Hep C Infections Largely Undiscovered

Hepatitis C infections unknown to many of those infected and treatment rates are low

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Hepatitis C is a term many people are familiar with, but don’t really devote much thought to – and that may represent part of a very serious problem.

A new report in the New England Journal of Medicine stated that only around half of people infected with hepatitis C are aware they are infected, with even fewer people being referred to medical care — and still fewer being successfully treated.

"Ask your doctor if you should be tested for Hep C."

A hepatitis C infection can cause major damage to the liver, but it does so slowly and over time, meaning many people with the infection won’t see symptoms for years. According to the Mayo Clinic, it is generally thought to be the most serious type of hepatitis infection and is spread through contaminated blood.

Led by Scott D. Holmberg, MD, MPH, of the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC), the authors of this new article claim, “Care for hepatitis C is evolving rapidly, with increasingly effective and better-tolerated antiviral therapies being evaluated and approved for use.

“It’s clear, however, that not everyone who would qualify for therapy has been tested and identified, referred for appropriate care, and offered or given the best therapy available,” wrote Dr. Holmberg and team.

The authors utilized data from two large national studies: the Chronic Hepatitis Cohort Study (CHeCS), which involved over 13,000 hepatitis C patients, and the National Health and Nutrition Examination Survey (NHANES), which involved 5,000 participants.

After analyzing the data, the authors estimated that there are 3.2 million people in America living with hepatitis C, but that only around half of these people have been tested for the virus and are aware of their infection.

Furthermore, the authors deduced that between 63 and 77 percent of people who tested positive for hepatitis C receive follow-up care – a number that amounts to around only 32 to 38 percent of all infected Americans. 

Dr. Holmberg and team also estimated that between 5 and 6 percent of all hepatitis C-infected people in the US have been treated successfully (usually with antiviral therapy), though they noted that this estimation is more difficult to establish.

One problem blocking proper care is a high cost of treatment. According to the authors, a full course of therapy for some antiviral drugs used to treat hepatitis C can cost more than $70,000.

“This big picture suggests that there are many points of intervention – or opportunities – to improve the identification and care of patients with HCV [Hepatitis C virus] and to mitigate the increase in hospitalizations and deaths resulting from HCV infection,” the authors wrote.

The authors mentioned the CDC’s recent recommendation of a one-time hepatitis C test for all people born between 1945 and 1965. The authors also highlighted a need to increase rates of care for people already aware of their infection.

The article was published on May 16 by the New England Journal of Medicine. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
May 16, 2013
Last Updated:
August 12, 2013