NLM Director’s Comments Transcript
Improving Hepatitis C Awareness: 08/20/2012

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.

Recent medical advances to care for patients with hepatitis C have not improved clinical outcomes mostly because of poor public awareness of the disease, suggests an interesting perspective recently published in the New England Journal of Medicine.

Despite clinical advancements, the perspective’s authors note hepatitis C contributed to about 6,572 deaths in the U.S. in 2007 compared to about 4,839 deaths in 2002. Similarly, the authors report the number of U.S. patients treated with antiviral therapy for hepatitis C (a virus that begins with infected blood which can damage the liver) declined from about 126,000 persons in 2002 to about 83,300 in 2007.

To explain the downturn, the authors report about half of infected adults and children do not know they have hepatitis C. Among those who are oblivious, the authors write (and we quote) ‘only a tiny fraction are treated’ (end of quote). The authors explain the scenario establishes a silent epidemic where hepatitis C is spread by unaware, infected persons via activities such as shared needle use, sexual intercourse, or inheritance from mother to child.

To boost public awareness, the authors (who are from Duke University) suggest more hepatitis C campaigns need to be targeted at the populations most at risk of hepatitis C infection.

The authors explain (and we quote): ‘the challenge of improved diagnosis and treatment is made more acute by the disproportionate distribution of the burden of hepatitis C among vulnerable groups’ (end of quote).  The authors add at-risk population groups for hepatitis C include: African Americans, Hispanic Americans, adults with a family income below the poverty line, and persons with low health literacy.

The authors add infection with hepatitis C is independently associated with a high likelihood of being uninsured — and only about one third of patients with hepatitis C have private medical insurance.

Since the latter demographic characteristics mirror a profile of health disparities in the U.S., the authors find more aggressive efforts to generate awareness — as well as foster prevention and the early diagnosis of hepatitis C — could be a focal point of public health efforts to thwart health disparities.

The authors suggest public health agencies need to increase community awareness with culturally sensitive and linguistically appropriate educational messages. They add campaigns are especially needed among injection drug users as well as workers and visitors to the U.S. from Egypt and some Southeast Asian nations (where infection rates are high and awareness of hepatitis C is low). There are about 180 million estimated cases of hepatitis C around the world.

Similarly, the perspective’s authors endorse the Centers for Disease Control and Prevention’s proposal to screen for hepatitis C among all U.S. adults born between 1945-1965, which would cover the increased population exposure to hepatitis C from the 1960s through the 1980s. The authors assert the CDC’s proposed screening for hepatitis C is more comprehensive and efficacious than current recommendations to screen based on a person’s perceived risk.

The authors find (and we quote) ‘we are at a critical juncture…(to) translate the rhetoric of health disparities into better programs and outcomes for patients with hepatitis C’ (end of quote).

In addition, the authors note new educational efforts need to be focused on primary care physicians and medical students so they recognize hepatitis C’s symptoms and refer patients to specialists for optimal care.

Meanwhile, an overview of the common tests used to screen for hepatitis C (from the American Association for Clinical Chemistry) is available in the ‘diagnosis/symptoms’ section of MedlinePlus.gov’s hepatitis C health topic page. An interactive tutorial about hepatitis C that discusses diagnosis, symptoms, treatment, and management is available in the ‘start here’ section of MedlinePlus.gov’s hepatitis C health topic page. Interactive tutorials engage you to learn about health and are easy-to-understand.

MedlinePlus.gov’s hepatitis C health topic page contains the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the hepatits C health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.

MedlinePlus.gov’s hepatitis C health topic page also contains information on living with chronic hepatitis, managing its pain, and related issues such as alcohol and hepatitis, as well as HIV and hepatitis C. Some tailored hepatitis C information for children and teenagers is provided in the ‘children’ and ‘teenagers’ sections respectively.

To find MedlinePlus.gov’s hepatitis C health topic page, type ‘hepatitis C’ in the search box on MedlinePlus.gov’s home page, then, click on ‘hepatitis C (National Library of Medicine).’ MedlinePlus.gov also has health topic pages devoted to hepatitis, hepatitis A, and hepatitis B. 

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A disclaimer – the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider. I want to take the opportunity to wish you a very happy holiday season and a healthy New Year. The National Library of Medicine and the 'Director's Comments' podcast staff, including Dr. Lindberg, appreciate your interest and company – and we hope to find new ways to serve you in 2012.

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