How to Turn Back the Threat of HCV

Posted in: News, News 2018
Corinna Dan, R.N., M.P.H., Viral Hepatitis Policy Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

Although Black Americans are making gains in the fight against HIV, we are not doing nearly as well when it comes to hepatitis. That was the message conveyed at a Brown Bag Lunch Webinar hosted by the Black AIDS Institute in October 2017.

New infections of the most common type of hepatitis, the hepatitis C virus (HCV), have increased nearly 300 percent between 2010 and 2015 (pdf), according to the Centers for Disease Control and Prevention. Not only that, but deaths associated with hepatitis C reached an all-time high of 19,659 in 2014. Black Americans had the second-highest rates of new hepatitis C infections (behind American Indians) in 2014. Such statistics make it imperative to sound the alarm, experts say.

“The bottom line when it comes to hepatitis is, we’re losing ground in the fight,” says Corinna Dan, a viral hepatitis policy adviser at the U.S. Department of Health and Human Services. It’s imperative that we turn things around.

Understanding the Threat

Viral hepatitis is a group of viruses that lead to inflammation of the liver. HCV affects approximately 3.5 million people. Injection drug use is the most common way that hepatitis C is transmitted in the United States, but it can also be transmitted through donated blood that is not screened properly, body piercing using nonsterile instruments and childbirth.

Hepatitis C hits African Americans particularly hard. Although Black people account for just 12 percent of the U.S. population, Blacks make up 25 percent of Americans living (pdf) with hepatitis C. Blacks are also more likely than other groups to have hepatitis C-related deaths. In fact, in Black communities, chronic liver disease and cirrhosis, often caused by hepatitis C, are among the leading causes of death among those between ages 45 and 64. Black men in their 50s have the highest rates of HCV, with 1 in 7 men affected.

The rates of HCV are also higher among the prison population than the general population. This is particularly troublesome for minorities, since Black and Latino people make up 58 percent of the U.S. prison population.

For those people who are living with HIV/AIDS (PLWHA), hepatitis C poses another set of concerns. Approximately 25 percent of PLWHA are co-infected with hep C, and nearly 75 percent of PLWHA who inject drugs are co-infected with hep C. When someone is co-infected with HIV and HCV, that person’s risk of liver disease, liver failure and liver-related death triples.

Turning the Tide

The good news is that hepatitis C is treatable; in fact, treatments have cure rates of more than 90 percent. So why are we losing the fight?

There are a number of factors:

  • Only 59 percent of people with chronic hepatitis C have been diagnosed, and only 22 percent have received treatment.
  • The expense associated with treatment—which costs $25,000 to $50,000 per course—is prohibitive.
  • The opioid epidemic has had an impact on the growing hepatitis threat because many people have moved from taking prescription drugs to injecting heroin.

The webinar provided a number of suggestions for helping to turn things around.

One strategy is to focus on ensuring that prevention messages and programs reach more people. It is also important to urge people to get screened for HCV so that they will know whether they have it. Just as important is making treatment more accessible. While there are programs that provide funding for treatment, such as one offered by Gilead (pdf), many people are unaware of or unable to get access to medication that they can afford. Finally, changes in state policies, such as what Medicaid beneficiaries have to pay in order to access HCV medication, could also make a difference.

Education and information are key to getting the word out about how to prevent and treat HCV, Corinna Dan says. But with the rise in recent years in the number of people who are affected, there is no time to waste.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes about health, wealth and personal growth.