WBAL-TV11 Reports On Importance Of Screening, Treatment For Hepatitis B, C
Dr. Paul J. Thuluvath, Chief, Division of Gastroenterology at Mercy
Most people are never routinely screened for Hepatitis B or C... partly because there's a belief that there's nothing you can do for them -- but one doctor believes everyone should be screened because there seems to be a cure.
Around 600 million people around the world have Hepatitis B or C, and thousands of people die from the viruses, according to statistics.
Wallace Harding found out he had Hepatitis C about nine years ago when, at a routine checkup, the nurse mistakenly tested him for it.
"They came back into the office and they said (I had) Hep C, and I said, 'No way.' I went into denial at first. I didn't believe it -- didn't want to believe it," Harding said.
Having no symptoms is not unusual for the virus, according to doctors, so Wallace had no idea how he contracted hepatitis C. He said he thought maybe it was his tattoos.
"Maybe those old tattoo parlors back in the day. Not today -- I'm sure everything is clean now -- but back in the '70s, lifestyles were a little crazier," he said.
Hepatitis B and C are spread through contaminated blood, so an infected needle from a tattoo or a piercing could be the cause.
When Harding received his diagnosis, the only treatment available to him was interferon injections, which have serious side effects. He said he didn't respond to the drug, so he stopped treatment.
The possible outcomes for Hepatitis B and C aren't good. They include cirrhosis of the liver, liver cancer and liver failure, which is why Dr. Paul Thuluvath of Mercy Medical Center’s Institute for Digestive Health and Liver Disease said he wants testing for the viruses to become routine.
"Ideally, everyone should be tested. It's a simple blood test that can rule in or rule out Hep B or C," Dr. Thuluvath said.
According to Dr. Thuluvath, part of the issue is that doctors have other conditions to worry about, such as hypertension, diabetes and heart disease, but the other problem is that there's no diagnosis code to support a routine test.
"If they have abnormal liver enzymes, then they can check, but if they have normal liver tests -- perfectly healthy -- they don't have an (internal classification of diseases) code," he said.
ICD codes are codes insurance companies use to determine payment, so if a test is run for a disease without a reason, the company may deny payment. Dr. Thuluvath noted that what's needed is education for doctors and insurance companies.
"In the long run, they will benefit. If we detect people at the early stage, we can prevent the progression to cirrhosis, liver failure and liver cancer," he said, adding that it will also save money in the long run by reducing the need for liver transplants, which are extremely expensive.
Although Dr. Thuluvath believes everyone should be routinely screened, intravenous drug users are especially at risk, as are health care workers who handle needles. Anyone who had a blood transfusion before 1992 or lived in a country with lower health standards should also be tested.
Less commonly, the virus can be spread through unprotected sex. Spouses of hepatitis sufferers should definitely be tested, Dr. Thuluvath noted.
Years after deserting treatment, Harding found his way to Dr. Thuluvath's office, where they found in July that his disease had progressed. He became part of a new study that had him on a three-drug cocktail, plus interferon.
After two weeks, he got a call from Dr. Thuluvath's nurse.
"She said, 'Wallace, we have some good news for you. Your viral load -- which is a count load that they do -- has gone from 4 million to under 300.' And the next day I was totally cleared of the virus," Harding said.
He said it's kind of like a miracle.
"I have to admit that when she called and told me, I broke down and cried like a baby for about 10 minutes. It had to be one of the better moments in my life," Harding said.
Months later, Harding is still clear of the Hepatitis C virus.
Dr. Thuluvath said that a code for routine screening for Hepatitis C will be in the IDC code list in 2013. He estimates that within about five years, patients will not have to deal with injections and possibly be on only one pill that's taken for three to six months to be completely cured.
Founded in 1874 in downtown Baltimore by the Sisters of Mercy, Mercy Medical Center is a 183-licensed bed acute care university-affiliated teaching hospital. Mercy has been recognized as a top Maryland hospital by U.S. News & World Report; a Top 100 hospital for Women’s Health & Orthopedics by Healthgrades; is currently A-rated for Hospital Safety (Leapfrog Group), and is recognized by the American Nurses Credentialing Center as a Magnet Hospital. Mercy Medical Center is part of Mercy Health Services (MHS), the parent of Mercy’s primary care and specialty care physician enterprise, known as Mercy Personal Physicians, which employs more than 200 providers with locations in Baltimore, Lutherville, Overlea, Glen Burnie, Columbia and Reisterstown. For more information about Mercy, visit www.mdmercy.com, MDMercyMedia on Facebook, Twitter, or call 1-800-MD-Mercy.