What do you know about hepatitis C?
Did you know that it is the most common bloodborne infection in the United States? That it is five times more common than HIV, yet has a fraction of the government funding for prevention, care and research? That it is often called a silent killer, because infected people can live without symptoms of the virus for as long as two decades before showing signs of liver disease like cirrhosis or liver cancer? Did you also know that 50% to 75% of people living with hepatitis C don't even know they are infected? Or that, because hepatitis C often goes undiagnosed until significant liver damage has been done, it now kills more people a year in the United States than HIV?
As a clinician whose work focuses on hepatitis C, I see its impact every day. But how do I get the average Philadelphian to pay attention? With World Hepatitis Day on July 28th quickly approaching, I felt I needed a new strategy. So, I did what everyone else with a computer does when they don't know the answer – I Googled it. And among the things I found is a different, but increasingly effective way to draw the public's attention to this difficult issue: a dancing flash mob (for other Australian videos of a dancing liver, click here; he's cute!).
So, along with my colleagues at HepCAP (Hepatitis C Allies of Philadelphia), I have become obsessed with creating a Philadelphia version of this fun event – 1:30 p.m. Friday at LOVE Park, 16th Street and J.F.K. Boulevard – to raise awareness about hepatitis C. (Click here for an update: It was a success!) But you may still wonder: Why should I care about World Hepatitis Day, let alone come out to Love Park and dance with a large liver mascot? Because this is the only time in your life that you are likely to see a human-sized dancing liver mascot, or even have the opportunity to dance with one.
Dancing livers aside, the grim statistics should also push you to learn more. Even if you don't know anyone affected by hepatitis, you probably know many Baby Boomers, who make up the vast majority of people living with hepatitis C. Although people born between 1945 and 1965 make up a about a quarter of the U.S. population, they account for about 75% of all hepatitis C (HCV) infections and 73% of HCV-associated deaths, and are at greatest risk for liver cancer and other HCV-related liver disease. The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF), an independent advisory panel of experts, recognize the urgency of increasing the number of Baby Boomers aware of their hepatitis C status and recommend that all everyone – e v e r y o n e – born between 1945 and 1965 be tested once in their lifetime. People who report hepatitis C risk factors, like a blood transfusion before 1992, injection drug use, or getting a tattoo in an unlicensed setting should also be screened.
The reason to test is simple: hepatitis C can be cured. Knowing their status allows people to get into care, so they can learn how to keep their liver healthy and obtain the medication they need to be cured of their infection. The way we treat hepatitis C is rapidly evolving; there are many new drugs in development that are more effective, promise a shorter duration of treatment and are much easier to tolerate.
In Philadelphia alone, 40,000 people have been diagnosed with hepatitis C, yet many, many more are unaware of their infection. We can do better! If we don't, Philadelphia's Baby Boomers will eventually learn of their HCV diagnoses when they have symptoms. For some, this will be too late to prevent deaths that could have otherwise been prevented. And for most of them, it will result in millions and millions of health care dollars needlessly spent on managing end stage liver disease, hepatocellular carcinoma, and for a few of the lucky ones, a liver transplant. Until recently, roughly half of people with the most common genotype of hepatitis C could not be cured. That has changed: Drugs that can effectively cure the disease have recently become available, and more than 90 drugs currently in development will make the treatments shorter in duration, easier to tolerate and more effective.
Even if public dancing with a large liver mascot isn't your cup of tea, there are other ways to get involved. One of the best ways is to join the HepCAP coalition, which is working to raise awareness and improve access to hepatitis services in Philadelphia. If you have already fulfilled your yearly quota of do-gooding and public health activism, then make sure that the next time you or a loved one – particularly someone in a high-risk group – visits a health-care provider, you ask to be tested for hepatitis C.
And if you've always had a hankering to two-step with a giant liver . . .
Hope to see you all there!
Stacey Trooskin, M.D. Ph.D., is in clinical practice, specializing in infectious diseases, HIV, and hepatitis C. She is the community co-chair of HepCAP and conducts research that focuses on the epidemiology of hepatitis C and identifying and overcoming barriers to testing and treatment.