Viral Hepatitis is an inflammation of the liver that results from infection with one or more of the Hepatitis Viruses. There are three primary forms of Viral Hepatitis in the US: Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV). All three hepatitis viruses present in acute infections, but Hepatitis A and B frequently clear without treatment interventions. Hepatitis C develops into a chronic infection in 80% of cases and, if left untreated, will likely result in chronic liver disease. The Hepatitis viruses are frequently asymptomatic, and often only show external symptoms when liver damage is present. Symptoms can include: jaundice (yellowing of skin and eyes), gray stools, fever, fatigue, and abdominal pain.
There are two primary populations at high risk for Hepatitis C:
Hepatitis C can NOT be prevented with a vaccine. Not sharing any injection drug works is crucial to prevent the transmission of Hepatitis C Virus. It is important to note that Hepatitis C Virus can survive on dry inanimate surfaces for up to three weeks and suspended in a syringe for up to sixty days. Using barrier protection is also effective in preventing sexual transmission of Hepatitis C Virus if there is blood present. Although bleach is the most readily available defense for Hepatitis C disinfection, it is important to note that it is not 100% effective at destroying the Hepatitis C virus. Using new works, or not sharing your works is the best defense against Hepatitis C for people who inject drugs—bleach should remain the last option.
Hepatitis C has a cure that is 97-99% effective at achieving a Sustained Virologic Response (SVR) in an 8-12 week treatment regimen (SVR means that the virus is no longer detectable 12 weeks after treatment). This differs from the previous Interferon based treatments which only achieved SVR in 50-60% of cases and were associated with debilitating side effects such as hair loss, extreme fatigue, and excessive weight loss. The new treatments are highly effective with minimal side effects, and if taken early enough, can prevent the onset of severe liver complications.
In August 2016, MassHealth, the Massachusetts State Medicaid program, removed liver fibrosis, sobriety, and prescriber restrictions that previously barred access to treatment coverage. If you receive insurance coverage through MassHealth, regardless of your plan, you can access treatment coverage. For more details, please see Hepatitis C: The State of Medicaid Access, a national summary report produced by the National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation at Harvard Law School.
Looking for payer specific information? The Center for Health Law and Policy Innovation at Harvard Law School compiled a 2017 coverage guide detailing treatment costs for specific insurers. Access it here.
Additional Viral Hepatitis Resources:
For more information regarding Viral Hepatitis prevalence and treatment, please consult the CDC’s Viral Hepatitis Overview.
A useful fact sheet to discern between the three primary forms of Viral Hepatitis: The ABCs of Hepatitis.
The CDC has also developed a guide with information specific to individuals who inject drugs:
The Harm Reduction Coalition released a comprehensive safety manual for people who inject drugs titled “Getting Off Right.”
The Center for Health Law and Policy Innovation at Harvard Law School developed a 2017 payer specific Hepatitis C Coverage Guide titled: Hepatitis C Treatment at A Glance: January 2017.