Editor’s note: The following article was submitted by Patricia A. Tichnell, a registered nurse and manager of the Telemedicine/County Program, Division of Infectious Diseases, Johns Hopkins School of Medicine.
The month of May is designated as Hepatitis Awareness Month in the United States, and May 19 is Hepatitis Testing Day. These observances are an opportunity for us to raise awareness of hepatitis C and encourages people to be tested.
Unfortunately, due to COVID-19, we were unable to have a testing event this year.
The Centers for Disease Control and Prevention estimates 2.7 million people in the United States have chronic hepatitis C and almost half are unaware they have it. People can live with chronic hepatitis C for years or even decades without symptoms, while the virus slowly damages their liver. By the time symptoms do appear, liver damage is often advanced.
Left untreated, chronic hepatitis C can cause liver damage, cirrhosis and even liver cancer. It’s one of the leading causes for liver transplants today.
Hepatitis C is a liver disease that results from infection with the hepatitis C virus (HCV). It is spread primarily through contact with blood from an infected person. Injection drug use is the most common risk factor for HCV, and accounts for 60% of acute HCV infections. Hep C can cause acute and chronic infection. Acute hep C infection usually does not have symptoms and 15 to 25% of those infected with HCV will clear the virus without treatment. The other 75% to 85% will develop chronic hep C infection, needing treatment to cure their infection.
In April, the CDC updated the recommendations for hepatitis C screening in adults. The guidance has two new recommendations: a one-time HCV screening for all adults 18 and older, and HCV screening for all pregnant women with each pregnancy. The CDC still recommends HCV screening regardless of age if a person has risk factors, with repeat testing for those with ongoing risk factors for HCV. The new CDC recommendations were a major change from the prior 2013 recommendation to screen all adults born between 1945-1965 and those with known risk. Such risks include:
• Injection drug use or intranasal illicit drug use, current or ever.
• Tattoos or body piercings in an unclean environment using unsterile equipment.
• Worked in a place where you came in contact with infected blood or needles, for example, health care workers.
• Received clotting factor concentrates produced before 1987 or a blood transfusion before 1992.
• Children born to a mother with hep C.
• Have signs or symptoms of liver disease (e.g., abnormal liver enzyme tests).
• Living with HIV infection.
• Were ever incarcerated.
Yearly testing is recommended for persons who inject drugs and for men living with HIV who have unprotected sex with men. Periodic testing should be offered to other persons with ongoing risk factors for exposure to HCV.
Testing is the only way to know if you have hepatitis C infection. The screening test is a simple blood test. Ask your medical provider for a test and if the test is positive, take steps to get treated. Treatments today are short in duration (typically 8 to 12 weeks), very well-tolerated, and highly effective with cure rates 95% or higher.
Recent legislative efforts to improve treatment access have paid off. As of January, Maryland Medicaid lifted liver fibrosis restrictions to allow access to treatment regardless of the degree of liver damage. Prior to this change, people with minimal liver damage due to HCV were often denied access to curative treatment.
With improved access to treatment and disease education, hepatitis C elimination goals are achievable. If you are at risk of HCV or know someone who is, don’t wait to be offered a screening test. Take charge of your health and seek an HCV test today. Know your HCV status.
Call the Johns Hopkins Viral Hepatitis Program office located in the Allegany County Health Department for questions or appointments at 301-759-5101. Rapid hepatitis C antibody tests are free and results are available in about 20 minutes.