Hepatitis C has become increasingly treatable with the emergence of a number of federally approved regimens, but a lack of detection in the infected population remains a major problem. Among the Pennsylvania Department of Health's responses to this are educational sessions that target addiction professionals among their invited groups.
“We're advocating that addiction facilities test for hep C,” says Rachel Levine, MD, the physician general for the commonwealth. Levine says that as many as 200,000 to 250,000 Pennsylvanians are living with the disease, and “as many as 50% don't realize they're infected” because they experience no noticeable symptoms. Untreated, the illness often develops into a chronic infection with dangerous consequences.
Patterns of hep C transmission across the state have generally followed the opioid crisis's migration to previously unaffected areas. If you looked at data from two years ago, Levine says, you'd find that hep C cases generally were clustered in urban areas such as Philadelphia, Pittsburgh and Allentown. More recent numbers show penetration into more remote communities as well. “It's now suburban, rural, everywhere,” Levine says.
In terms of who is being affected, “Pennsylvania is seeing a number of new hep C reports in adolescents and young adults, particularly associated with substance abuse,” says Levine. Needle sharing is one of the most common ways the virus is transmitted.
Providers on board
The most recent educational seminar sponsored by the health department, an event called “Hepatitis C: The 'Silent Epidemic,'” was held Dec. 9 in Lancaster. Co-sponsored by the Community Liver Alliance and Retreat Premier Addiction Treatment Centers, the session had a specific focus on hep C risk in the 35-and-under population with opioid use disorders. In the past, Baby Boomers tended to be the group most targeted in hep C awareness efforts, with the Centers for Disease Control and Prevention (CDC) recommending that everyone in that age range be tested.
Topics in this month's seminar included epidemiology, prevention strategies, linking individuals with hep C to medical care, co-infection factors for hep C and HIV, and counseling approaches. Medical providers, community health workers and corrections-based counselors were among the other invited groups for the educational session.
Rapid diagnostic tests are now available to facilitate the screening process for addiction treatment facilities and other providers, Levine says. Moreover, “In the last two years, there have been a number of FDA-approved treatment regimens that can cure this infection,” Levine says. “I hesitate to use that word 'cure,' but that's the word the CDC uses.”