Real World Health Care Blog

Tag Archives: hepatitis

Hep, hep, hooray!

Editor’s Note: As we come to the conclusion of Hepatitis Awareness Month, we are pleased to share with our readers a column written by Gene Weingarten of the Washington Post. Gene Weingarten is a Pulitzer Prize-winning journalist and writes “Below the Beltway,” a weekly humor column that is nationally syndicated. The column initially appeared online on May 21, 2015.

As far as helping to erase the unfortunate stigma of the disease, I fear my personal story may not be of much value. While it is true that many hep C victims become infected through blood transfusions or organ transplants, or in other innocent ways, mine was contracted during my college years, when I showed as much care for my personal health as your average suicide bomber. I got hep C because of my appetite for altered states of consciousness, which is a highly dignified way of saying that I enjoyed sticking needles in my arm to facilitate nodding and drooling.

HepatitisAwarenessMonthBecause of modern medicine I no longer have hep C, but in a sense, I am still “living with it.” That is because most every time I get blood drawn for any reason, the results arrive with a gigantic warning that I have hepatitis C. (As it happens, once you have the disease, the telltale antibodies in your blood hang around forever, like your wife’s doofus brother Duane.) For the instant until you remember this fact, the medical news is terrifying, but even afterward you are dispirited. It’s like having one of those suggestive small-of-the-back tattoos, the occasional glimpse of which reminds you that you were once a stupid dirtball.

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A message from our sponsor: If you or someone you love is living with Hepatitis C and is struggling to afford the treatments, the HealthWell Foundation may be able to help. Click here to visit HealthWell’s eligibility page.

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I know that hep C is a particularly insidious scourge, since many people who have it are asymptomatic for a long time, meaning they don’t know they have it, meaning the disease often progresses without treatment for far too long. If you were ever at risk, get tested! I can testify to the wisdom of this because of how I was diagnosed.

I discovered that I had it, and that I’d had it for two decades, only by accident, after going to the doctor following a startling grease-related bodily event that caused me to have to leave work and buy a new pair of pants. (I am telling this here because of my deep commitment to disseminating important medical truths during Hepatitis Awareness Month, and because, as a humor columnist, I have no remaining sense of shame.) My grease problem turned out to have been benign, the result of a single binge episode of eating peanut butter from a tablespoon. This would have been deeply reassuring, except the doctor then told me that something else had shown up in the blood work. “Something else showed up in the blood work” is one of those things that is not good to hear, like a concerto for flugelhorn, vuvuzela and cowbell.

But in the end, my experience with hepatitis C is that I got over it, which I hope will be an inspiration for readers of this blog. It is true that my cure came only after injections into my thighs three times a week for nine years, but this should not be discouraging.

First, the treatment is easier now. Second, the life-or-death uncertainty with which I was living provided philosophically beneficial. For nine years I embraced life as never before, becoming more responsible, more appreciative, a more sober and serious person.

Then I got cured and forgot about all that crap. Win-win!

Awareness and Assistance Are Crucial to Fighting Hepatitis C

May is Hepatitis Awareness Month, a time when the healthcare and patient advocacy communities rally support for the millions of Americans afflicted with the disease, including an estimated 3.2 million suffering from chronic Hepatitis C (also known as HCV).

HepatitisAwarenessMonthOver time, chronic Hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. In fact, Hepatitis C is a leading cause of liver cancer and is the number one cause of liver transplants.

While millions live with Hepatitis C, many don’t even know they are infected. This “hidden epidemic” can strike just about anyone, but those born from 1945 to 1965 are five times more likely to have the disease than those in other age groups. That’s why the CDC has issued a recommendation for all Americans born during that time to get a blood test for the disease.

In addition to the baby boomer generation, others may be at high risk for HCV infection, including those who:

  • Use injection drugs
  • Used unsterile equipment for tattoos or body piercings
  • Came in contact with infected blood or needles
  • Received a blood transfusion or organ transplant before July 1992
  • Received a blood product for clotting problems made before 1987
  • Needed blood filtered by a machine (hemodialysis) for a long period of time due to kidney failure
  • Were born to a mother with HCV
  • Had unprotected sex with multiple partners
  • Have or had a sexually transmitted disease
  • Have HIV

For people at risk, knowing they have Hepatitis C can help them make important decisions about their healthcare. Successful treatments can eliminate the virus from the body and prevent liver damage, cirrhosis, and even liver cancer. But sometimes, the cost of those treatments are out of reach, even for those with medical insurance.

Financial Relief Available

The HealthWell Foundation’s new Hepatitis C Fund is bringing financial relief to underinsured people living with the disease. Through the fund, HealthWell will provide copayment assistance up to $15,000 for HCV treatment to eligible patients who are insured and have annual household incomes up to 500 percent of the federal poverty level. To determine eligibility and apply for assistance, or learn how to support this program, visit http://bit.ly/HepC2015.

“The new generation of hepatitis C treatments has brought excitement to patients who have been hoping for a breakthrough,” said Krista Zodet, HealthWell Foundation President. “Through the generosity of our donors, our Hepatitis C Fund is able to help more people receive these treatments while minimizing the worry over financial stress.”

Because many HCV infections are identified only after the patient becomes symptomatic, community health centers are extremely important for getting patients into care. BOOM!Health is a community service organization located in the Bronx, New York, the epicenter of the Hepatitis C epidemic in New York City. It offers a variety of services to those living with HCV infections, including a fully staffed health center, pharmacy services, case management, nutrition education, counseling, pantry services, syringe exchange, behavioral care, and more.

“People living with HCV continue to face serious challenges, such as stigma and lack of access to treatment,” said Robert Cordero, President and Chief Program Officer, BOOM!Health, a community health center based in the Bronx that supports individuals on their journey towards health, wellness and self-sufficiency. “Non-profits that provide funding assistance like HealthWell fill a gap that we’ve watched grow.”

“Nearly 3.2 million people in the United States and about 150 million people worldwide are chronically infected with HCV,” said Tom Nealon, Esq., National Board Chair of the American Liver Foundation, a national patient advocacy organization that promotes education, support and research for the prevention, treatment and cure of liver disease. “The HealthWell Foundation and other independent copay charities play a vital role in seeing that those who are insured but can’t afford their medication copay are able to access and stay on treatment.”

If you or someone you know is living with Hepatitis C, emotional, physical and financial support are critical. What organizations and programs are you turning to for help? Let us know in the comments.

Targeted Therapies Open Door to Improved Outcomes and Lower Costs to Treat HCV

As we were reminded on World Hepatitis Day, early detection is critical to turning the tide of this “silent epidemic” that impacts millions. However, strategies to end the deadly effects of viral hepatitis don’t stop there. Personalized treatment is another essential tool that fuels better outcomes for patients with hepatitis C (HCV) while saving money in the long term for the health care system too. 

Paul DeMiglio

Paul DeMiglio

The importance of finding effective therapies for HCV is underscored by the reality that the disease often goes undetected, with an estimated 80 percent of Americans with HCV unaware of their status. Many HCV-positive people show mild to no symptoms, making it more likely for the illness to progress and become more expensive to treat as a result. 

Although safe and effective vaccines are available for hepatitis A and B, none exist for HCV. To help answer this need, Abbott created the fully automated RealTime HCV Genotype II Test – the first FDA-approved genotyping test in the United States for HCV patients – to facilitate targeted diagnosis and treatment that boosts desired outcomes.

This treatment-defining genotyping test empowers physicians to better pinpoint specific strains of HCV, determine which treatment option is best for the patient, and make more informed recommendations about when it should be administered. Available to individuals with chronic HCV, the test is not meant to act as a means to screen the blood prior to diagnosis.

So how does finding the right HCV treatment save money?

Targeted therapies like these are important for diseases like HCV because they reduce the “trial and error” of having to use additional treatments when the initial ones don’t work, saving money and time for patients and providers. Early detection, combined with follow-up care, can prevent patients from developing later stages of hepatitis that can mean more serious long-term conditions that are harder and more expensive to treat.

Treating HCV patients with end-stage liver disease, for example, is 2.5 times higher than treating those with early stage liver disease. Advanced HCV can also escalate to chronic hepatitis infection, a side effect of this being cirrhosis (scarring of the liver and poor liver function) and liver cancer. Treatment for these two conditions (which can include a liver transplant) can cost more than $30,000. Liver cancer treatment can be more than $62,000 for the first year, while the first-year cost of a liver transplant can be more than $267,000.

As more and more patients find themselves unable to afford treatments, HCV is becoming an increasingly larger financial burden on the health care system.

The annual costs of treating HCV in the United States could be up to $9 billion, and over the course of a lifetime the collective cost associated with treatments for chronic HCV is estimated to total $360 billion.

“As we see patients with more advanced liver disease, we see significantly more costs to the system,” says Dr. Stuart Gordon, author of the Henry Ford Study. “The key, therefore, is to treat and cure the infection early to prevent the consequences of more advanced disease and the associated economic burden.”  

Targeted therapies show great promise to improve outcomes while saving time and money by linking patients to the specific treatments they need at earlier points of diagnosis. But what can health systems do to make innovations like the HCV Genotype II Test accessible to more patients and increase the cost-savings benefit on a larger scale?

World Hepatitis Day Spotlights Importance of Early Detection to Improve Prevention and Treatment Strategies

This Sunday, July 28, is World Hepatitis Day, an observance that reminds us that hepatitis (inflammation of the liver) remains largely unknown as a major health threat. Approximately half a billion people worldwide and 4.4 million people in the U.S. live with chronic viral hepatitis, with one million deaths resulting from the disease each year.

Linda Barlow

Linda Barlow

The goal of World Hepatitis Day is to move from awareness to action to address the “silent epidemic” of viral hepatitis – so named because most people don’t experience symptoms when they first become infected, often not until they develop chronic liver disease many years later.

Stakeholders in government and private industry are stepping up to answer the call, supporting early detection and medical intervention as key starting points to effectively address the epidemic.

Earlier this month, Quest Diagnostics announced a partnership with the CDC to improve public health analysis of hepatitis C screening, diagnosis and treatment for the 3.2 million Americans living with it. Under the collaboration, anonymous patient data will be evaluated to identify and track epidemiological trends in hepatitis C virus infection, testing and treatment and determine how those trends differ based on gender, age, geography and clinical management.

“Our collaboration with the CDC underscores the importance of using diagnostic information to derive useful insights enabling effective prevention, detection and management programs for diseases with significant impact on public health,” Jay Wohlgemuth, M.D., senior vice president, science and innovation, Quest Diagnostics, said in a statement.

Early detection was also the focus of a 2012 National Institutes of Health (NIH) study published in Proceedings of the National Academy of Sciences. In the study, researchers concluded that elevated blood levels of a specific enzyme and a specific protein early on in the course of hepatitis C infection were much more likely to develop into advanced fibrosis or cirrhosis. The study found:

  • The long-term course of chronic hepatitis C is determined early in infection.
  • Rapidly progressive disease correlated with persistent and significant elevations of alanine aminotransferase (ALT), an enzyme released when the liver is damaged or diseased.
  • Rapidly progressive disease correlated with persistent and significant elevations of the protein MCP-1 (CCL-2), a chemokine that is critical to the induction of progressive fibrogenesis and ultimately cirrhosis.

Armed with this information, clinicians are expected to make a fairly accurate assessment of which patients are likely to develop advanced disease rapidly. Instead of waiting for a new class of drugs to be approved, these patients are likely to be pressed to start treatment right away – with the goal of treating the virus before it causes cirrhosis of the liver.

Because hepatitis does not result in symptoms until serious liver damage occurs, getting tested is also crucial. In fact, the CDC recommends that everyone born from 1945-65 get a one-time test for hepatitis C because they are five times more likely than American adults in other age categories to be infected and face an increased risk of dying from hepatitis C-related illnesses.

The first FDA-approved hepatitis C genotype test is now available in the U.S. From Abbott, the fully automated Realtime HCV Genotype II test determines the specific type or strain of the HVC virus present in the blood of an HCV-infected individual.

To locate organizations where you can access services including Hepatitis testing, vaccines and treatment, click here. You can also take this 5-minute Hepatitis Risk Assessment to obtain a personalized report from the CDC.

Early awareness and prevention-based practices are crucial to avoiding hepatitis. But what else can be done to ensure access to and availability of reliable and cost-effective screening and diagnostics, in addition to safe and simple treatment regimens for people with the disease?

We hope this post serves as a resource for journalists covering or interested in writing stories about World Hepatitis Day and related issues. Also stay tuned for our follow-up post next week that will address the cost-savings implications of vaccination and early treatment of hepatitis.