Common reasons people aren't treated for hepatitis C

Hepatitis C is a type of liver infection. It’s caused by a virus that spreads through infected blood or body fluids and affects more than 2 million adults in the United States, according to the Centers for Disease Control and Prevention (CDC). If left untreated, it can cause serious health issues, including liver damage, liver cancer, and even death.

The U.S. Preventive Services Task Force (USPSTF) is an independent group of health experts that recommends guidelines for disease screenings. They advise every person between the ages of 18 and 79 years old get screened for hepatitis C at least once in their lifetime. In addition to testing all adults at least once, the CDC also recommends screening pregnant people during each pregnancy. Anyone who’s been exposed to hepatitis C or who has risk factors for exposure may be tested more frequently.

There are treatments available that can cure the vast majority of hepatitis C infections. But published data show that many people don’t receive these potentially lifesaving medications. Instead, they become lost along the way during the care process. Here are some reasons why, and tips that can help.

Reason 1: Many people aren’t aware they have the virus

Most cases of hepatitis C don’t display noticeable symptoms, so it may be difficult to know if you’re infected. When symptoms do occur, they typically appear 2 to 12 weeks after exposure to the virus. They may include:

• Fatigue
• Depression
• Joint pain
• Abdominal pain
• Loss of appetite
• Jaundice (yellowing of the skin and eyes)
• Nausea or vomiting
• Dark urine
• Stool that’s clay-colored

It’s important for everyone to be aware of these symptoms, but perhaps especially people at high risk for hepatitis C. These include the following.

• People with abnormal levels of liver enzymes
• Those with HIV
• People who have been receiving long-term (maintenance) hemodialysis
• Healthcare workers or public safety officials exposed to blood infected with HCV
• People who currently inject or have injected drugs in the past
• People who received an organ donation or blood transfusion before 1992
• People who received clotting factor concentrates made before 1987
• People who received a blood donation from a person who later tested positive for HIV infection
• Babies born to people diagnosed with hepatitis C

People in high-risk groups should ask a healthcare provider (HCP) about testing. Tests look for antibodies (immune system proteins) that your body makes to help stop and destroy the hepatitis C virus, or they look for genetic evidence of the virus itself.

Getting tested is the first step, and if the test comes up positive, the next step is finding out which variant (called a genotype) you have. In the U.S., genotypes 1a, 1b, 2, and 3 are the most common.

Reason 2: The effectiveness and importance of newer treatments isn’t well known

Medications called direct-action antiviral (DAA) treatments can cure hepatitis C 95 percent of the time, according to the CDC. This is true no matter which genotype a person has. However, without treatment, less than 50 percent of people with hepatitis C successfully clear the virus from their body.

People may believe that they’re too sick for treatment to be effective. However, even if you have had unsuccessful treatment in the past, the odds of managing the infection are almost as good as the general population’s odds of managing it with treatment.

U.S. hepatitis C deaths have dropped more than 40 percent since DAA treatment was introduced in 2014, according to the CDC. Treating the condition can also help reduce the chances of serious health issues, such as cirrhosis of the liver.

Reason 3: Past treatment side effects were concerning

Past treatments revolved around the use of interferon and ribavirin, which required weekly skin injections combined with pills. These treatments weren’t usually successful and had so many unpleasant side effects that many people stopped taking the drugs. The newer interferon-free therapies are usually taken in pill form by mouth, and typically have no or mild side effects. When side effects do occur, they may include nausea, headaches, insomnia, and fatigue.

Reason 4: Many people are worried about the cost of treatment

Even though the cost of DAA treatments has dropped significantly since they were first introduced, they’re still considered to be high-priced by many insurance providers. This is one reason the CDC says only about one in three people with insurance receive the treatment.

Ultimately, the amount you pay will depend on a number of factors, including your general medical condition and your insurance status. Discuss your coverage with your HCP and your insurance provider, whether it’s a private insurance company or a government program such as Medicare or Medicaid.

If you’re not insured or underinsured, the American Liver Foundation has a comprehensive list of financial assistance resources that may be able to help pay for treatment. Many drug-makers and organizations offer help.

Hepatitis C treatment can be lifesaving. If you have the condition or believe you might be at risk, talk with your HCP about your risk factors, screening, and the best ways to ensure you receive treatment.