Missouri health officials announce plan to address hepatitis C

Jun. 10—The state of Missouri is taking new aim at hepatitis C, a liver infection caused by a virus that is transmitted primarily through unprotected sex or contaminated needles.

The liver is an organ that removes toxins from the blood, and hepatitis C can attack it hard.

"It's the most common cause of liver transplants" in the U.S., said Dr. Uwe Schmidt, infectious disease specialist with Freeman Health System.

At its worst, while lying dormant for many years or decades, the infection can cause considerable inflammation of the liver, which can progress to liver scarring called cirrhosis — meaning "the liver doesn't work properly anymore and can lead to many complications," Schmidt said.

Advanced cirrhosis can cause the liver to cease functioning altogether, forcing transplant surgery.

Hepatitis C is one of the most significant dangers for the human liver, Schmidt said. Nationwide, between 2.4 million and 2.5 million people suffer from hepatitis C. There were 4,890 cases reported in Missouri in 2020, though many more most likely remain unreported.

"A lot of people have it ... and many don't know they even have it," Schmidt said.

That's the reality of hepatitis C, he said. Common symptoms — fatigue, poor appetite, itchy skin, weight loss — can often be mistaken for other, less severe health problems. "Giveaway" symptoms, however, include bleeding or bruising easily and dark-colored urine.

Missouri health officials have announced a new state program — Show Me the Cure — that's geared toward ridding the state of hepatitis C.

The initiative has three prongs: ensuring universal testing, improving health care outcomes for people living with the virus and preventing new infections.

"Missouri's hepatitis C plan provides a road map for the state to use to eliminate (it)," said Alicia Jenkins, viral hepatitis chief for the state health department. "This plan was developed in collaboration with diverse partners from across the state, which was essential for ensuring that the needs of Missourians were addressed in the plan."

State health officials hope to both educate and encourage individuals ages 18 to 79 to be screened for hepatitis C, even those without symptoms or known liver disease. According to Mayo Clinic, the largest group at risk includes individuals born between 1945 and 1965, a population five times more likely to be infected than those born in other years. For those who test positive, DHSS officials want them to receive immediate care from their local physician or health provider so the virus won't lie dormant for years.

Until recently, hepatitis C treatment required weekly injections and oral medications that many patients couldn't take because of other health problems — but no longer. Direct-acting antiviral tablets, of which there are several, have proven to be the safest and most effective medicines for treating hepatitis C, Schmidt said. Patients only need to take three pills daily for eight weeks — a vast improvement, Schmidt said, "with close to a 100% cure."

The state launched a program in January called Project Hep Cure to provide free hepatitis C testing and treatment to active participants in MO HealthNet, the state's Medicaid program. Project Hep Cure has tested more than 100,000 patients in 2022, diagnosing more than 17,000 residents and treating nearly 3,300, according to the Missouri Department of Social Services.

The Show Me the Cure plan and more information about hepatitis C can be found at health.mo.gov/mohepc.

Kevin McClintock is features editor for The Joplin Globe.