Hepatitis C: The Silent Epidemic

07/31/2018 by Sarah Pena

By Sean L’Huillier, F.N.P., North Country HealthCare

We’ve seen the TV commercials and read the advertisements about Hepatitis C Virus (HCV) that affects the liver and the recommendation to get tested for the disease, especially for those born between 1945 and 1965 (commonly known as baby boomers). But is there really a need to be concerned or are the advertisements just a way for drug companies to promote their products?

Sean L’Huillier. F.N.P

The truth is yes there is a reason to be aware and get tested. Hepatitis C has been called a silent epidemic because most people with Hepatitis C do not know they are infected. Nearly 75 percent of Americans who have the chronic disease do not even know they are infected. That means not only are they possibly infecting others, but they also are not getting the necessary treatment to stop the disease and improve their current and long-term health.

People born between 1945 and 1965 are five times more likely to have Hepatitis C than other adults.

What is Hepatitis C?

Hepatitis C is a serious liver disease that results from infection with the Hepatitis C virus. Most people who get infected develop a chronic, or lifelong, infection. Over time, chronic Hepatitis C can lead to serious liver problems including liver damage, cirrhosis, liver failure, or liver cancer.

The early symptoms of the disease include fatigue, fever, nausea, loss of appetite, abdominal tenderness and muscle and joint pain. Over time, chronic Hepatitis C can cause serious health problems including liver damage, cirrhosis, liver cancer and even death. In fact, Hepatitis C is a leading cause of liver cancer and the #1 cause of liver transplants.

How big is the Hep C problem?

In Arizona, according to the Arizona Department of Health Services:

  • An estimated 80,000 Arizonans are living with the virus
  • Between 1998 and 2008, there were 83,115 newly diagnosed cases of HCV reported in Arizona – that is an average of 7,514 cases each year
    • 68% were male
    • The average age of diagnosis was 45 years old
    •  59% were white
    • 25% were Hispanic
    •  8% were American Indian
    •  7% were African American
    • 5% were Asian/ Pacific Islander
  • The average age of death associated with the Hepatitis C Virus is 59 years old, compared to 74 years old for all deaths
  • More than two-thirds of those diagnosed are men
  • Baby Boomers – those born between 1945 and 1965 – are at the greatest risk of having the disease
  • Native Americans are seeing the largest increase in reported cases
  • A large percentage of HCV cases had a history with injection drug or intranasal drug use
  • More than 50% of those diagnosed had gotten a tattoo

How is Hepatitis C spread?

The Hepatitis C Virus is a bloodborne pathogen, meaning the virus is spread through exposure to blood or body fluids. This transmission can happen via non-sterile injection drug use, tattooing or body piercing; sharing personal hygiene items such as nail clippers or a razor; or blood transfusions with infected blood (this was more prevalent prior to 1992). It can also be transmitted during intercourse or from a mother to her child during childbirth, although both situations are rare.

The best way to prevent the illness is to avoid behaviors that can spread the disease.

Can Hepatitis C be treated?

There currently is no vaccine for HCV, but new treatment options to cure the disease are available and have seen huge improvements over the last few decades. In the last five years, new drugs are being developed at a rapid rate. Some people who get infected with HCV are able to clear or get rid of the virus through medications called antivirals that can help eliminate the virus from the body and prevent further liver damage.

Doctors began treating HCV in the 1990s with interferon, which fights the disease by boosting the immune system. But the treatment took nearly a year, came with many side effects and only offered a cure rate of about 50 percent.

A huge breakthrough in HCV treatment came in 2011 when new virus-fighting medications were introduced. Constant developments in treatment have increased the cure rate for certain types of HCV to 99 percent.

Not only have cure rates improved, but patients’ quality of life – during and after treatment – is much better. Additionally, the treatment time has decreased from 48 weeks to between 8 and 12 weeks, and patients are experiencing far fewer side effects; fatigue is the most common.

Treating HCV patients at North Country HealthCare

At North Country HealthCare, our providers offer the most advanced treatment options for HCV. Once a patient has been diagnosed with HCV, treatment can begin within a few weeks. Most patients follow a protocol of a once-daily oral medication for 8 to 12 weeks. During the treatment period, patients only see their provider once or twice, rather than weekly. Three months after the completing the treatment, blood lab work is done to confirm the virus is no longer present in the blood, in which case, the patient is considered cured.

North Country HealthCare’s Hepatitis C Care Team is an integrated, specialty-trained team of healthcare providers, clinical pharmacists, behaviorists, health coaches, program coordinator and other support personnel.

Using telemedicine and state-of-the-art technology, the team works with specialists from St. Joseph’s Hospital and Medical Center in a collaboration called Project ECHO, which brings leading HCV specialists and primary care providers together to develop the best treatment options for each patient.

The Hepatitis C Care Team helps coordinate approval from patients’ insurance to pay for treatment. For those who are uninsured, the team helps patients apply for assistance programs to help cover the cost of treatment. Team members also work closely with patients undergoing treatment to ensure they are taking medications, completing necessary blood tests and following up with specialists, as appropriate.

Collaborative programs, like those between St. Joseph’s Hospital and Medical Center and North Country HealthCare, increase patients’ access to curative programs. These programs focus on treatment, as well as helping patients resolve any barriers they may face when it comes to receiving the care they need to receive a cure, thus diminishing the spread of Hepatitis C.

About North Country HealthCare

North Country HealthCare serves as the medical home for nearly 50,000 people throughout northern Arizona, 20,000 who reside in Flagstaff and the surrounding area. North Country HealthCare accepts Medicare, AHCCCS, commercial insurance and offers a sliding-fee scale based on income and family size. North Country has a large and diverse team of providers and is always accepting new patients. For more information on the locations, programs and services, call 928.522.9400 or visit NorthCountryHealthCare.org. Follow North Country HealthCare on Facebook.

Sean L’Huillier, F.N.P., is a family nurse practitioner and is one of the primary providers of North Country HealthCare’s HCV program. Prior to joining North Country HealthCare, he worked as an emergency department staff nurse and charge nurse. Sean is passionate about family medicine, emergency medicine and treating patients with Hepatitis C.

Categories: Health Tips

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