Twenty-five years ago, the virus now widely known as hepatitis C was discovered by researchers who applied the most advanced cloning techniques to verify its existence.
Since then, hope for success in the battle against this chronic, infectious, life-threatening disease has never been higher than it is right now. Public-health officials have united in urging those at risk for hepatitis C to be tested and treated, resulting in many Americans now having easier access to screening. Medicare recently announced that hepatitis C testing will be provided as a no-cost preventive service in primary care. Breakthrough drug treatments with high cure rates became available only last year, with additional promising treatment options to be approved in the next year.
In short, tools to eradicate hepatitis C in the United States have arrived.
But today on World Hepatitis Day, we're reminded that the fight against this silent epidemic is far from over. Hepatitis C still kills about 16,000 Americans a year -- more than one every hour. Why?
For one, hepatitis C is a "silent epidemic," as the Institutes of Medicine (IOM) and the Department of Health and Human Services (HHS) call the disease. Many patients infected with hepatitis C have no symptoms -- the virus attacks with insidious stealth -- and thus no cause to suspect they are infected, much less take action. You can look and feel absolutely healthy, even as serious liver damage worsens. All too often, as a result, this hidden disease remains long undetected, sometimes for decades.
No generation of Americans is at greater risk for developing hepatitis than baby boomers (individuals born from 1945 to 1965). The statistics supporting this claim speak starkly. Boomers are five times more likely than other Americans to have the disease. Three in every four Americans with hepatitis C -- more than three million in all -- are boomers. That's why CDC recommends that all baby boomers get tested for hepatitis C.
But our hope to beat this disease, however ambitious, is no substitute for strong, straightforward action. The hepatitis C crisis will only worsen unless we all do more about it. How do we collectively face this challenge?
Here is our five-point blueprint for action:
- Raise awareness. Awareness of hepatitis C, especially among baby boomers, remains dangerously low. State and local health departments, medical providers and community organizations should commit to educating those at risk about the importance of hepatitis C testing through grassroots mobilization and other tactics.
- Boost testing. The U.S. Preventive Services Task Force (USPSTF) -- the nation's leading experts on preventive and primary care -- recently released new hepatitis-C testing recommendations calling on all baby boomers to get a one-time blood test. These guidelines -- a game-changer, really -- concur with CDC's recommendations. One-time testing of all boomers would detect an estimated 800,000 undiagnosed hepatitis C cases and save as many as 120,000 lives. These recommendations must be implemented swiftly.
- Eliminate stigma. We should conduct research to better recognize, understand and ultimately break through the barriers to testing, whether those are purely psychological or caused by the healthcare system itself. People who have hepatitis C should feel no shame, and they deserve to be treated. We must prevent individuals who inject drugs, the group most at risk for new infections, from being systemically excluded due to discrimination.
- Expand and ensure access to screening. The Affordable Care Act (ACA) plays a critical role in combating hepatitis C. The law places at least as much emphasis on detection, diagnosis and prevention as it does on treatment. The ACA must deliver on its promise to increase the number of Americans carrying health insurance and expand access among baby boomers and others to the screening tests available. Already we're making incremental progress toward those ends. Starting this year, for example, most private insurers are now required to provide hepatitis C testing to baby boomers and at-risk individuals without a co-payment. Still, more needs to be done to ensure that all public and private payers cover screening and educate patients about the importance of getting tested.
- Improve linkage to care and the cure. All new hepatitis C treatments must be made available -- without barriers -- through public and private insurers immediately after FDA approval. Compared to previous regimens, these drugs have high cure rates, short duration of treatment and minimal side effects. Pharmaceutical companies and payers must work together to ensure those infected are able to access life-saving treatments.
A landmark public-health achievement -- stopping suffering and death from end-stage liver disease and liver cancer, while reducing and even eliminating new infections -- is now well within our grasp. But we must commit to this plan and work fast. Only then will we put hepatitis C where it belongs -- in our rear-view mirror.
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