2. Scope of Second Year
9Health Fair is working with Hep C
Connection to promote hepatitis C
antibody screening at several 9Health Fair
sites:
Hep C Connection will assist with the
education and testing sign-up at these sites
4. Hep C Connection Staff
Please contact Chris Grano with
general questions about hepatitis C, the
screening, results, etc.
cgrano@hepc-connection.org
Please contact Sascha Larsen-Helbing
with questions or information related to
health fair staffing
slh@hepc-connection.org
5. Hepatitis C:
What You Should Know
Caused by the hepatitis C virus
(HCV)
HCV can live outside the body
Remains infectious for up to 6 weeks
First identified in 1989
Previously known as
“non-A/non-B hepatitis”
An accurate screening test was
developed in 1992
6. Hepatitis C
HCV is transmitted through contact with
blood of an infected person
“Blood to Blood” - in order to be infected,
blood containing the hepatitis C virus must
enter the bloodstream through an entry point
in the skin (cut, sore, tear, scrape, etc.)
There is NO hepatitis C vaccine
7. Hepatitis C - The Numbers
100 people infected
with hepatitis C
80 people
develop chronic
hepatitis C
20 people clear the
virus within
2-6 months
20 people never develop liver
damage or physical
symptoms
60 people will develop some level
of long-term symptoms or signs
of liver inflammation
16 people will develop cirrhosis
of the liver over 20 years
1 -2 people with cirrhosis will
Develop liver cancer after a
further period
Note: successful
antiviral treatment
can clear the virus in
about 75% of those
in this group.
8. “The Silent Killer”
At least 3.2 MILLION
Americans are chronically
infected with HCV
And half of them aren’t
aware they’re infected!
9. Hepatitis C
Risk Factors (1 of 2)
Have you ever injected drugs? Have you
ever snorted drugs?
Did you receive any blood, blood products or
tissues prior to 1992?
Are you a military veteran?
Have you ever been incarcerated?
Do you work or have you worked in a position
where you may be exposed to blood?
10. Hepatitis C
Risk Factors (2 of 2)
Do you have any tattoos or piercings that
may have been done without sterile
instruments and/or inks?
Have you ever received medical care in a
foreign country?
Do you live or have you lived with someone
who has hepatitis C?
Have you ever had sexual contact with
someone infected with hepatitis C?
11. Who Should Get Tested?
1. Anyone who has ever injected drugs – even
once, ever
2. Those who received blood or blood products
before 1992, or anytime outside the US
3. Recipients of unsterile tattoos or piercings
4. Someone with a known HCV+ sex partner
5. Baby Boomers (born between 1945-1965)
12. Hepatitis C:
An Epidemic Among Baby Boomers
Baby boomers (born 1945 – 1965) account
for more than 75% of cases of chronic HCV
infection in the United States
HCV infection prevalence rates are highest
among Americans born in the early 1950s
As baby boomers infected with HCV age,
their disease may progress from
asymptomatic infection to advanced liver
disease
Source: “Consequences of Hepatitis C Virus (HCV): Costs of a Baby Boomer Epidemic of Liver
Disease,” 2009 report by Milliman, Inc.
13. 2012 CDC Recommendations
August 2012:
The Centers for Disease Control and
Prevention recommend that everyone
born between 1945 and 1965 receive a
one-time screening for hepatitis C.
http://www.cdc.gov/knowmorehepatitis/
14. Most people who get infected with HCV have no
apparent illness after getting infected and
may never know they are infected
without receiving specific testing for hepatitis C!
The Importance of Testing
15. Get tested if you have even ONE risk factor
If you wait until you have symptoms to get
tested, it most likely means that your liver has
already sustained damage
This isn’t a standard test ordered at a physical
– you have to ask specifically for a hepatitis C
test!
HCC’s Testing Message
16. What Happens if You Test
Positive?
A positive antibody test result means you
have been infected with hepatitis C, and at
one point you may or may not have cleared
the virus
A confirmatory test called a viral load is
needed to confirm the presence or absence
of a virus
Hep C Connection is available to provide
more information and referrals
17. Hepatitis C is Manageable!
If you are HCV+, you can take steps to prevent or
slow liver damage!!
Lifestyle
NO alcohol or smoking
Discuss ANY medications with your healthcare provider
Diet
Reduce your intake of salt, fat and iron
Increase your intake of fresh fruits and vegetables and
your water consumption
Hepatitis A and B vaccinations
18. Hepatitis C is Treatable!
The goal of treatment is permanent clearance
of the virus
New drugs on the market and in development
Higher rate of clearance
Shorter duration of treatment
Fewer side effects
19. Hepatitis C is a
preventable, manageable
and curable illness!
Early identification is key
– get tested today!
20. MISSION: The mission of Hep C Connection
is to educate the general public about
hepatitis C and to provide resources and
support for those affected by the virus.
We offer a variety of prevention and support
opportunities for people living with hepatitis
C, their families and friends, and healthcare
providers
21. Awareness + Prevention
Educational Presentations
Confidential Testing
Health Fairs and Outreach
Linkage to Care
Support Network
Toll-free HelpLine
Local and Statewide Support Groups
Monthly E-newsletter
Advocacy
The hepatitis C virus is able to live outside of the body (unlike HIV and other viruses), but it can be eliminated with a 10:1 bleach solution.
*broken* skin – even if scabbed over, still vulnerable to virus entry
Not transmitted through ANY other body fluids!
A hepatitis C vaccine is being researched. Vaccines do exist for hepatitis A and B.
Approximately 1.1 million Americans infected with HIV (for comparison)
Most people don’t experience symptoms until their liver has sustained significant damage.
(*Risk factors are in order of most risky to least risky*)
Drugs:
- stigma of hepatitis C being an “addict’s disease,” but you can be infected just by injecting or snorting ONCE
- drug paraphernalia or “works” – water, cotton, cooker, etc. – that come into contact with blood can lead to infection
Pre-1992 blood/blood products:
- transfusion
- transplant
- long-term hemodialysis
- hemophiliac
Veteran:
- in-field transfusions
- air gun (“jet”) inoculations
- tattoos abroad
- drug use
Prison or Jail:
- shared personal items (razors, toothbrushes, nail clippers, etc.)
- prison tattoos
- fights
Work:
- needle stick OR blood splash to the eyes, mouth or on broken skin
- healthcare professionals
- emergency responders: firefighter, police officer, paramedic/EMT, etc.
- sanitation workers (come into contact with needles in the solid waste system)
(*Risk factors are in order of most risky to least risky*)
Tattoos/Piercings:
- at home
- in prison
- in a foreign country
Foreign Country:
- transfusion
- dental work
- surgery
Live with:
- shared personal items
Sex:
- menstruation
- rips and tears
- other STIs
- multiple partners
Unfortunately, some people have been infected in medical settings as well.
Why?
- an accurate test wasn’t available until 1992
- received blood or blood products prior to 1992 (ask them to recall hospital stays and investigate medical records)
- “experimented” with drugs in their youth
- got tattoos or piercings before regulations were set
- veterans, especially those who served in Vietnam
This Hepatitis C testing recommendation was made because:
There are high rates of Hepatitis C in people born during 1945-1965. People born during 1945 through 1965 are 5 times more likely than other adults to be infected. In fact, 75% of adults with Hepatitis C were born in these years. The reasons why baby boomers have the highest rates of Hepatitis C are not completely understood.
Testing can help prevent deaths from Hepatitis C. The numbers of people who will develop serious health problems and die from Hepatitis C are expected to rise rapidly in the coming years. Early diagnosis and treatment can help prevent liver damage, cirrhosis, and even liver cancer. It is estimated that one-time testing of everyone born during 1945 through 1965 will prevent more than 120,000 deaths.
There is a lack of awareness.Many people with Hepatitis C do not know that they have Hepatitis C. One-time testing of everyone born during 1945 through 1965 would find an estimated 800,000 undiagnosed Hepatitis C cases.
There have been recent advances in treatment.Two new medicines are now available, that when added to the standard treatment can increase the effectiveness and shorten treatment time for many people. For many people with Hepatitis C, medical treatment can result in the virus no longer being detected in the blood. This is referred to as a sustained viral response or SVR.
OraQuick hepatitis C antibody RAPID TESTING
Also uses whole blood (finger stick), however the test processes in the office and results are available in 20 minutes!
Antibody testing is free in our office (for those with risk factors) and should be fairly inexpensive in a clinic setting.
Elevated liver enzymes are also a prompt to get tested – prompt from previous 9Health Fair testing
ANY medications: prescription, over-the-counter, vitamins and supplements
Diet
Also – avoid shellfish, limit red meat and processed foods
Vaccines
People with chronic hepatitis C should receive immunizations against hepatitis A and hepatitis B, if they are not already immune to these viruses
Permanent clearance of the virus prevents cirrhosis and liver cancer
Current Standard of Care:
Direct-acting antiviral medications, typically combined with other DAAs and/or Ribaviron and Interferon
New classes are:
- protease inhibitors
- polymerase inhibitors
- NS5A inhibitors
Picture = patient education dinner and forum, January 2011