An estimated 80,000 Arizonans live with hepatitis C, one of Arizona’s most commonly reported infectious diseases, according to the Arizona Department of Health Services. Unfortunately, half of those with hepatitis C are unaware they are infected, causing the disease to spread even more rapidly. The Hepatitis C Care Team at North Country HealthCare is actively working to raise awareness of the hepatitis C virus (HCV) and to provide screenings and treatment to prevent the spread of this potentially deadly disease in Northern Arizona.
Hepatitis means inflammation of the liver. Hepatitis C is a viral infection of the liver that is caused by the hepatitis C virus; it is the most common infection spread by blood in the United States, according to the Centers for Disease Control and Prevention (CDC). There is currently no vaccine for HCV. The best way to prevent it is to avoid behaviors that can spread the disease.
HCV is transmitted by blood-to-blood contact, which can happen via injection drug use, tattooing or body piercing, sharing personal hygiene items such as nail clippers or a razor, or blood transfusions, especially prior to 1992. HCV can also be transmitted during intercourse or from a mother to her child during childbirth, although both cases are rare.
About 15 out of 100 people who are exposed to HCV can fight off the virus with their own immune system. For some people, HCV is a short-term illness, but for 75-80 percent of those infected with HCV, it becomes a long-term, chronic condition. Left untreated, chronic hepatitis C continues to damage the liver and can result in cirrhosis, eventual liver failure and even death.
Those outcomes can often be prevented with treatment. In fact, 99 percent of those who receive treatment for chronic HCV are cured. Treatments for HCV have seen huge improvements in the past five years, and new drugs are being developed at a rapid rate.
Unfortunately, many living with chronic HCV are not able to be treated because of a number of barriers. The two largest barriers are cost and behavioral issues. First, treatment for HCV is very expensive; costing around $90,000 for one patient. Because of cost, insurance companies must target their resources on those who are the most sick. Lab results determine how sick a patient is, not symptoms. Many patients will not feel symptoms and will not be able to tell how sick they are on their own. Second, behavior issues also prevent treatment. Those who are current alcohol or drug users are not eligible to be treated. Also, those with severe, untreated mental illness are also not able to be treated. Once these issues are addressed, the patients can then be eligible for treatment.
North Country HealthCare’s longstanding HCV Care Team does everything it can to remove barriers to treatment and improve patients’ quality of life by supporting all aspects of patients’ well-being. North Country’s providers care for and educate patients, helping them to manage their health and prevent spreading the virus. For those who can be treated, the HCV Care Team works to get approval from their insurance to pay for treatment. The team also assists patients who have been denied by insurance or are uninsured by applying for assistance programs to help cover the cost of treatment. Team members work closely with patients undergoing treatment to ensure they are taking medications, completing necessary blood tests and following up with specialists, as appropriate. FBN
The HCV Care Team is made up of providers, clinical pharmacists, behaviorists, health coaches, a program coordinator, and other support personnel. For many years, the HCV Care Team has worked with specialists from Banner Medical Center using telemedicine in a collaboration called Project ECHO. Through this partnership, North Country HealthCare providers work with leading HCV specialists to treat and cure HCV in the primary care setting.
Patients who are not actively being treated are also supported with education and other services to help them either become eligible for treatment or slow the worsening of their disease. To date, 131 patients have completed HCV treatment at North Country HealthCare, and 30 more are currently in treatment.
By Kimberly Chen
Kimberly Chen, BSPharm is the Director of Pharmacy for North Country HealthCare. She has been practicing pharmacy over 24 years and has been in Flagstaff since 2001. Kimberly received her degree from the University of Cincinnati, James Winkle College of Pharmacy. Kimberly is passionate about patient care and improving patients’ access to services, especially clinical pharmacy services.
About North Country HealthCare
North Country HealthCare serves as the medical home for nearly 50,000 people throughout northern Arizona, 20,000 who reside in Flagstaff and the surrounding area. North Country HealthCare accepts Medicare, AHCCCS, commercial insurance and offers a sliding fee scale based on income and family size. If you are in need of a medical home, North Country has a large and diverse provider team and is always accepting new patients. For more information on the locations, programs and services, call 928-522-9400 or visit northcountryhealthcare.org. Like North Country HealthCare on Facebook.