Baby boomers in Hawaii face an elevated risk of being infected with hepatitis C, and officials recommend they be screened for the virus, which can hide out for decades in their cells undetected and eventually cause serious liver damage and cancer.
"Even though we have high rates of hepatitis in Hawaii, most people who have it don’t know that they have it," said Thaddeus Pham, adult viral hepatitis prevention coordinator for the state. "They don’t do anything to treat it, and then it possibly leads to liver cancer or other liver complications."
The Centers for Disease Control and Prevention issued a nationwide call for everyone born between 1945 and 1965 to take a one-time blood test for hepatitis C, a contagious liver disease. The advice is especially apt in Hawaii, which has the nation’s highest rate of liver cancer, with viral hepatitis the leading cause.
A Nov. 17 symposium, "Viral Hepatitis in Hawaii: 2012," will focus on prevalence, evaluation and treatment of the blood-borne disease. Presented by the Hepatitis Support Network of Hawaii, the meeting at the Queen’s Conference Center is aimed at health care professionals, substance abuse counselors, social workers and students but is also open to the public.
"The main thing we’re trying to do is prevent liver failure, cirrhosis or end-stage liver disease and liver cancer," said Dr. Daniel Saltman, an internist at Waikiki Health Center and course director for the symposium. "You can’t live without your liver."
Nationally, 1 percent to 2 percent of the population is infected with hepatitis B or hepatitis C. In Hawaii, 1 percent to 3 percent of residents have hepatitis B, and about 2 percent are infected with hepatitis C, according to the Hepatitis Support Network of Hawaii.
Baby boomers nationwide are five times as likely to be infected with hepatitis C as the general public, according to the Centers for Disease Control, but most are unaware of it.
"I had zero symptoms, absolutely none," said Jane Hanson, a baby boomer and social worker who contracted hepatitis C through a transfusion, before the nation’s blood supply was screened for the virus. She didn’t get treatment until her liver function tests "went sky high" in 2005, she said.
"At that point Iāfound out that I had quite significant liver damage and needed to be treated immediately," Hanson said. "People often have zero symptoms until they are near liver failure. And you don’t want to wait that long."
Hanson, who went through treatment and was cured, became the hepatitis care coordinator for Hep Free Hawaii in January. The mission of the nonprofit is to educate people about the disease, prevent its spread and provide access to screening and care.
Deaths from hepatitis C-related diseases, such as cirrhosis and liver cancer, have risen steadily nationwide for more than a decade and now outnumber deaths from HIV, according to the Centers for Disease Control. The incidence of primary liver cancer in Hawaii was 9.6 per 100,000 residents, well above the national rate of 6.3 per 100,000 residents, according to "Hawaii Cancer Facts and Figures 2010." And the disease is deadly.
"If you have liver cancer, your chance to die is much higher than if you have breast cancer or colon cancer," said Dr. Naoky Tsai, a professor at the University of Hawaii Medical School and medical director of the Liver Center at the Queen’s Medical Center.
HEPATITIS C
>> People born from 1945 to 1965 should have a blood test for hepatitis C. >> Baby boomers are five times as likely to be infected as the general population. >> Most infected people don’t know they have it, but as they age, their risk of serious liver disease grows. >> Early detection and treatment can prevent liver damage and cancer.
Source: Centers for Disease Control and Prevention
QUESTIONS?
To learn more or to be tested for hepatitis C, contact your health care provider, call 211 or visit www.hepfreehawaii.org.
SYMPOSIUM
“Viral Hepatitis in Hawaii 2012” >> When: 8 a.m. to 4 p.m. Nov. 17 >> Where: Queen’s Conference Center, 510 S. Beretania St. >> Presenter: Hepatitis Support Network of Hawaii >> Cost: $50, including lunch; $25 students >> Register online: www.hepatitissupportnetwork.org/symposium2012. html >> Email: hepsymphawaii@gmail.com >> Also: Attendees can earn Continuing Medical Education credits. |
The good news is that it is easy to screen for hepatitis C with a simple blood test, and new treatments have boosted cure rates.
"We now have very, very effective therapies to cure the disease," Tsai said. "We anticipate probably by the end of this decade, we should achieve close to a 90 percent cure rate for hepatitis C."
In the past, screening for hepatitis C was targeted to high-risk groups, such as those exposed to blood through unsanitary needles. But the prevalence of the disease among baby boomers, who account for 75 percent of adults with hepatitis C, triggered the broader warning by the federal government in August.
Many people do not know how they were infected. They may have been exposed through unsterilized needles, medical instruments, razor blades, piercings or tattoos. They may have received contaminated blood before 1992, when screening began for hepatitis C in the blood supply. It is also possible for blood-to-blood contact to occur through shared use of straws while snorting drugs that damage nasal passages.
"Anything that pierces the skin and there is blood involved can be a risk for hepatitis B and hepatitis C," Pham said.
Most people carrying the hepatitis C virus feel fine. As they get older, they are more likely to develop serious liver disease. There are generally no acute symptoms with the initial infection, which usually leads to chronic hepatitis C.
"The symptoms are nonspecific — things like fatigue and joint pains that everyone has for all kinds of reasons: Those are also the symptoms of hepatitis C," said Saltman, the Waikiki Health Center internist.
The word "hepatitis" means inflammation of the liver and also refers to viral infections of the liver, a large organ that plays crucial roles in the body, from processing nutrients to removing toxins. Hepatitis A is an acute disease that is cleared by the body, while hepatitis B and C can become chronic and are the leading causes of liver cancer. Children in Hawaii are vaccinated against hepatitis B, but there is no vaccine for hepatitis C.
"The reason to get tested is to ensure that you and your family stay healthy," Pham said. "You can take care of something that is treatable before it becomes something that is not treatable, like liver cancer. … The earlier people know they have hepatitis, the better the outcome."
The state Health Department advises individuals to contact their health care providers to be tested for hepatitis C, or to call 211 or visit www.hepfreehawaii.org.
The Waikiki Health Center, which has several sites on Oahu, provides testing and treatment for hepatitis, and welcomes patients with or without insurance. It also screens 1,500 people annually statewide for hepatitis in substance abuse treatment facilities.
"We’re seeing new hepatitis patients regularly, and we do our very best to accommodate their needs," said Marc Gannon, chief of special programs at the center. "We offer a well-rounded, comprehensive approach to treatment."
State health officials encourage Hawaii residents who were born in Asian or Pacific island nations to be screened as well for hepatitis B, which is more prevalent in those areas. That virus can be transmitted through blood, from mother to newborns at birth, or through sexual contact.
"Viral hepatitis is a significant public health burden for our state," said Tsai, who will speak at next week’s symposium. "Since we now have very good treatments for both hepatitis C and hepatitis B, hopefully through this education we can get more people tested and under management or treatment. We can decrease the burden of the disease for the community, the number of people who have to be transplanted, the people who lose their lives."