Thanks to medical breakthroughs, doctors can probably cure your hepatitis C. But if you don’t get treatment, it can lead to liver disease, liver cancer, or death. Despite this, there are fewer people with hepatitis C who start treatment than there were a few years ago.
The number of cases is rising in the 18 to 40 age group, and it infects about 2.4 million people in the U.S. The CDC says about 120,000 of those start treatment with direct-acting antiviral (DAA) drugs each year. But to meet public health goals and wipe out hepatitis C by 2030, that number needs to grow to 260,000 annually.
Here are some other facts about hepatitis C:
- About 58 million people worldwide have ongoing (chronic) hepatitis C virus infection (HCV).
- In the last 10 years, direct-acting antiviral (DAA) medicines became available, which transformed how doctors treat hepatitis C.
- Today doctors can cure about 95% of people with hepatitis C.
- Only about 1 in 3 people who have hepatitis C and health insurance get treatment for the illness.
Why Do Some Delay or Ignore Treatment for Hepatitis C?
Meds that are safe and work well to treat hepatitis C have been available for years, but many people with the condition delay treatment or avoid it altogether.
If your hepatitis C isn’t treated, you can pass it to others through your blood. It can also cause you to have other serious health problems including liver scarring (cirrhosis) and liver failure.
But even with advances in treatment, many people put it off or decide not to get it at all. The reasons are complex. Here’s a closer look at some of them:
You’re symptom-free. About half of those with the virus that causes hepatitis C live with it for decades without any symptoms. You might not have symptoms until the virus seriously damages your liver, causing liver disease.
Cost. Even though their price has fallen, direct-acting antivirals can still come with a high cost. And Medicaid may not cover the expense of hepatitis C treatment.
Treatment restrictions. Some states limit access to DAAs by requiring you to meet specific criteria. For example, you must have liver damage (fibrosis), be sober from alcohol and drugs, and get a prescription from a liver disease or infectious disease specialist. Certain states have eased restrictions so more people can get hepatitis C treatment.
Disparities in health care. A CDC study found that people of color enrolled in Medicaid are 27% less likely to start DAA treatment than white people also enrolled in the program. Researchers think this imbalance is due to access, a lack of doctors and other health care professionals, quality of care, distrust of the health care system, stigma, and language and cultural barriers.
COVID-19. The pandemic disrupted many aspects of life, including health care. Researchers looked at its impact on hepatitis C treatment. They found the number of hepatitis C prescriptions dropped in 2020 by 43% compared to the previous 2 years. The numbers rebounded a bit in the next few months, but only by a small amount.
Treatment is out of reach. For many people, hepatitis C treatment isn’t part of their regular doctor’s visits or offered where they get health care.
Delayed specialist visit. It may take a while to see a hepatitis specialist, which can delay treatment. Your regular doctor may not understand the ins and outs of the disease and hold off on making a referral. You could face long wait times to see a specialist, or you might have to travel far from home. A Canadian study found it takes around 6 weeks to see a hepatitis C specialist.
Drug misuse. Your chances of getting hepatitis C go up when you inject or inhale illicit drugs. Studies found that people who inject drugs face barriers to care, including low screening and treatment numbers and the chance of repeated infections. America’s opioid crisis has also worsened the treatment gap.
Removing Barriers to Treatment
Everyone 18 to 79 years old should be screened for hepatitis C, even if they don’t have symptoms or liver disease.
Doctors and other health professionals, insurance companies, and policymakers need to work together to help more people get hepatitis C screening and treatment.
Health advocates say this involves:
- Doing away with requirements and restrictions that make it harder to get hepatitis C treatment
- Offering screening and treatment in more places like your regular doctor’s office, community clinics, syringe services programs, drug treatment centers, and prisons
- Limiting the number of visits needed for treatment
- Allowing more primary care doctors to offer hepatitis C treatment
Show Sources
Photo Credit: Towfiqu Barbhuiya / EyeEm / Getty Images
SOURCES:
CDC: “Too Few People Treated for Hepatitis C: Reducing Barriers Can Increase Treatment and Save Lives,” “New estimates reveal declines in hepatitis C treatment in the U.S. between 2015 and 2020.”
MMWR and Morbidity and Mortality Weekly Report: “Vital Signs: Hepatitis C Treatment Among Insured Adults — United States, 2019–2020.”
AJPM: “Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic.”
Canadian Journal of Gastroenterology and Hepatology: “Rate, delay and predictors of hepatitis C treatment in British Columbia.”
JAMA Network Open: “Modeling Hepatitis C Elimination Among People Who Inject Drugs in New Hampshire.”
