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OHA Hep C 070217

Jun 28, 2017|

AN INTERVIEW WITH DR. ANN THOMAS, A PUBLIC HEALTH PHYSICIAN WITH THE OREGON HEALTH AUTHORITY, ABOUT WHAT HEPATITIS C IS, HOW IT’S DIAGNOSED AND TREATED, AND IT’S INCIDENCES IN OREGON AND THE U.S.

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Automatically Generated Transcript (may not be 100% accurate)

You're listening to microscope and Entercom radio Portland public affairs program. I'm Gary blocks. On the show this time I would like to welcome doctor and Thomas doctor Thomas is the public health positions in you cute and communicable disease prevention section at the Oregon health authority public health division. Welcome to the show doctor. I. Certainly so on the show this time we wanna talk about hepatitis C. So maybe we should get started first by explaining to our audience what is hepatitis C. Sure. If he has the liver disease caused by infection with hepatitis C virus and people often don't know of other it actually does hepatitis a in hesitated beats. And they're all viruses. That act pretty differently but it. They have in common they all in fact deliver. Now it makes hefty differences is usually spread when blood from a person infected it would have the answers to the body of someone who's not infected. So hepatitis C infection can range from a brief illness lasting a few weeks. To a more serious than life longer road call chronic ailments. And about 75 CE 5% of people who are initially infected with hepatitis C get all chronic infection. Most people don't experience symptoms and her person affected. And many people don't have any sentence for the first ten to eighteen years after infection. Ten to fifteen years. That's a long time. Exactly and that's the problem you can do other things can damage your liver during that time centers. Drinking alcohol. Or taking medication that. Are trying to promote people like Tylenol condemn a looter if you take too high antidote and that liberty the team you know. You might be oblivious church 1020 even thirty years. How does somebody you get hepatitis C. It can be spread. Basically to blood. So before 1992. And widespread screening at the blood supply or supply for hepatitis he began in the United States. The infection would spread to transfusions. Blood product organ transplant. Just other health care exposures. As well as through you know illicit drug use and share equipment such as you know sharing needles and syringes. And thirty days the most common brother infections increased strains of blood supply and ultra settings take you know really great cheer for event that's bad blood borne pathogens. And remaining main high risk factor is you're sharing injection equipment like needles or syringes. Obama luckily these health care related exposures Ers are very rare. I'm and then left commonly hepatitis he could be transmitted through new. Shared personal items determine can come into contact with to just like. Tests he infected blood on a raise her toothbrush. You know it's a little from the Stanley uses. I can be spread from the pregnant mother with past feature infant. And then rarely up by having sex with someone who has hepatitis feel that it's pretty rare. Is hepatitis C a relatively new in. Virus discovered. That's an interesting question we think it's probably been around for a while and what happens if you think about it. We've known about we had good catcher hepatitis BM and ate her last blog I am sure it. And prolonged time there was just this other entity. Oh this book just like hepatitis A your beads but the tested negative does it refers to it. Non a non B hepatitis it's probably got around for me fifty years. In toasting. And well what's the main age group that is affected by hepatitis C. Well Dick Cheney is now that because the blood supply is safe the only. Like a new infections that we see most commonly occur in people who are injecting. Let it happen though it's because we had this time period back. You know credit them dvds and even into early ninety's where. I'm just more commonly spread in other settings health care settings entrant to carry the big issue among. Vietnam veterans. There are sure on precautions taken what for. You know confusion doubt and feel you can imagine so sure. What CDC recommends now I can lead them to do most commonly affected our our people born between 1945. In 1965. The baby boomer population. That's really interesting that that there would be of the affecting net population which is deemed low one of the largest populations in the country. Exactly yet what this thing that we look at you get the virus in or again. We heated most of our new cases are occurring in young adults only 16% of them are Tunisia is an eighteen and 35. And you've either been reported injection drug use. However. We also made important people that are reported to us because they're having symptoms of the viral hepatitis. But we had made. Two K computer anyone who has a positive as he. Lab test is reportable for the state and we get over 5000 report a year and they're mostly people who got it. You know 2030 years ago. And compared her to the ages of 45 and 65. What are some of the symptoms of hepatitis C. When it first appeared. And only can be typically MD 80% people out of those symptoms. But it would look like other types so viral hepatitis. Two people usually are very tired in Adelaide street say. You know kind of from Shiite and some like not being not the end all thing diarrhea they might ask stomach pain. And they do have jaundice switches. Is try and elevated Billie the level that makes your your eyes and sometimes even your skin turn yellow when people are usually pretty miserable for. Several weeks. Now most people don't have any symptoms. And won't. Had any issues sure for years. But by the time they do that content can be pretty serious and often times it's really the most part can he is in the common cause as you know Derosa and stage liberties groups liver failure. And liver cancer and supporting developing specific content delivered these people often report. Chronic fatigue but we'll we noted that about twenty to 30% of people. We untreated. Chronic has fueled all around this or twenty to thirty years. She wrote this is that it ease in which delivers ultra vanished replaced by scar tissue and once someone has wrote there's about one to 4% will develop. Negative liver failure. Or liver cancer each year. So we're talking today with doctor and Thomas with the organ health authority. The doctor can you tell us how is hepatitis C diagnosed. Can pull it basic blood test. The first half they usually get. Is one that called an antibody test there is whether your your immune system has been exposed to viruses complaint. But then to determine if you're one of those seventy to 80% of people who still have a chronic infection or the second blood tests. You reboot abbreviated to PCR witnesses so polymerase chain reaction. And it tells you the virus is still circuit leading in your in your blood. And then it. That would mean you're chronic cheer your factor that there's kind of a more advanced. You know what we call speeding or evaluation to determine how much liberties you have. That easy bulk. Kind of ultrasound typing stand and additional blood test to tell you suffered in the liver damage from the infection. Is hepatitis C treatable. Yes I and that that could answer that I could not given so confidently even five years ago. The medication. I initially fur coat. And the first medications rally early ninety's. And you'll probably a good ten years they weren't that affected. They had to take control long times six months to year. And there are lot of site protection people really hadn't. Problems. Already not a lot of people just talk about or counseled other commission. Not to bother. I heard the last few years usually been a revolution treatments and now. Over 90% of the people who take the medications are completely created the virus. Medication is much easier to tolerate and you're legally taken from our twelve weeks. Is hepatitis C is it took curable. Yes that good things because you know we had a much better HIV treatment that all it does is suppress the virus. In the same is true really whip hepatitis B. But perhaps he they've managed to develop to take advantage of you know problem could virus. Replication that they can completely eradicate it from. I'm your systems so typically the standard is just taking medication and you'll have a follow up of the PCR test to tell whether still circulating and usually you're cleared then you'll be free and pro life and that's good because that it's been shown to reduce your chances of getting liver cancer or dying from your affection. Is it preventable completely like with the vaccine or anything. Well. I'd like to say that it is preventable and I'd like it also emphasized that has he cannot be spread by casual contact that you and I household member. You're not gonna get it from. Cheering me you know eating utensils or sharing food. Hugging or kissing holding hands coughing or sneezing. Is not spread to prove water or insect bites. And because it is possible to screen perhaps see our in our national blood suppliers is safe and it's very rare to have transmission health care settings so. I'll let you may be an exception there are people who are on dialysis because there's kinda small risk that each episode they're screened more often. The main area of risk he is really in prevention of spread among persons to inject in this. Kind of the strategies have to happen at multiple levels we need chew. On. We need more effort to reduce the risk of Oprah you're dependant and transitioning to injection drug use. We need more harm reduction efforts finishes improved access to clean needles and syringes. And really translate into better availability of mental health and addiction treatment. I will point out that another hit people need to know about it there's no vaccine can prevent hedge C. But. They're important for people with hepatitis C don't protect delivers Larry mentioned. Limiting alcohol use and being careful of other medications they take. But the jet their provider not being vaccinated for hepatitis a and B because in food although they're completely different viruses that can damage the liver. And you don't want someone with pet he has further damage to deliberate so all he's after power and they indeed next. He's a little bit earlier that the main age group for Pepsi is the baby boomer generation what are you seeing it on the rise at all because of we've all heard about the use the open going to. Problem in the United States now are we seeing and seeing Pepsi on the rise. And that that is true what we have seen is that. Pretty much. The case is weak doesn't Nikita delegate getting reported try to get two thirds of whom are in this baby boomer age group but just as we look at. These chronic cases that come in the media people who. I must have been eight symptomatic and you know had a blood tests perhaps he. I'm don't have been increasing each year so presence in. 2006. People under the age of 35 accounted for only about seven and a half percent of our she's kind of what do look at about 700 cases back in. Actually feeling. In 2011. There were 710. Cases and people under the age of 35. And that number wrote quite a bit so. In the 2015 for instance sir I would continue to stay you're diagnosed in people under the age of 35. And we don't know that much when they got it but they're probably if you're younger you get at poly means that you. Acquired in the last few years to look ahead translated into it and increases in in younger people. Still an area where I think we really need to intervene. Now for sure so public to a problem is this nationally and to specifically in Oregon. It's really one of the biggest public health problems of our time. Has exceeded the most common chronic blood borne infection in the US. And he's he recently released estimates stating that one point 67%. Of the adult population in the US has as Cassie. Which translates into three point nine million Americans. They all who should the Kremlin for each state and just over 3% of oregonians. Which is 90000 people have anybody that's the best start third highest. Problems in the US central Oklahoma and the District of Columbia. And would even more sobering is the high mortality. Debt should have seen organ are now more common than for HIV. And have been rising. The mortality rates from have to fear among the highest in the nation they're twice the national race. And there are six times higher than the rate of death through HIV in Oregon. And what. I think probably as impressive to me is that they do you know the leading infectious disease caused the death organ flute. The median age of food yes. It is 81 and forehead she is it 61. Almost 80% of the deaths are occurring. In Oregon in people between the ages of 45 and 65 cents really what we would consider premature death. Absolutely so what why is organs and and so hide. You know it it's good it could be passed blaming it because. There are so many of these cases to be your I guess I was the new year in debt. What we actually don't have the resources to investigate each one and talk to each person and find out how they got it. And the assumption is certainly most of them have gotten it 20/20. Or thirty years ago. And do we can only feel that they got it to some type. Probably a medical procedure orchard injection drug users and so it. It's hard to know is they're really more injection drug users cheered in Oregon and and you know. Other parts of the country we do know that where. We're not alone among lacked true state in that report and I was mentioning from CC. On the West Coast and has the highest prevalence. Has seen. In the nation. And hepatitis is who's considered a silent killer what does that mean. Chicken acted. You know heavy 80% of people. Do not have symptoms when they first get it so they are alert to factor they have something. And then you just don't have anything can enter 2030 years so you know just seems like you're spying and assassination someone who. Maybe you injection drug a few times in their twenties and and I kind of moved on their lives and all of a sudden feeling Derek Jeter they're seeing some more statistics just something does Derosa doesn't. See a doctor about it or hopefully we'll get screened because they're in that need to build it to be found early. I'm definitely the cities where you want it to be to be found early because. Once you have to read this you're delivers starting your kids at risk for complications. So should be routine screening be done. Exactly right you've fallen right into my my playing here so you're. He he had his strategy. That we look I mean people don't risk so people that had you know transfusion or organ transplant prior. Terry in 1992. And everything was. I can win like those organs no blood was fleeing you should get. And test that you know or keep. Then on dialysis for a long time or you have elevated liver functions practiced some tests that are commonly done Tata liver functions those elevated. We're children born to women living with Pepsi infection. You know or Chris people who. Injection drug they should get tested but it just didn't seem to be having an impact and especially they were just sort of noticing inert data that. You know I really like the majority of people are in this baby boomer age group. And we're just not seeing taken testing they've done studies where. Beating these are employing. Help interviews screens and and they. Take blood from people all the national health nutrition valuation survey. And then get up about a lot of different conditions and do a lot of different tests since the kind of thing that let me read studies about. What percentage of people smoker how many have diabetes or ask message from one of these national surveys. And what happened in the third they were surprised when they first is that the electorate that it had he had found out a back in the nineties that almost 2% of Americans had it. And then they would do these followup surveys and take. Did you know that you have I seen it always the answer is always good about like at least 50% it is only 5% saying no I had no idea. So it just seems the right. Groups Yahoo! is as good an age group where most people are getting a lot of other preventative services they're being recommend had a colonoscopy is their cholesterol tested and you know prostate screening and mammograms typed. Just it just be part of that package and just make it very routine and I think a big issue with hepatitis C is because there are the risks fact the main risk factors. There's a lot of stigma and I think we just need to make it like a routine health care issue gets addressed. Tell us about that Steve know what they do what would people who have not won their doctor to screen them because of and perhaps they had a drug problem. You know I think people don't like to talk about us. And I think. Just not a big international. Studies that even after the baby boomer recommendation at midnight PDT and 2013. And meanwhile these health interview survey that I described they have to play New York jury that they too could even train track Tennessean people saying oh no I haven't done. That number did not increase even a couple of years after the recommendation has been made I think. Well a lot of the issues they're just because you're not around it. Transmission people don't wanna talk about it on an opinion on either side book factually patients and clinicians. That a patient who looks fine and you know. They don't have any reason spec they injected drugs twenty years ago. And I think it's easier sometimes. To make it a routine thing and just say hey you know we're recommend people that they can get screen have you had discussed okay look you'll get it done today. They're perhaps it's not top of mind with doctors which is where the organ health authority comes in. Because you can't have an educational campaign going on. Yeah we're excited here had. You were able to identify them finding. In a weird do you leading we're concentrating. Try met buses and radio ads in the Portland area and ideas. To focus on encouraging baby boomers to get tested. Because one of the most likely because to be infected. And also since they had perhaps been churned by terrorists or twenty to thirty years the ones that are most likely differ from the complications. Of liver disease and little you know they're the ones you really need to get treated. Soon. What's the goal this educational campaigns besides the obvious. Right well and requested task because the way I mention I think many people. You know you're in your forties can do it each year every time you go when there's a new test just put that your cholesterol your colon appear past Syrian mammogram. And to people do that well and get out both times so anything. That is recommended they I would have gotten right. But had mentioned some studies have shown that not a good the other complete adoption of the recommendations so. Our artists. Our slogan is required to test match back here clinician. Yes he'd ever been tested for hepatitis C that they don't know about it then you should go and get tests. Do you suppose there could be a day when the hepatitis C is no longer. Well it helped. I think it I think we can do a lot with treason because unlike drink and hepatitis B and HIV. I'll. You know you can eradicate it and you know treatment is available I think we can really. Knock it down if we work on and I think a barrier now it the treatment are very expensive but. More and more insurers are covering them. Indian you don't have it takes persistence on the part of patients and providers to get that authorization to get treated but it is available. And I think. Over time people see the benefit just because it can be sure it is not like. HIV medication which maybe not quite as expected but generally is taken over the course just on flight time. Doctor Thomas what is the main message is trying to get out there. Yet and main thing is awareness of that that just because that serve as violence disease a lot of people don't know about it. We have I stayed action plan that has four main components which are. Eagle countries prevention efforts we want to we might see higher rates of screening better access to care and cure. And awareness that the real driving factors awareness to just like we're doing at this. News media campaign so we hope that some people both you know patients and providers. We'll be more open that you know talking about getting the test. Is there hope for people with hepatitis C and what do you see as the future. Like a treatment are gonna keep getting better and better than you know just the market courses and more and more medications out there are new ones coming out all time I'm. I'm hoping that prices go down. And the good thing is. The medications are very goods that are that are effective and erratic seeing the virus in over 90% of people and their house. Ben that it just shows that that really can reduce your risk of liver cancer deaths from hepatitis C. Is Eric didn't information source of people can go get more information in May and find out more about hepatitis C. Sure there are a number of web site are. You frankly if you just Google. Viral hepatitis or again. You'll get a link to our profile and an updated fact sheets they can feel a lot about hepatitis and organ and that has links to other web sites. I would imagine there's lots of information out there. And talk to your doctor. Excellent played like to thank you so much for being on the show today doctor and Thomas public health position in the acute and communicable disease prevention section. At the during health authority public health commission thinks of me limited scope. Mitchell's bill is an Entercom radio Portland public affairs program I'm Gary blocks of if you're involved with a nonprofit or public affairs organization or do you have an idea for an upcoming show I'd like to hear from you. Visit microscope PDX dot com and submit your ideas you can also go to the station's website handsome richer information there. Thanks for listening to metals go and enjoy the rest of your weekend.