A new analysis finds that a very low percentage of people chronically infected with hepatitis C over the last decade ever make it through treatment.

 

Hepatitis C is a common blood-borne disease that scars a patient's liver and can lead to cancer. People who inject drugs are at higher risk for it, as are baby boomers, in part because pre-1992 blood transfusion protocols didn't screen for it.

Baligh Yehia, a researcher at the University of Pennsylvania, recently reviewed thousands of available studies on hepatitis C treatment in the U.S., and concluded that of the some 3 million people chronically infected with the virus, fewer then 10 percent get all the way through treatment and are effectively cured.

"That number is low," he said. "And it represents an opportunity for us in the field to really strive to increase that number."

Until very recently, Yehia said, hepatitis C treatment has been difficult and not always effective. It also requires a patient to have access to a whole series of health services, including liver biopsies and regular checkups. But with a more effective drug hitting the market this past year, he said, the real challenge moving forward will be identifying people who have the disease and connecting them to care.

"Now the bottleneck is upstream," said Yehia. "So how can we get them diagnosed and aware of their infection and then get them into care? And then really make sure we have the appropriate ability to pay for these new therapies?"

The new therapies are expensive and, depending on a patient's insurance plan, may be difficult to access. In Pennsylvania's fee-for-service Medicaid program, for example, a patient must have advanced liver disease to qualify for the treatment.

Yehia said lessons are available from what happened with HIV. Once effective treatments came out, the challenge turned to successfully linking people to that care.