Hepatitis C

This morning I attended University Hospitals Primary Care Institute’s second annual Wellness Symposium.  We had great talks on new guidelines for managing high blood pressure, diabetes, obesity, atrial fibrillation and quite a few other problems.  The one I want to talk about today though is the amazing advances in treating hepatitis C.

Hepatitis C is a viral infection that affects the liver.  It’s estimated that about 3.5 million people in the United States have chronic hepatitis C infection.  75% of patients with hepatitis C do not know they have it.  Hepatitis C kills more people per year than HIV, and has done since 2006, but there is not nearly the same urgency or awareness of testing for hepatitis C as there is for HIV.

This is curious, because hepatitis C is transmitted exactly the same way as HIV, but is much easier to catch than HIV.  Far and away the most common cause of hepatitis C infection is intravenous drug abuse, which is a huge concern with the current epidemic of heroin addiction.

Other ways to catch hepatitis C include blood transfusions and the medical use of blood products, from infected mother to baby, and through unprotected sex (although the risk is low particularly for monogamous heterosexual couples).  It also can be transmitted in the medical field through needle-stick injuries and other exposures to infected blood and bodily fluids.

About 10% of people with hepatitis C have no idea where they got it.  Scary.

Current recommendations are to offer screening to anyone who has one or more risk factors for infection, and to screen everyone who was born between 1945 and 1965.  This is because the baby boomers account for 70-80% of patients with hepatitis C.  (This may change with the IV drug abuse epidemic we’re currently having.)

Why do we care about hepatitis C?  Hepatitis C is the #1 cause of liver transplant in the United States.  It is also the leading cause of hepatocellular carcinoma (primary liver cancer).  And as I mentioned above, it now kills more people per year than HIV.

What happens if you have hepatitis C?  Everyone knows viral infections can’t be cured, right?  Actually, that isn’t true.  Hepatitis C is nearly 100% curable with current medications, and new medications expected to be released soon will push the cure rate even higher with fewer side effects.

What does this mean for you?  If you were born between 1945 and 1965, have EVER abused intravenous drugs, have ever traded sex for drugs or money, have a household contact with hepatitis C or are concerned about your personal risk, PLEASE talk to your doctor and get checked.  The screening test is covered by insurance plans.

Talk to friends and family members.  If you love someone who has risk factors or was born between 1945 and 1965, make sure they get screened.  Hepatitis C can kill them, and it’s curable if it’s diagnosed before permanent damage is done to the liver.

Hepatitis C is estimated to affect 3.5 million Americans.  It often has no symptoms until the liver begins to fail or cancer develops.  75% of Americans with hepatitis C don’t know they have it.  It is curable, if we find it.

Get tested.

QUESTION:  Has your doctor ever asked you about your risk factors for hepatitis C?

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4 thoughts on “Hepatitis C

  1. I’m 5mos. Into a 6mo, treatment for Hep C. Genotype 3. I take 1 400mg. Sovaldi in the morn, 1 30mg. Daklinza in the morn. And 3 200mg. Ribavirin in the morn, Also another 3. 200mg. Ribavirin in the evening, Not sure how I got it?

    • I’m so sorry you have to deal with this, Mark! On the positive side, this is the best time in history to be treated for Hepatitis C. Existing treatments are getting more effective and new treatments are just getting better and better. God bless you!

  2. As someone living with hep c, I found this article to have a couple of errors. For one, transmission through heterosexual sex is disputed heavily, and every doctor that me or my wife have spoken to have assured us that there is little to no evidence that it’s transmitted that way at all and that we can continue our sexual relationship without concern. Second, hep c comes with a laundry list of extra hepatic symptoms that can occur when there is little or no liver damage at all. The virus affects the whole body and there most certainly are symptoms.

    • Hi, Chris! I’m sorry it took me a minute to address this comment. Thanks for your input BTW!

      I agree that monogamous heterosexual sex confers a low risk of transmission. I believe the risk is not zero, but it is low according to available research. However, this article was intended to get people considering whether or not they should get screened, and those who are concerned about STDs, have multiple sex partners or work in the sex trade should certainly be screened.

      From what I have found, there are a lot of nonspecific symptoms (fatigue, joint pain) that are reported in hepatitis C patients, and some associated conditions (like fibromyalgia and multiple myeloma) for which no causative relationship has been demonstrated. Meaning some patients with fibro and myeloma have hepatitis C but it hasn’t been proven that hepatitis C causes them. There are some symptoms like jaundice, clay-colored stools, and low white blood counts that are related directly to the liver disease and happen late in the illness (after liver damage has occurred). And there are a few conditions that are directly caused by hepatitis C like lichen planus and cryoglobulinemia and porphyria cutanea tarda.

      Again, thank you so much for your comment! Have a great day!

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