Here’s what you should know. Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting just a few weeks to a serious, lifelong chronic disease that attacks the liver. It results from infection with the Hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person.
Hepatitis C causes inflammation of the liver. Over time, that inflammation can begin to cause scarring of the liver, called fibrosis. If fibrosis progresses it can result in cirrhosis, a severe condition of the liver. At this point the liver is unable to perform its functions and complications, including liver failure, and liver cancer can develop. Chronic hepatitis C can also be linked with other medical conditions such as autoimmune disease, some renal diseases, and is one of the primary reasons for liver transplants in the U.S.
Anyone can get hep C, but people born from 1945–1965, sometimes referred to as baby boomers, are 5 times more likely to have hepatitis C than other adults.
Well-Being turned to Tina Gregg, Certified Family Nurse Practitioner at GI Associates, who specializes in the treatment of Hepatitis C, for information about the risks, screening and treatment of the disease that is believed to affect more than 3.5 million people in the United States, many of whom are not aware they have been infected.
Why are Boomers at Higher Risk?
According to Ms. Gregg, the reason that ”baby boomers” have a high rate of hepatitis C is not completely understood and some theories are controversial. “Because hepatitis C is primarily spread through contact with blood from an infected person, some believe that many in this population may have been infected from medical equipment or procedures before universal precautions and infection control procedures were adopted,” explains Gregg. “Reuse of syringes before disposable syringes were available in the 1950s may have been a contributor to HCV. Some persons may have become infected through contaminated blood and blood products before widespread screening eliminated the virus from the blood supply by 1992. But many people simply do not know how they were infected with hepatitis C.”
“Hepatitis C is a silent disease meaning that most people with hepatitis C have no symptoms. Others may have vague symptoms such as fatigue, nausea, loss of appetite, abdominal pain, joint pains, or possibly yellowing of the eyes or skin,” notes Gregg. “Due to the lack of specific symptoms the virus can go undiagnosed until the damage it can cause to the liver is severe.
The Center for Disease Control and the U.S. Preventive Services Task Force recommend that all persons born between 1945 and 1965 be screened for hepatitis C.
What is involved in the screening test for Hep C?
Several different blood tests are used to test for Hepatitis C. A healthcare provider may order just one or a combination of these tests. Typically, a person will first get a screening test that will show whether he or she has developed antibodies to the Hepatitis C virus. (An antibody is a substance found in the blood that the body produces in response to a virus.) Having a positive antibody test means that a person was exposed to the virus at some time in his or her life. If the antibody test is positive, a healthcare provider will most likely order a second test to confirm whether the virus is still present in the person’s bloodstream.
Can Hep C be treated?
“Not only can hepatitis C be treated, but it can now be treated successfully,” says Gregg. “Until 2013 the standard of care for hepatitis C treatment was pegylated interferon and ribavirin which offered a low cure rate and a high side effect profile. In 2013 newer treatments known as direct acting antivirals came into play. We now have many options from which to choose with cure rates above 90% for most.”
The primary goal of hepatitis C treatment is to eradicate the virus in an attempt to halt the progression of the liver scarring/fibrosis. If this is accomplished and severe scarring has not already occurred, the liver has the remarkable ability to regenerate and heal itself. The risk of development of liver cancer can also be reduced after a successful hepatitis C treatment.
“While our focus tends to be primarily on liver health, some people experience an improvement in fatigue level, diabetes status, renal disease, joint pain and other issues,” Gregg adds.
Even though treatment of hepatitis C is now possible, there are a number of factors that may prevent some people from seeking the treatment they need. Just a few of these include:
Is the treatment for Hep C expensive?
Hepatitis C treatment is expensive. These medications are considered specialty medications, which require pre-approval by insurance companies, often a lengthy process that is initiated by the healthcare provider or the pharmacy. Therapies can range from $60,000-$90,000 (and higher). Most persons will require 12 weeks of treatment although a select few may qualify for 8 weeks of treatment. In an attempt to make treatment affordable, those who treat hepatitis C, pharmacies and patients can take advantage of co-pay coupons, patient assistance programs, grants, and any other assistance that can be found.
“Fortunately, hepatitis C screening is covered by most insurances in those at risk for hepatitis C, which includes those born between 1945-1965 and no additional risk factors for hepatitis C,” adds Gregg. “Screening is also covered by most insurances in persons outside of that age group who do have other risk factors such as receipt of blood transfusion before 1992 or blood productions before 1987, history of intravenous drug use, tattoos with shared instruments or ink, or long term hemodialysis.”
When discussing treatment cost, consideration should also be given to the “work-up” that is needed prior to treatment initiation, which can be costly depending on insurance coverage.
“I can’t stress enough how important it is for anyone born between 1945-1965 and anyone with other risk factors for hepatitis C to be screened for hepatitis C and referred for treatment evaluation if hepatitis C is diagnosed. Whenever possible, I recommend treatment early in the disease before significant liver damage and other symptoms occur. Unlike older therapies, the newer hepatitis C treatments have very high success rates and tolerable side effects. For these reasons most everyone is a candidate for treatment so GET SCREENED and GET TREATED,” Gregg concludes.
Tina Marie Gregg, Certified Family Nurse Practitioner, is a member of the staff of GI Associates. She received her Bachelor of Science in Nursing from Mississippi College and then earned her Master of Science in Nursing from the University of Mississippi Medical Center. She is a member of the American Academy of Nurse Practitioners and the American Association for the Study of Liver Diseases.