What is hepatitis C and why are so many people not receiving treatment for it?

Of the 1.7 million people in the US diagnosed with hepatitis C between 2013 and 2022, only a third (34%) could be considered “cured”. That’s the result of a survey of data that concluded far too many people lack access to treatment. High drug prices can limit the availability of the medication.

If that weren’t bad enough, the CDC reckons around 40% of those with hepatitis C in the US are unaware of their status. They have no idea of the serious damage it could be doing to their bodies.

A breakthrough medication became available for hepatitis C in the early ’00s. However, as this survey shows, a worrying number of US citizens have been unable to take advantage of it.

“Jarringly low”

Carolyn Wester, MD, MPH, director of the CDC’s Division of Viral Hepatitis, called the 34% cured figure “jarringly low” in a recent press conference to announce the results. Those aged 20-29 were least likely to be cleared of the virus.

Of the 1.7 million diagnosed with hepatitis C, half had commercial health insurance. A further 23% were covered by another payer — including self-payers — 11% by Medicaid, 9% by an unspecified payer and 8% by Medicare.

Those who had insurance through “another payer” were more likely to fall into the “not cured” camp. Those most likely cured were older and covered by commercial insurance plans.

Wester says some insurance plans restrict who is covered for hepatitis C medication. Or they require “burdensome preauthorization” before treatment can commence.

“All of these restrictions can delay or even prohibit access to these lifesaving medications,” she said.

“Overcoming these barriers can mean the difference between life and death. Everyone with hepatitis C deserves the chance to be cured.”

What is hepatitis C?

Hepatitis is an inflammation of the liver. Alcohol and other toxins can cause the condition, but it’s usually caused by a viral infection. The viral hepatitis sub-groups are A, B and C.

Hepatitis A is the milder form of the disease and most people will recover with or without treatment. There are vaccines to protect against hepatitis A and B. However, there is no vaccine for C: the most serious form of the illness.

Hepatitis C is caused by a virus and is often called the “silent killer”. This is because symptoms (fatigue, abdominal pain, fever, jaundice, dark urine) only begin to appear after the liver becomes significantly damaged, and that can take years.

However, just because you’re not experiencing symptoms, it doesn’t mean you should postpone treatment. The virus is quietly wrecking your liver and setting you up for future health issues.

Most people who become infected with the virus develop chronic hepatitis C. It is a leading cause of liver transplants and liver cancer. However, the CDC says that if caught early, hepatitis C is “curable in more than 95% of cases.”

Why should gay men be concerned?

Gay men are disproportionately represented in the hepatitis statistics. For example, they make up around 20% of all new hepatitis B cases.

Blood-to-blood contact is the main route of transmission for hepatitis C. It only takes a microscopic amount for transmission to occur. Poor infection control has caused outbreaks in health facilities while sharing needles or syringes puts drug users at risk. Tattooists and body piercers who don’t properly sterilize their equipment have also been linked to cases

Hepatitis experts also warn that anyone who shares banknotes or straws to snort cocaine consider testing. Nasal cavities are rich with blood capillaries, and it only take a tiny amount of blood on a straw to spread the hepatitis C virus.

It was previously thought that hepatitis C was not sexually transmitted. However, it’s now accepted that some transmission can occur through sex, particularly if there is a risk of bleeding.

The number of cases of sexual transmission may be relatively low, but if you engage in fisting, rough sex, share sex toys, or take part in group sex, you’re more at risk of hepatitis C.

For example, if you put a sex toy inside someone who has hepatitis C, and a small amount of blood gets on that toy, and you then put that toy inside yourself or someone else, transmission can occur.

Your physician may not ask you detailed questions about your sex life, and you may have little desire to volunteer such details. However, if you have any concerns, ask your doc about taking a test. You can live with hepatitis C for decades before you begin to fall ill, but the sooner you receive a diagnosis, and get medication, the better.

Hepatitis C can be fatal if left untreated.

Related:

This gay bathhouse wants ‘NoMoreC’ in Amsterdam

Will we soon have a vaccine to protect against this STI that is growing resistant to treatment?

Fingers crossed that this proves effective.