The CDC revised their testing and screening guidelines in 2012. There are a wide variety of ways one can come into contact with Hepatitis B (HBV) and Hepatitis C (HCV). There is a broad-based perception that everyone who has HCV is a drug user. Certainly some are, but many are not. Remember the list of risk factors discussed in the aforementioned articles? Drug use, yes, even if only once, but also: any blood products received prior to 1992, military service, medical treatment outside the U.S., tattoos, piercings, unprotected sex, vertical transmission (mother to child in childbirth). Additionally, especially with HCV, it’s possible to be infected for 10-40 years and be completely unaware of your infection status. After careful study and reconsideration, the CDC has decided to push for age-based testing instead of riskbased testing. This is a much better system for several reasons – doctors don’t have to ask patients questions they’d rather not ask, patients don’t have to decide whether or not to admit to marginal
behavior, everyone is on equal footing, we’re all in the same boat. The new guidelines call for everyone born between 1945 and 1965 to get tested……period! Did anyone count the number of times in those articles I said, “Just go get tested!”? How many of you followed through?
The good news is that treatment has also changed significantly. In the old days (about two years ago!), most people had to treat for 48 weeks, some longer. Some lucky people with the “easy” genotype could treat for 24 weeks. For either group, treatment was not a piece of cake. A weekly shot (interferon) that produced flu symptoms, depression and agitation. Twice daily pills (ribavirin) that resulted in anemia and skin rashes. Then they introduced a third drug (protease inhibitor) that was added to the other two. Treatment times were cut to 24 weeks for everyone, some even only went 16 weeks. These add-ons had their own side effects (worse anemia and rashes) that were piled on top of the already existing issues with the shot and the pills. At least, however, cure rates went from 50% to almost 90%.
Emerging now, newer drugs – polymerase inhibitors, NS5A inhibitors, NS3A inhibitors. These drugs are eliminating the need for the shot and reducing treatment times for most people to 12 weeks. Some combinations are eliminating the need for the ribavirin, as well. Side effects are much easier to deal with, even minimal for many people. Many of these newest drugs are in the last stages of clinical trials and will be available within the next two years – quite possibly sooner. Cure rates are starting to hover around 100%.
Please consider (or reconsider) getting tested. The consequences of not knowing your status can be lifethreatening. If you have any questions, you’re welcome to e-mail me: firstname.lastname@example.org
Many thanks to all of you who gave me such positive feedback on my articles.
Click here for the entire “Your Liver, Your Health” series.
Hollis Pickett, in partnership with Toni Donovan, runs a Redding area non-profit – Local Area Support For Hepatitis, also known as LASH. Hollis has been involved with hepatitis advocacy since 2002 and is a steering committee member with CalHEP Alliance. She has been the bookkeeper and office manager for the law firm of Carr, Kennedy, Peterson & Frost for the past 25 years. Toni has just completed a Masters in Public Health (MPH) and is currently employed by Planned Parenthood and Acaria Health (a specialty pharmacy). LASH provides community education and patient/caregiver support for those infected with chronic viral hepatitis. A support group meets once a month for patients and their families. LASH offers group presentations, individual counseling and clinical education for patients entering treatment. You can contact them via e-mail at email@example.com or call Toni (945-7853) or Hollis (524-5601).