhaps as a result of receiving contaminated blood before the blood supply was screened beginning in 1992. People can live with hepatitis C for decades without symptoms. Chronic hepatitis C can lead to serious health problems including liver damage, but new, highly effective medications are available.
No external funding contributed to this research.
INFORMATION:
Citation: Meyers DJ, Hood ME, Stopka TJ (2014). HIV and Hepatitis C Mortality in Massachusetts, 2002-2011: Spatial Cluster and Trend Analysis of HIV and HCV Using Multiple Cause of Death. PLoS ONE 9(12): e114822. doi:10.1371/journal.pone.0114822
http://dx.plos.org/10.1371/journal.pone.0114822
About Tufts University School of Medicine and the Sackler School of Graduate Biomedical Sciences
Tufts University School of Medicine and the Sackler School of Graduate Biomedical Sciences at Tufts University are international leaders in innovative medical and population health education and advanced research. Tufts University School of Medicine emphasizes rigorous fundamentals in a dynamic learning environment to educate physicians, scientists, and public health professionals to become leaders in their fields. The School of Medicine and the Sackler School are renowned for excellence in education in general medicine, the biomedical sciences, and public health, as well as for innovative research at the cellular, molecular, and population health level. Ranked among the top in the nation, the School of Medicine is affiliated with six major teaching hospitals and more than 30 health care facilities. Tufts University School of Medicine and the Sackler School undertake research that is consistently rated among the highest in the nation for its effect on the advancement of medical and prevention science.
BALTIMORE, December 11, 2014 - Insilico Medicine along with scientists from Vision Genomics and Howard University shed light on AMD disease, introducing the opportunity for eventual diagnostic and treatment options.
The scientific collaboration between Vision Genomics, Inc., Howard University, and Insilico Medicine, Inc., has revealed encouraging insight on the AMD disease using an interactome analysis approach. Resources such as publicly available gene expression data, Insilico Medicine's original algorithm OncoFinderTM, and AMD MedicineTM from Vision Genomics allowed ...
How much protection the annual flu shot provides depends on how well the vaccine (which is designed based on a "best guess" for next season's flu strain) matches the actually circulating virus. However, it also depends on the strength of the immune response elicited by the vaccine. A study published on December 11th in PLOS Pathogens reports that genetic variants in a gene called IL-28B influence influenza vaccine responses.
Adrian Egli, from the University of Basel, Switzerland, and colleagues started with blood samples from organ transplant patients. Such patients are ...
New circulating metabolites might allow early diagnosis of cardiovascular disease. A team of scientists from Uppsala University, Karolinska Institutet and Colorado State University have identified novel lipid-derived molecules associated with future coronary heart disease events. The study published in the journal PLOS Genetics has examined the metabolic profile of blood samples from more than 3,600 individuals that have been followed-up for up to 10 years.
Professor Erik Ingelsson and graduate student Andrea Ganna have used novel biochemical and bioinformatics approaches ...
CHAMPAIGN, Ill. -- An international effort involving more than 100 researchers, nine supercomputers and about 400 years of CPU time has yielded the most reliable avian tree of life yet produced, researchers report in the journal Science. The tree reflects the evolutionary relationships of 48 species of birds.
The paper describing the bird family tree is one of eight articles on avian evolution published together in Science. The overall endeavor was coordinated by Erich Jarvis of Duke University; M. Thomas P. Gilbert of the Natural History Museum of Denmark; and Guojie ...
Crocodiles are the closest living relatives of the birds, sharing a common ancestor that lived around 240 million years ago and also gave rise to the dinosaurs. A new study of crocodilian genomes led by scientists at UC Santa Cruz reveals an exceptionally slow rate of genome evolution in the crocodilians (a group that includes crocodiles, caimans, alligators, and gharials).
The UC Santa Cruz team used the crocodilian genomes, combined with newly published bird genomes, to reconstruct a partial genome of the common ancestor of crocodiles, birds, and dinosaurs. The study, ...
Conventional wisdom holds that changing the views of voters on divisive issues is difficult if not impossible -- and that when change does occur, it is almost always temporary.
But Michael LaCour, a UCLA doctoral candidate in political science, and Donald Green, a Columbia University political science professor, have demonstrated that a single conversation can go a long way toward building lasting support for a controversial social issue. In addition -- nearly as surprisingly -- the effect tends to spill over to friends and family members.
The key is putting voters ...
A new computational technique developed at The University of Texas at Austin has enabled an international consortium to produce an avian tree of life that points to the origins of various bird species. A graduate student at the university is a leading author on papers describing the new technique and sharing the consortium's findings about bird evolution in the journal Science.
The results of the four-year effort -- which relied in part on supercomputers at the university's Texas Advanced Computing Center (TACC) -- shed light on the timing of a "big bang" in bird evolution, ...
RIVERSIDE, Calif. - The absence of teeth or "edentulism" has evolved on multiple occasions within vertebrates including birds, turtles, and a few groups of mammals such as anteaters, baleen whales and pangolins. Where early birds are concerned, the fossil record is fragmentary. A question that has intrigued biologists is: Based on this fossil record, were teeth lost in the common ancestor of all living birds or convergently in two or more independent lineages of birds?
A research team led by biologists at the University of California, Riverside and Montclair State University, ...
LOS ANGELES, Dec. 11, 2014-- It's possible to lastingly persuade conservative voters to support a controversial issue like marriage for same-sex couples--and at a greatly accelerated rate compared to their neighbors--according to groundbreaking data published in this week's issue of the peer-reviewed journal Science. The 12-month study also shows how the Los Angeles LGBT Center's voter persuasion methods reduced anti-gay prejudice and may have the potential to reduce other forms of prejudice.
The independent researchers who led the study, prominent Columbia University ...
This news release is available in Danish and also Chinese on EurekAlert! Chinese.
An international effort to sequence the genomes of 45 avian species has yielded the most reliable tree of life for birds to date. This new avian family tree helps to clarify how modern birds--the most species-rich class of four-limbed vertebrates on the planet--emerged rapidly from a mass extinction event that wiped out all of the dinosaurs approximately 66 million years ago.
It reveals how some of the earliest bird species diverged, answering many long-standing questions about the common ...
