Rhode Island Responds to Increased Threat of Hepatitis C

In the last decade, Rhode Island has experienced an increase in hepatitis C (HCV) cases that have resulted in hospitalizations and deaths, which have prompted the Rhode Island Department of Health (RIDOH) and the Rhode Island Public Health Institute (RIPHI) to compose their first ever, comprehensive epidemiologic report using various data from HCV-related sources for Rhode Island. The report also includes a Hepatitis C Strategic Plan.

In the report, Nicole Alexander-Scott, MD, MPH, director of health, said, “Building healthy communities and a healthy, thriving Rhode Island means working to eliminate infectious diseases such as hepatitis C. As the first comprehensive epidemiological profile of hepatitis C in Rhode Island, this report will be an invaluable tool in our work in the areas of hepatitis C prevention, testing, diagnosis, and treatment, which together will save lives.”

Hepatitis C is a blood-borne virus that infects the liver. Approximately 70-80% of individuals who become infected with the virus have it as a long-term, chronic infection. The majority of infected individuals are sometimes unaware of being infected. In addition, the CDC also notes that recently, the most common causes of acquiring hepatitis C are through the use of sharing needles or through other equipment that is used to inject drugs into the bloodstream.

In the “Message from the Director of Health,” in the official report, Alexander-Scott outlined the Hepatitis C Strategic Plan, she said the plan, “will address four priority areas: expansion of HCV screening, care, treatment, and cure, with a focus on reducing and preventing liver disease and HC-related morbidity and mortality; strengthening HCV surveillance; education of healthcare providers and communities about HCV screening, care, and cure; and reduction in the transmission of HCV that is a consequence of substance abuse.”

According to a press release, the report includes a number of important findings concerning Rhode Island. From 2005 to 2014, the number of deaths related to HCV increased fourfold from 25 to 102 deaths. Since these numbers are taken from death certificate data, there is also a chance that the number of deaths caused by the virus may be underreported. In addition, between 2005 to 2014, the number of inpatient hepatitis C-related hospitalizations increased six-fold. Inpatient as well as outpatient clinical setting data suggest that the prevalence of hepatitis C is higher than previous estimates and data from both clinical and laboratory reports have shown a notable increase in HCV diagnoses throughout Rhode Island hospitals. Since 2013, the Rhode Island Department of Corrections has worked to improve the screening and treatment of the virus. Effective medications to treat the virus are now available in Rhode Island and with the aid of these medications, hepatitis C can be cured within a few weeks or months. This increases the potential to reduce the overall rates of HCV in Rhode Island.

In the press release, Amy Nunn, PhD, director of RIPHI, said, “The first step in curing Rhode Islanders of hepatitis C is screening. Both Baby Boomers and anyone who is at high risk, such as people who have used injection drugs or people who received blood transfusions prior to 1992, should ask their physicians to screen them for hepatitis C. People should then seek evaluation and treatment if they have hepatitis C.”

It is important that everyone, especially people born between 1945 and 1965 get tested for HCV because it has been estimated that 75% of people born within that time period have the virus. This is due to the fact that between the 1950s and the 1980s there were high transmission rates of the infection and people who had been infected during that time period, the “Baby Boomers,” have likely never been screened for the virus. They might not even know that they are infected.

Among those who should get tested for the virus are individuals who have injected any illegal drugs; those who have snorted drugs, such as cocaine, through the nose; anyone who has received a blood transfusion or solid organ transplant prior to 1992; anyone who has HIV, and others. The importance of testing for the disease is paramount because often, people do not know that they have HCV; people who are in the later stages of HCV often do not show symptoms.