Ask a Health Care Professional – Hepatitis C

By Diana Weber, M.D., Medical Director, Blue Cross and Blue Shield of New Mexico

Hepatitis C is one of the most common infectious diseases in the world. New Mexico has a high rate of this infection, with approximately 2.8 percent of the population experiencing chronic hepatitis C virus (HCV) infection. One third of cases in New Mexico are in people in the baby-boom generation and older, and most infected people do not know they have it. This viral illness causes liver damage and can lead to cirrhosis, liver cancer, disability, and death. Additionally, hepatitis C increases the risk of developing diabetes as well as heart and kidney disease.

But the news is not all bad. The development of an effective treatment means that for the first time there is a cure for a chronic viral infection, a revolutionary medical breakthrough.

How is hepatitis C transmitted?

The virus is transmitted through infected blood. Prior to the discovery of HCV, infection was primarily passed through blood transfusions or injection of other blood-derived products. In 1989, the hepatitis C virus was discovered. Soon after, a diagnostic test to detect HCV was developed. This made it possible to test for HCV in blood products to prevent further spread of the virus from infected blood. The primary means of transmission now is seen in people who inject drugs and share infected needles or those who are exposed to unsterile instruments, such as when getting a tattoo. Sharing razors, nail clippers, and toothbrushes with infected people can also result in virus transmission. Because half of people who are infected with HCV are not even aware that they are infected with the hepatitis C virus, it is important to be selective when you share these instruments.

What are the symptoms of hepatitis C?

Hepatitis C is often completely asymptomatic, which is why so many people are unaware that they are carrying the disease. The symptoms of hepatitis C are non-specific, such as fatigue, impaired cognitive function (brain fog), joint or muscle pain, and depression. In many people, the HCV infection remains asymptomatic for years or even decades. When the disease does advance, it can progress to cirrhosis, liver failure, and even liver cancer.

Who is at risk of hepatitis C?

Almost 5 percent of people in the U.S. born between the years of 1945 and 1965 are infected. Males are more likely to have the virus than females. Hepatitis C is often considered a disease of the marginalized and is likely underreported. While only 2 percent of the U.S. population is infected, 90 percent of people who have used injection drugs for over 10 years have HCV. Other groups at high risk of infection include those who are homeless or incarcerated.

How is hepatitis C diagnosed?

Screening for HCV is done with a blood test. Because of the prevalence of the disease and the fact that many infected people do not have symptoms, the U.S. Preventive Services Task Force recommends that all individuals between the ages of 18 and 79 be screened for HCV. If you do not know your HCV status, a simple blood test can detect the virus. If the initial test is positive, additional tests will be done to get more information about the infection and the state of your liver.

What is the treatment for hepatitis C?

If you are diagnosed with HCV, talk to your doctor. Remarkable work has been done to find a safe and highly effective treatment for HCV. It is a combination pill with minimal side effects that is taken daily for eight to 12 weeks, depending on the medication that you are prescribed. In the past, most people needed to see gastrointestinal specialists to be treated. Now, due to improved medications and widespread training opportunities, primary care clinicians can manage this disease in most people. After treatment, the risk of liver cancer is reduced by 70 percent, the risk of death related to liver disease reduced by 90 percent, and the risk of dying from anything else decreased by 60 percent. Besides treatment, you should minimize alcohol consumption to prevent further injury to your liver.

Make it a point to get tested for the hepatitis C virus. And if you are positive, seek treatment, which can save your life. Encourage others to be tested. Together, we can eliminate the hepatitis C virus infection in our state.

For more information, visit the New Mexico Department of Health website at https://www.nmhealth.org/.

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected]. BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.

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