World Hepatitis Day was celebrated this week, a day set aside to raise awareness about viral hepatitis, which affects 400 million people worldwide. It also marks a historic moment for the hepatitis community – the launch of NOhep, the first global movement to eliminate viral hepatitis.
In the United States, it is estimated that between 2.5 million and 4.7 million people are living with chronic hepatitis C (HepC), a liver infection caused by the hepatitis C virus (HCV). The Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force recommend that anyone of any age with high risk behaviors such as current or past injection drug use should get HepC tested once yearly. They also recommend baby boomers or people born from 1945 to 1965 should be tested at least once for HepC due to high prevalence. Baby boomers are five times more likely to have HepC, and most of them don’t know they are infected.
HepC has been called a “silent epidemic” because most people with the disease don’t know they are infected. Over time, HepC can cause inflammation and gradual liver fibrosis or scarring, which can lead to cirrhosis. It is also a leading cause of liver failure, liver cancer, liver transplantation and liver-related death. And according to a recent CDC article, more people die each year from HepC than from 60 other infectious diseases, including HIV. Yes, HepC kills more people each year than HIV.
For the African-American community, HepC is a relevant yet neglected disease. In fact, HepC is more prevalent among African Americans than among persons of any other racial group in the nation. And although African Americans represent about 13 percent of the overall U.S. population, estimates suggest they represent around 22 percent of all HepC infections. Additionally, African-American baby boomers have twice the rates of HepC infection as other baby boomers. This picture is equally revealing at the hospital level. In a recently published article in the journal Public Health Reports, we found a HepC prevalence rate of nine percent among baby boomers within MedStar Washington Hospital Center’s Primary Care Clinic. This was significantly higher than the U.S. prevalence of 3.3 percent and the D.C. prevalence of 2.5 percent (among all ages). Within this group, the HepC positive rate among African-American men was 16 percent, substantially higher than the CDC rate of eight percent.
So what does this mean, and what can you do? The National Black Leadership Commission on AIDS launched the first National African-American Hepatitis C Action Day four years ago, with the intention of mobilizing the community to reduce the burden of HepC on the Black community, and impact a neglected health disparity by promoting education, testing, linkage to care and treatment. So for everyone, especially people of the African-American community, it starts with a test, it’s that simple. HepC is curable. CURABLE. But one of the biggest barriers to HepC elimination is a lack of identification.
Lastly, but importantly, the Centers for Medicare and Medicaid Services (CMS) now covers the cost of a HepC antibody screening test – in a primary setting – if the following conditions are met:
- A screening test is covered for adults at high risk for HepC infection. “High risk” is defined as persons with a current or past history of illicit injection drug use; and persons who have a history of receiving a blood transfusion prior to 1992. Repeat screening for high risk persons is covered annually only for persons who have had continued illicit injection drug use since the prior negative screening test and have not been.
- A single screening test is covered for adults who do not meet the high risk as defined above, but who were born from 1945 through 1965.
So take the HepC challenge and ask your primary care provider to be tested. If you are chronically HepC infected and not currently in care with a specialist (Infectious Diseases, Hepatology, or Gastroenterology), please contact the HepC Linkage to Care Navigation program at MedStar Washington Hospital Center for assistance.
Phone: 202-877-0679 or 202-877-3296
In this video, patient Sharon Billings kept her hepatitis C diagnosis a secret and lived in silence for 18 years. She shares her story of overcoming HepC.