Hepatitis C-Associated Deaths, Hospitalizations Increasing in Rhode Island, According to New Report


New Treatments Available that Can Cure the Infection

Rhode Island has seen a significant increase in hepatitis C virus-related
hospitalizations and deaths in the last decade, underscoring the importance of
diagnosis and treatment, according to a new report released today by the Rhode
Island Department of Health (RIDOH) and the Rhode Island Public Health Institute

“Building healthy communities and a healthy, thriving Rhode Island means working to
eliminate infectious diseases such as hepatitis C,” said Director of Health, Nicole
Alexander-Scott, MD, MPH. “As the first comprehensive epidemiological profile of
hepatitis C in Rhode Island, this report will be an invaluable tool in our work in
the areas of hepatitis C prevention, testing, diagnosis, and treatment, which
together will saves lives.”

Some key findings of the report include:
* Hepatitis C-related deaths rose from 25 in 2005 to 102 in 2014, based on death
certificate data, which may underreport hepatitis C-related deaths.
* The number of inpatient hospitalizations with a primary discharge diagnosis of
hepatitis C increased six-fold between 2005 and 2014.
* Clinical and laboratory reports since 2009 suggest significant increases in
hepatitis C diagnoses at hospital systems throughout Rhode Island, and screening
data from both inpatient and outpatient clinical settings suggest that hepatitis C
prevalence is much higher than previously estimated.
* The Rhode Island Department of Corrections has significantly increased its efforts
in the areas of screening and treatment since 2013.
* Safe, highly effective hepatitis C medications are now available. These
medications create an opportunity to reduce rates of hepatitis C and, cure the virus
in a few weeks or months.

“The rise in hepatitis C-related death rates is alarming. However, the good news is,
we have medications that can cure people living with hepatitis C,” said Dr. Amy
Nunn, Director of RIPHI. “The first step in curing Rhode Islanders of hepatitis C is
screening. Both Baby Boomers and anyone who is at high risk, such as people who have
used injection drugs or people who received blood transfusions prior to 1992,
should ask their physicians to screen them for hepatitis C. People should then seek
evaluation and treatment if they have hepatitis C .”

Hepatitis C virus can cause a liver disease that ranges in severity from a mild
illness lasting a few weeks (acute hepatitis C) to a serious, lifelong illness
(chronic hepatitis C). Health impacts of hepatitis C can include liver damage, liver
failure, and liver cancer. This results from infection with the hepatitis C virus,
which is spread through direct blood-to-blood contact with the blood of an infected
person. Hepatitis C is the most common blood borne illness in the United States.
Between 3 and 5 million people in the United States have chronic hepatitis C.

All Baby Boomers (people born in the United States between 1945 and 1965) who have
not been previously tested for hepatitis C should do so at least once. Approximately
75% of the people who are living with hepatitis C in the United States were born
between 1945 and 1965. This is because of high rates of transmission of hepatitis C
between the 1950s to 1980s, before the discovery of hepatitis C in 1989. Most Baby
Boomers were infected decades ago, do not believe themselves to be at risk, and have
never been screened.

The increases in hospitalizations and deaths are partially attributable to the fact
that, as Baby Boomers age, the illness is progressing in those who are infected and
are unaware of their infection. The symptoms and health impacts of chronic hepatitis
C are often not experienced until later in life. Increases in diagnoses may also be
attributable to increased testing and increased use of injection drugs.

Other people who should be tested, in addition to Baby Boomers, include:
* People who have ever injected illegal drugs, including those who injected only
once many years ago.
* People with a history of intranasal (through the nose, or snorting) drug use,
including those who snorted only once many years ago. An example is snorting
* All people with HIV infection.
* People who received clotting factor concentrates made before 1987.
* People who received a blood transfusion or solid organ transplants before 1992.
* People who have ever received long-term hemodialysis treatment.
* People with signs or symptoms of liver disease (e.g., abnormal liver enzyme blood
* Children born to hepatitis C-infected mothers.
* People who received unsafe medical injections (steroids, for example).

People should see their primary care providers to get tested for hepatitis C.

Although high prices have prompted some health plans to restrict access to treatment
to individuals with more advanced stages of hepatitis C, testing is still extremely
important for Baby Boomers who have not been previously tested and for people who
fit into one of the categories listed above. This is because without testing leading
to diagnosis, people cannot know if they have hepatitis C. Often, even people with
later stage hepatitis C, who may be a priority group for receiving treatment, do not
have symptoms.

RIDOH is working closely with the Rhode Island Department of Corrections and with
insurers, including Medicaid, to continue expanding access to hepatitis C treatment
for Rhode Islanders who would benefit.

A copy of the complete report is available online