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News & Press: MPCA News

Lack of HCV Testing Means a Losing Battle

Wednesday, October 18, 2017  
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by Loretta V. Bush, MSHA, CEO


According to the Centers for Disease Control and Prevention, about 3.9 million Americans are living with hepatitis C (HCV) — and many of them don’t know it. That’s because people can live with the virus for years before symptoms manifest, and by then, the virus may have led to complications such as cirrhosis or liver cancer. More than 50 percent of all liver cancer cases are HCV related.

So why aren’t more people getting tested and treated?

In the past, medical professionals recommended testing only for individuals within the so-called birth cohort (those born between 1945 and 1965) or those with certain risk factors, such as people who received blood transfusions, blood products, or organ donations before June 1992. But today, studies suggest that more than 90 percent of HCV transmission in developed countries, including the U.S., takes place through needle sharing and injection drug use. Between 2005 and 2015, the number of cases of chronic HCV in U.S. young adults increased by 302 percent, which loosely correlates to rise of the opioid epidemic.

It’s harder for many of those people to get care. Individuals with substance use disorders are often unfairly blamed for acquiring HCV (or HIV) and may even be seen as being “unworthy” of treatment. And unfortunately, some health care professionals are not immune from these value judgments.

This stigma, coupled with access to care challenges, is a massive barrier when it comes to diagnosing and treating the disease. A culture change is necessary to ensure that all physicians, especially those in underserved areas, can provide the care and treatment everyone rightfully deserves. Right now, only 16 percent of the people diagnosed with HCV are prescribed treatment.

We can’t win the war if we’re not even fighting the battle.

Fighting starts by routinizing and normalizing testing and treatment in primary care environments. In 2006, the Centers for Disease Control and Prevention recommended routinized HIV screening in all people aged 13–64 regardless of risk factors. By providing routine screenings at our community health centers, we can catch more people who are unaware of their status, link those people to care, and provide treatment. Routinization also helps to make HCV testing a matter of course, reducing stigma and encouraging people to get the care they need — without fear or shame.

There’s no excuse not to test. We have more tools than ever to increase our ability to provide HCV-related care. The Michigan Department of Health and Human Services (MDHHS) is working hard to provide technical assistance for the implementation of the HCV screening tool, as well as the incorporation of testing reminders in the Electronic Health Record. In addition, MDHHS labs will accept blood samples and conduct the HCV antibody test and HCV RNA test free of charge for Michigan health centers.

We can look beyond the state for help, too. Michigan health centers can apply to be a part of Gilead’s FOCUS program, which was created to increase partnerships and make routine HIV/HCV screening a standard of medical care. As part of the program, Gilead will provide seed money to help augment electronic health records for testing triggers. To learn more, contact Monique Rucker, Regional Lead for Michigan and Ohio, by emailing or by calling 410.207.6701 before October 23, 2017.

There is a cure. We just have to deliver it.

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