Nurse’s notes: Hep C virus is treatable

(Missoulian) Tremendous progress has been made in controlling the pandemic of hepatitis C virus. This virus, which affects about 180 million people globally and up to 5 million Americans, has been difficult to treat, using drugs with only modest potency and significant side effects resulting in cure rates of only about 50 percent.

However, two new drugs were approved by the U.S. Food and Drug Administration in 2011, and several additional agents are in late stages of clinical testing. Cure rates now are in the 65 percent to 85 percent range, depending on the stage of the disease and which strain of the virus is involved. And within the next few years, cure rates are expected to rise even more dramatically.

HCV has been called a “silent killer,” because the majority of infected individuals are unaware of their disease and have minimal symptoms. However, it is now recognized most infected people will develop chronic liver disease. The effects begin to show up decades after the initial infection; HCV is now the leading cause of end-stage liver disease (cirrhosis) and liver cancer.

Who is at risk for HCV, and who should be tested? HCV is a virus transmitted person to person by exchanging blood or blood-tainted body fluids. The virus is not transmitted casually, and you will not be infected by engaging in normal social activities with infected individuals. Before developing a test to check for HCV in 1992 for blood donors, approximately

10 percent of all units of blood were contaminated. So anyone who received a transfusion before then is potentially at risk.

The majority of new infections occur in people who engage in activities such as injectable drug use with needle sharing, getting a piercing or tattoo in any setting other than a licensed establishment that strictly follows health department regulations, intranasal cocaine use with sharing of straws or other paraphernalia, and sexual intercourse. Mother-to-child transmission also occurs occasionally.

Anyone who fits into the above categories is encouraged to be tested. Additionally, in 2012 the Centers for Disease Control and Prevention recommended that anyone born between 1945 and 1965 be tested. These baby boomers account for about 2 million of those infected – the vast majority of whom are unaware if they are infected.

There are important reasons to be tested. The first is to prevent transmission of the virus to others by modifying one’s behavior. Secondly, because of dramatic therapeutic advances, the disease frequently can be cured, either with current drugs or with ones that will become available soon. There is no latent or dormant state. Once your physician tells you the virus is gone, it stays gone (unless you are exposed again). Finally, it has been shown that advanced liver disease will improve once the virus is eliminated.

We have significant optimism that we can get ahead of the HCV epidemic.

In conclusion, all baby boomers, anyone who received a transfusion of blood or blood products before 1992, anyone who has engaged in activities involving exposure to the blood of other individuals, or anyone who has been sexually active with several partners may harbor hepatitis C.

Finding out if you have HCV is the first step to getting rid of it. The CDC website – cdc.gov – can provide you with additional information about all aspects of the disease.

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