Have You Been Thinking About Treating Hepatitis C?

Treatment of hepatitis C for the majority of cases is straightforward and can be effectively done, by general practitioners, in primary care. Approximately 60,000 people in Washington State in the United States are living with hepatitis C. In 2021, the Washington State Department of Health found that 44% of people newly diagnosed with HCV in WA are among people aged 25-34 years old. Hepatitis C is a leading infectious disease killer that is highly transmissible.  Left untreated, hepatitis C can cause liver failure, liver cancer, and death. Amongst people who use drugs, a single hepatitis C infection will spread to approximately 20 other people in a 3-year period.  

​Fortunately, excellent medicines are available to cure hepatitis C. Called Direct Acting Antivirals (DAAs), these medicines cure hepatitis C in more than 95% of cases. The treatment regimen consists of 1-3 pills per day for 8 to 12 weeks. Side effects are minimal for most patients. Now guidelines recommend rapidly treating nearly everyone who has evidence of current infection from a viral load test.

With recent guidelines and policy updates, it is now easier than ever to treat hepatitis C. Treatment of hepatitis C in people without cirrhosis or with compensated cirrhosis is straightforward and can be effectively done, by general practitioners, in primary care. Additionally, studies from various settings show good adherence and high cure rates among people who use drugs. People who use drugs or alcohol are eligible for treatment.

The benefits of treatment are substantial. In addition to a reduction in liver cancer, liver fibrosis, and liver complications, treating people with DAAs leads to a reduction in all-cause mortality, deceased inflammation and non-hepatic complications, and a reduction in transmission to others. Once people complete hepatitis C treatment and get cured, we also see an increase in interest in tackling other health challenges in their lives (e.g., substance use disorder).

CDC now recommends universal hepatitis C testing for all adults at least once in their lifetime. For those at high-risk, the recommendation is to test for hepatitis C at least once per year. Once a person receives a positive hepatitis C diagnosis, it is imperative to get them on treatment as quickly as possible.

With the availability of DAAs, we have the potential of eliminating hepatitis C.  Washington State has set a goal to eliminate hepatitis C by 2030.  This is an ambitious goal which will require a major expansion in treatment.  Currently, less than 1/3rd of people diagnosed with hepatitis C go on to receive treatment despite the widespread availability of DAAs.  Expanding treatment for all people with hepatitis C is essential to reducing viral hepatitis-related disparities and eliminating hepatitis C as a national public health threat.
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Please join in the fight against hepatitis C. With your support, Washington State will become the first state in the county to eliminate hepatitis C. Be a part of history!


Local Resources
Hepatitis C Case managers in King County: The Hepatitis Education Project (HEP) Care Coordination Program case managers identify, document, and track clients’ needs; support progress towards good health; and support clients with relapse, and, in the case of HCV, support access to treatment and cure.
More than Hepatitis C Case Reporting: Local and state public health agencies rely on information and data provided in these reports to prioritize and guide direct follow up with patients. Incomplete reports often result in prolonged duration of infection and transmission risk due to unsuccessful contact attempts and linkage to care.
Curriculum and Training:  Hepatitis C Online, Building Skills in Sexual Health Session: Hepatitis B and C Screening and Treatment, Building Skills in Sexual Health Session: Hepatitis Update
 
Primary care providers and clinicians at addiction treatment facilities who would like to learn more about diagnosing and treating hepatitis C can join the Viral Hepatitis ECHO Program.  This program provides weekly case conferences and co-management support.
 
For questions including on how to get started, please contact:
Apoorva Mallya
Executive Director of the Hepatitis Education Project
[email protected]
206-384-3551
 
 
Organizational bio: Since 1993, the Hepatitis Education Project (HEP) has been fighting to make viral hepatitis less deadly. What started as a support group for people living with chronic viral hepatitis has grown into a multi-service organization devoted to stopping this killer.
 
Through outreach and within our space in Seattle’s Central District, HEP provides vaccinations, testing, and other essential health services to at risk communities. Beyond our backyard, HEP’s national arms—the National Hepatitis Corrections Network and the National Viral Hepatitis Roundtable—strive to ensure care reaches everyone who needs it no matter where they are.
 
Guided by tenets of harm reduction and health equity, our work prioritizes the needs of people who use drugs, those experiencing homelessness, and marginalized communities disproportionately impacted by viral hepatitis.

Author bio: 
Apoorva Mallya is the Executive Director of the Hepatitis Education Project where he supports efforts to eliminate viral hepatitis and serve communities impacted by viral hepatitis. Prior to this role, Apoorva spent 15 years at the Gates Foundation played a pivotal role in the global effort to eradicate polio and deliver vaccines to children.  Highlights of his work include reaching millions of vulnerable children in conflict countries with lifesaving vaccines and driving a 99% reduction in polio cases.  Mr. Mallya has a BA in Economics from the University of Pennsylvania and an MBA from Washington University in St. Louis.
 
Resources

1. [1]Centers for Disease Control and Prevention. “Clinical Care of Hepatitis C”. 2023. https://www.cdc.gov/hepatitis-c/hcp/clinical-care/index.html​

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