New treatments help health care workers and others with hepatitis C

SPONSORED: Safety protocols keep infection risks low for health care workers and first responders while improved treatments put a cure within reach for everyone infected with the virus.

No matter the profession, workplace injuries are always a concern. But for health care workers and emergency first responders, including nurses and doctors, EMTs and firefighters, those occupational hazards include the risk of contracting viruses which, if undetected, may result in a lifetime of serious health issues.

Until recent improvements in treatment, hepatitis C was one of those viruses. A bloodborne pathogen, the hepatitis C virus is transmitted almost exclusively through exposure to infected blood, said Dr. Brian McMahon, medical and research director of the Alaska Native Tribal Health Consortium Liver Disease and Hepatitis Program.  It is a chronic inflammatory disease that ranges in severity from mild to serious. Those infected with the virus often don't realize it until they start to get sick, which may not happen for many years.

"It's a silent disease until something happens," he said. Early symptoms, such as extreme fatigue, body aches or headache, can easily be attributed to lifestyle or another less serious illness and thus are often ignored. Yet left untreated, hepatitis C can lead to cirrhosis of the liver, increase the patient's risk of developing liver and other types of cancer and increase the risk of heart attack or stroke, McMahon added.

Two to three percent of baby boomers born between 1945 and 1965 have chronic hepatitis C and the Centers for Disease Control and Prevention recommends that all these persons be tested one time for hepatitis C. This testing will be paid for by insurers.

While hepatitis C can be transmitted through blood-to-blood contact, it's important to note that it cannot be transmitted by casual contact. A person cannot contract the virus through kissing, hugging, sneezing, coughing, breastfeeding, sharing food and drink or sharing eating utensils.

Elevated risk, low infection rate

The exposure risk is heightened for health care workers and emergency first responders due to almost daily blood exposure. In the health care setting, exposure is almost exclusively due to accidental injuries from needle sticks and sharps — syringes, lancets, auto-injectors and other implements that come in contact with infected blood. According to the Centers for Disease Control, more than 1,000 hospital health care workers are injured each day due to accidental needle sticks or sharps exposure, with a 1 in 50 chance of being infected with hepatitis C.

Yet despite the increased exposure risk, the CDC reports that the rate of hepatitis C infection among all health care workers averages only 1–2 percent, which is no greater than the infection rate among the general population.

"In health care workers, that's really a pretty small percentage, and that doesn't appear to be changing much," said Kim Spink, Healthcare-Associated Infections Coordinator/Nurse Epidemiologist with the Alaska Department of Health and Social Services.

Precautions

That low infection rate is due in large part to the adoption of standard safety precautions and safe injection practices in hospitals and other health care settings, both of which are designed to minimize workers' exposure to hepatitis C and other bloodborne viruses, she said.

"It (the risk of infection) really has to do with the precautions that they take, particularly early on," Spink said.

Those precautions include proper hand hygiene, using soap and water or antiseptic hand washes or hand rubs, the use of protective barriers such as gloves and face masks, cleaning and sterilizing scopes and other medical instruments and appropriate use and disposal of needles and other sharp objects, she said. Needles and other injectables are also now being made with enhanced safety features to minimize the risk of accidental needle sticks.

For health care workers who have potentially been exposed due to an accidental needle stick, the CDC recommends immediate and follow-up testing, as it can take up to six months for hepatitis C virus antibodies to appear in the bloodstream. Despite the increased risk of exposure, infection rate is so low that routine testing for health care workers and emergency responders is not recommended, absent a recognized exposure to the virus.

The good news

Yet even if infection occurs despite taking all precautions, treatment options have improved dramatically so that hepatitis C is no longer considered the death sentence it once was, especially if the virus is detected early, McMahon said.

Today's treatment regimen consists of a single pill, taken at least once daily for 12 weeks, which may be comprised of one or more different drugs, depending on the genotype the patient has contracted. And they promise a 95 percent cure rate. That's a marked difference from past treatment options, which involved a year-long regimen of pills and promised only a 50 percent cure rate.

Side effects of the new treatment have decreased as well, and are generally so mild that patients undergoing treatment experience minimal disruption in their lives.

"Mild headache, upset stomach, uneasiness in the stomach, tired," McMahon said, rattling off side effects his patients have reported experiencing as they undergo treatment. "The side effects are pretty darn mild. Patients tell us it's tolerable. And when they're done (with treatment), they have a lot more energy and feel phenomenal."

And with new and improved drugs in constant development, those receiving treatment for hepatitis C — whether they're health care workers, first responders or in an unrelated profession — have every reason to believe they'll live out their normal lifespan free of the virus. For McMahon, that's a cause for celebration.

"I've been a doctor for 40 some years, and I've never seen anything like this before," he said of the new treatments. "It's just this incredible feeling (to know) you're curing someone with a disease that could be potentially fatal."

 

This article was produced by the special content department of Alaska Dispatch News in collaboration with ANTHC. Contact the editor, Jamie Gonzales, at jgonzales@alaskadispatch.com. The ADN newsroom was not involved in its production.