According to the World Hepatitis Alliance, there are 325 million people worldwide living with viral hepatitis—and 300 million of those are unaware they have the disease. The World Health Organization (WHO) has a goal to eliminate hepatitis by 2030, as more than 60% of liver cancer cases are due to late testing and treatment of viral hepatitis B and C infections. July 28, 2019, is World Hepatitis Day.
With the advent of direct-acting antiviral (DAA) drugs, the cure rate for most strains of the hepatitis C virus (HCV) approaches 100% with adherent patients. Currently, the underdiagnosis and undertreatment of HCV is undermining the United States’ goal to eliminate HCV. The Centers for Disease Control and Prevention (CDC) estimates that there were 2.4 million Americans living with HCV in 2016, but only 2,967 cases were reported to the CDC that same year.
In 2012, the CDC, in conjunction with the U.S. Preventive Services Task Force (USPSTF), recommended that all individuals born between 1945–1965, also known as the “baby boomers,” be tested for HCV. National prevalence data shows that HCV infections are five times more likely to be found in this age group; approximately 75% of people living with HCV were born during this range. However, since the screening recommendations were published, some states do see young adults with HCV outnumbering baby boomers with HCV.
NPs in primary care have the opportunity to contribute to the elimination of hepatitis C in their individual communities. A 2017 study in the Annals of Internal Medicine found that non-specialist providers—including NPs—can safely and effectively use DAA-based HCV therapy in real-world community health centers. As such, it’s imperative that NPs work to make screening more accessible and routine for their patients.