Almost 4 million people in the United States are living with Hepatitis C and don’t know they are infected. As a result, they have not received care and treatment for this virus which is a leading cause of complications from chronic liver disease.
The Centers for Disease Control estimates that the majority of infected persons were born during 1945 to 1965 and has recommended testing for this group of adults in an effort to prevent and control this blood-borne virus. Common risk factors for contracting Hepatitis C include past or current injection drug use – the most common factor, receiving a blood transfusion before 1992, getting an unregulated tattoo, and other incidences of blood-to-blood contact.
“During the time period in question, Hepatitis C was poorly understood. In fact, it was called Non A Non B hepatitis because we weren’t sure what the virus was,” says Christopher Shaver, MD of Birmingham Gastroenterology Associates. “We also didn’t have a way to screen the blood supply then, so Baby Boomers were at high risk. That led to the recommendation to screen everybody born during that time.”
Shaver says the cure rate for Hepatitis C has greatly improved thanks to the development of new medicines that are easier to use and tolerate. “Past therapies for Hepatitis C were toxic and had a lot of side effects. Interferon was the main drug used then, and it had to be injected into the skin weekly. The treatment made patients sick and could lower blood counts to dangerous levels,” he says. “As a result, each patient had to be closely monitored and the cure rate was not impressive. There were no guarantees that a patient would be cured.”
Over the past six months, Shaver says, a new class of medications to treat Hepatitis C have been approved by the Food and Drug Administration. “The age of interferon is basically over. These new medications are what we call ‘direct-acting antivirals.’ The pills are taken orally, and duration of treatment has decreased from 24-48 weeks down to eight to 24 weeks,” he says. “We’ve seen a major improvement in medical therapy for this virus in terms of safety and the end result. We are seeing these breakthrough drugs give patients a much greater chance at a cure, usually in excess of 90 percent.”
The only way to know if people have Hepatitis C is to test them. A simple antibody marker blood test makes it easy to mass screen the population so that those with the virus can be identified and treated quickly. “Testing and any necessary treatment can eliminate the virus safely and prevent long-term complications like cirrhosis or liver cancer,” Shaver says. “When you have simple, safe, and strong drugs, it makes a lot of sense to screen at-risk patients for the virus.”
Because this resting recommendation is new, Shaver encourages both physicians and patients to work together to identify those who may be infected. “Gastroenterologists typically will recommend screening in eligible patients. The virus may also be recognized during a routine physical or blood work that shows elevated liver enzymes, which may be an indication of liver inflammation related to Hepatitis C,” he says. “It needs to be a team approach. Doctors need to be vigilant about screening patients who might benefit from treatment, and patients need to ask questions if they are at risk.”
It is important, Shaver says, that patients in a high-risk group be proactive about being screened. “Whether you’re seeing your primary care physician or your gastroenterologist, you should ask if screening is appropriate,” he says. “Don’t avoid screening because you feel okay or don’t have any symptoms. Many of the people diagnosed with Hepatitis C have no idea where they got the virus and often are asymptomatic. So if you were born between 1945 and 1965, have elevated liver enzymes or other risk factors, I absolutely recommend that you be screened.”
