For those who have hepatitis C and have not yet been treated, it’s vital to take action. As scary as the diagnosis may seem, the past few years have seen extraordinary advances in treatment. Here are eight must-know things that people living with hepatitis C should be aware of.
1. Antivirals can cure hepatitis C.
More than 90 percent of people who have hepatitis C can be cured with an 8- to 12-week course of direct-acting antivirals, according to the CDC. “Sometimes patients who are infected believe that hep C is a death sentence and that it will inevitably lead to liver failure or liver cancer, but that is not the case,” says Cody Chastain, MD, an assistant professor of infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee. “Today, hepatitis C can be treated quickly and effectively.”
2. The new medicines don’t make you sick.
Years ago, hepatitis C was treated with interferon injections administered over the course of a year. The cure rate was only about 50 percent, and the side effects could be severe. “You could almost say the treatment was worse than the disease,” says Joseph Galati, MD, the medical director of the center for liver disease and transplantation at Houston Methodist Hospital. One of Dr. Galati’s patients, Sam Sloan of Richmond, Texas, underwent treatment for hepatitis C in the mid-1990s. Now cured, Sloan describes the side effects as “like I had the flu for about a year." Today’s antiviral treatments have been a huge success with almost no side effects. Hep C patient Stella Armstrong of Las Vegas says that after taking the medication, “Everything was functioning normally. My lab results went from outrageously high scores to normal scores. It was impressive.” Today, she is disease free.
3. You may need treatment, even if you have no symptoms.
It’s not uncommon to have hepatitis C and have no symptoms, but you should still see your doctor to determine if you need treatment. “Just because you’re not sick doesn’t mean you don’t have hep C,” says Stacey Rizza, MD, an infectious disease physician and a professor of medicine with the Mayo Clinic in Rochester, Minnesota. “It’s really important to get treated before it does any serious harm to the body.” Baby boomers account for a fair number of all newly reported cases of hepatitis C, according to the CDC, but a large proportion of them don’t even know they have it, because they haven’t been tested, they don’t have symptoms, or both. “We worry about progressive liver disease in that group because they’ve often had it for a long time unknowingly and it has allowed time for their liver to become increasingly damaged,” says Sherilyn C. Brinkley, a certified registered nurse practitioner and the program manager of the Johns Hopkins Viral Hepatitis Center in Baltimore.
4. Late therapy works, but sooner is better.
Early detection of hepatitis C can help prevent serious health consequences and the spread of the disease to others. But even people with a later diagnosis can benefit from treatment. Kris Kowdley, MD, the director of the liver care network and organ care research at Swedish Medical Center in Seattle, says that patients with advanced cirrhosis and advanced liver disease have shown improvements after receiving medications. “We are recovering patients from the brink of liver failure because these drugs are so effective in patients with advanced liver disease,” says Dr. Kowdley. “We have seen a dramatic reduction in patients needing liver transplants for hepatitis C within the last 24 months.” K.V. Narayanan Menon, MD, the medical director of liver transplantation at Cleveland Clinic, agrees that antivirals are effective in all stages of liver disease. Because the medications produce such successful results, Dr. Menon is also noticing more liver transplant patients who are hepatitis C negative but willing to receive a liver from a donor who had hepatitis C. “I’m seeing a positive response from recipients who are willing to take on this risk,” says Menon. “Even though it means they will get hep C, they know they can get cured afterward.”
5. Drinking alcohol can impede recovery.
Now cured of the virus, Sloan gives advice to newly diagnosed patients as part of a volunteer program with the center for liver disease and transplantation at Houston Methodist Hospital. “A lot of people I see are drinking, and that can lower their chances for full recovery,” says Sloan. “You’re pouring poison in your liver, and you’re trying to cure this virus at the same time. A lot of people won’t go through treatment because they won’t stop drinking.”
6. There’s been a demographic shift in who’s getting Hep C.
Although baby boomers used to account for the bulk of hepatitis C cases (36.3 percent), the disease has been rapidly spreading among young adults — so much so that in 2020, the CDC reported that younger adults (and particularly millennials) now make up the majority of newly reported chronic hepatitis C infections. Millennials (most adults in their 20s and early 30s) now account for 36.5 percent of these new infections according to the CDC. Generation X (adults in their late 30s to early 50s) accounts for 23.5 percent of new infections. People between ages of 20 and 40 are primarily acquiring hepatitis C through injection drug use, says Douglas Dieterich, MD, a professor of medicine with the division of liver diseases at Icahn School of Medicine at Mount Sinai in New York City. And, as he points out, people of those ages “are a much larger group than the baby boomers.” “The drug use explosion during the past COVID-19 year has increase hepatitis C [infections] exponentially,” says Dr. Dieterich, who is a member of the American Liver Foundation’s national medical advisory committee. Dr. Rizza adds that cocaine users may also spread the infection by sharing straws used for snorting. “If you get blood from the nose on the straw and share it with the next person, you can transmit the virus this way,” she says. It takes only a drop of contaminated blood entering the bloodstream to transmit the disease, and the virus can live outside the body for at least four days.
7. There should be no shame or stigma attached to hep C.
Individuals newly diagnosed with hepatitis C may not get treatment or seek support because they are afraid of how others will view them. “Some people don’t want to [get treatment for] the disease or tell anybody because of the stigma,” says Armstrong, who is a member of the American Liver Foundation’s patient advisory committee. “I want to encourage people to come forward and seek treatment.” “People say, ‘I don’t want anyone to know I have hep C. It has a bad connotation. People are going to look at me differently,’” says Galati. “I spend a lot of my time trying to dispel this stigma and embarrassment.” Kowdley says, “There are people in all walks of life and a variety of circumstances that have been exposed to hepatitis C. What they should focus on is to empower themselves, advocate for themselves, and link to care from experts like myself who are in a practice that has knowledge and expertise in treating hep C.”
8. Treatment costs are dropping and funding is available.
When the Food and Drug Administration approved the first antiviral medication at the end of 2013, it marked the beginning of a new type of treatment for hepatitis C. Since then, prices have dropped and generic versions have become available. Cost is a concern, but fortunately, more insurance plans are covering hepatitis C drugs. For those in need of financial assistance, funding programs are also available. “More states are also covering patients in terms of Medicaid,” says Dieterich. “Fortunately, getting the medicine is dramatically less of an issue nowadays.”
