Treating The New Hep C Generation On Their Turf

AP

Print Article

The Face Of Hepatitis C Is Getting Younger

This story by KHN Sacramento correspondent Pauline Bartolone aired Dec. 1, 2017, on Here & Now.

https://kaiserhealthnews.files.wordpress.com/2017/12/bur2303742174.mp3

Can’t see the audio player? Click here to download.

UKIAH, Calif. — Once a week, Dr. Diana Sylvestre puts her medical expertise to use in a rickety old house frequented by drug users in this small Northern California city.

She sets up in a stuffy office no bigger than a walk-in closet, just feet from a room where people who shoot heroin or methamphetamine drop off used needles and pick up clean ones. The needle exchange and Sylvestre’s makeshift clinic are under the same roof, part of a program run by the Mendocino County AIDS/Viral Hepatitis Network.

Sylvestre comes here in part to treat young drug users, people who are often homeless or suffering from mental illness, many of them newly infected with hepatitis C. She doesn’t see many of them at a hepatitis C clinic she runs in Oakland.

“They are the ones who are spreading hepatitis C,” she said. “They’re the ones who have the high-risk behaviors.”

The opioid addiction crisis has engendered an unfortunate side effect — an epidemic of new hepatitis C infections, mainly among young people who share infected needles. Although people over age 52 still account for the largest share of chronic hepatitis C cases, the highest number of new infections occurs among people in their 20s.

From 2009 to 2015, the rate of acute hepatitis C cases in the United States roughly tripled among people in their 20s, and it more than doubled among people ages 30 to 39, according to the Centers for Disease Control and Prevention.

In California, newly reported cases shot up 55 percent among men in their 20s and 37 percent for women in that age range from 2007 to 2015, the California Department of Public Health (CDPH) said.

The wave of hepatitis C infections among young people is “cause for alarm,” said John Ward, the CDC’s viral hepatitis director. The agency is studying the best ways to treat this population, he said, adding that a new “front of attack” is needed. Health experts and doctors like Sylvestre say that battle may be best waged outside traditional health care settings, in places frequented by young drug users.

At the needle exchange in Ukiah, caseworkers give $7 Subway gift cards to people who agree to be tested for hepatitis C. Those who test positive can visit Sylvestre and try to qualify for expensive new medications that wipe out the virus. Drug users can also get help for their substance abuse.

Patient advocates say this kind of on-site treatment is an anomaly in California, where only a few needle exchanges offer such services.

Treating young drug users is not easy, Sylvestre said. Their lives are chaotic, which makes it difficult to start or continue their medication. “They’re frequently homeless; they have untreated mental illness,” she said. “They aren’t the most reliable people in the world.”

The surge in hepatitis C cases among young people doesn’t surprise 28-year-old Stephanie Clarizio of San Francisco. She injected heroin for about six years, starting in her home town of Atlanta. Clarizio said many of her friends who used intravenous drugs there knew about the risk of hepatitis C, and many of them contracted the virus.

“Everyone kind of knows about it,” Clarizio said. “You just don’t care.”

Clarizio had hepatitis C for a couple of years before she was cured in San Francisco while in rehab for heroin addiction.

Experts and government officials say they’re concerned about the surge among young people, who are more challenging to treat because many of them do not regularly see a doctor.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Sign Up Please confirm your email address below: Sign Up

Many people who have been recently infected don’t experience symptoms of the viral disease. Left untreated, hepatitis C can cause severe liver damage or cancer later in life.

While the baby boomer generation, defined by the CDC as those people born between 1945 and 1965, still accounts for three-quarters of chronic cases, University of California-Berkeley epidemiologist Art Reingold suggests the public health response should target the newly infected population.

“The prevention opportunity is much greater” when treating the younger generation, Reingold explained. “If you’re working on a group that’s already got [75 percent] of the people infected, your opportunity to prevent new infections is much smaller.”

Dr. Heidi Bauer, chief of the sexually transmitted diseases control branch at the state Department of Public Health, said she encourages local health departments and community-based organizations to be creative about treating the younger population.

“We ask for people to think beyond that baby boomer box,” Bauer said. Public health organizations “can take their services on the road, so to speak, and they can make an extra effort to reach populations that may be more at risk.”

Dr. Sylvestre has been doing just that for more than a year. “If they’re not going to show up in our medical facilities, we need to go out where they are there,” she said.

Ashley Greene, a 29-year-old resident of Eureka, Calif., said treating young drug users for hepatitis C at needle exchanges is a good strategy. Greene recently recovered from the disease, which she said she contracted injecting cocaine as a teenager. She also used heroin on and off until 2011.

Greene feels much more energetic, clear-minded and optimistic about life since she was cured of hepatitis C, and she supports anything that educates young drug users about treatment, she said.

Not all will be ready for treatment, but at least “you can lead them to water,” she said.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Print Article

Read More National News

Podcast: ‘What The Health?’ Farewell, Individual Mandate

AP

December 15, 2017 at 10:45 am | The compromise tax bill emerging from Republican efforts in Congress appears to have jettisoned a number of contentious health-related changes. Still, it seems likely lawmakers will repeal the penalt...

Comments

Read More

Medicare Fails To Recover Hundreds Of Millions Of Dollars In Lab Overcharges

AP

December 15, 2017 at 5:00 am | Five years ago, Companion DX Reference Lab hoped to cash in on cutting-edge genetic tests paid for by Medicare. The Houston lab marketed a test to assess how a person’s genes affect tolerance for...

Comments

Read More

Good Deals For Some, Sticker Shock For Others As ACA Enrollment Winds Down

AP

December 15, 2017 at 5:00 am | In most states, Friday night is the last chance to sign up for Affordable Care Act health insurance for 2018. The enrollment period is half as long as last year’s, and it got just a fraction of the m...

Comments

Read More

FROM THE NEWSROOM: Thanks to Missourian and its readers, student journalists can dream big

AP

December 14, 2017 at 7:00 am | lucille headshot Lucille Sherman Three and a half years ago, I moved seven hours from home to pursue my dreams of saving the world the best way I knew how: enr...

Comments

Read More

Contact Us

(208) 263-9534
PO Box 159
Sandpoint, ID 83864

©2017 Bonner County Daily Bee Terms of Use Privacy Policy
X