With the recent outbreak of hepatitis C in Minot, the disease has been a hot topic and has found its way into the spotlight. Coincident-ally, a new treatment for hepatitis C will be available in early 2014.
According to Dr. Casmiar Nwaigwe, infectious disease specialist at Trinity Health, hepatitis C is spread by sharing a needle with someone who has hepatitis C, a blood transfusion, receiving an organ from someone who has hepatitis C, sharing razors or toothbrushes, or through IV drug use.
"People can have it for years and not know it," Nwaigwe said. "If you're never tested, then you won't know you have it until your liver fails." People in the baby boom generation, those born between the years 1945 to 1965, are encouraged to get tested for hepatitis C at least once, he added.
Dr. Casmiar Nwaigwe, right, infectious disease specialist at Trinity Health, left, pretends to give a hepatitis C test to one of the nurses at Trinity Health Center-Medical Arts.
Dr. Kent Martin
Some patients don't get sick from having hepatitis C, either, said Dr. Kent Martin, infectious disease specialist at Sanford Health in Bismarck. Maybe 50 percent of the people don't show any symptoms, he continued, but over 30 to 40 years, their liver is destroyed and they don't notice until their eyes are yellow. Some people will feel like they have a cold or the flu, Martin added, and then it goes away in a few days, or some peoples' eyes will turn yellow. "People should consider going in for testing if they lead risky lifestyles," he advised.
Using cocaine nasally, where it's drawn out in a long line and then snorted through a straw, is also a way to transmit hepatitis C, Martin said.
"If the straw touches the nose lining, it can pass along the hepatitis C virus through the nose lining," he added. "It only takes one time."
Also, if you're diabetic, Nwaigwe recommended that the needles be stored where other people can't use them. "Don't use the needle if you suspect it's been tampered with," he added.
Typically, when a person is diagnosed with hepatitis C, he/she must receive weekly injections for a minimum of six months and take medication. The injections, which are highly concentrated levels of what the body normally produces to ward off a viral infection, often lower white cell and platelet count, producing flu-like symptoms, thyroid problems, depression, gout, hair loss and rashes in patients receiving treatment. In addition, many people do not qualify for the treatment.
However, there is a new treatment soon to be available to people with hepatitis C. The new treatment involves medication in pill form, no injections, and will cut the response time in half, making treatment possible in just 12 weeks. Side effects will be minimal compared to the treatment involving injections.
The new treatment will be available in early 2014. It targets a different part of the virus and will improve the patient's response to treatment, Nwaigwe said.
There are three different strains of hepatitis C, Martin said, but the general virus acts the same and some respond to therapy better than others. Type 1 of hepatitis C is more aggressive, he added. The aim is to have treatment that is just pills for all three types, Martin said.
"When the FDA releases the new pill, it will just be for easier to treat types," he continued, "so patients will still have to use the other treatments for more aggressive types."
If left untreated, a person will not necessarily die from hepatitis C, Nwaigwe said. If it's left untreated and the person has no other disease that affects the liver, he continued, the person will start to develop cirrhosis and the liver will fail.
"The most common reason why people get a liver transplant is from hepatitis C," he said.
Also, the longer a person has hepatitis C, the harder it is to treat, Martin said. And if the person has had it for a long time, he continued, the more aggressive treatment that will be needed.
"The earlier it's treated, the higher probability you'll be cured, but if you wait, then response rates won't be good," he said. What's more, Martin said some people know they have hepatitis C and don't want to get treatment because they have heard about the bad side effects from the current treatment involving injections and pills.
Recently an outbreak of hepatitis C at Manor Care nursing home occurred in Minot and Nwaigwe said he is assisting the North Dakota Department of Health as much as he can. The outbreak has been contained in that one facility and everything is being done to control it, he added.
"Minot is a hotbed," Martin said about the reason for wanting to get the word out about the new treatment for hepatitis C. "Not just because of the outbreak but because of all the oil workers accustomed to using drugs."