Elimination: Public Event in Centralia to Screen for Hepatitis C as Part of a Statewide Initiative

Sep. 10—Miracle drugs for chronic and widespread illnesses are often heralded, headlined and heavily funded. But for hepatitis C — now incredibly curable with easy-on-your-body pills — that hasn't been the case, according to Michael Ninburg, executive director of nonprofit Hepatitis Education Project (HEP).

HEP was founded in 1993 by hepatitis C patients and medical professionals. Back then, not much was known about the virus. Early treatment, Ninburg said, "was basically a low-grade chemotherapy," with rough side effects and less-than-promising results.

Now, treatment is easy, and only takes a few pills a day for a couple months.

"It's amazing," he told The Chronicle. "It's really a revolutionary medication, and I think it's gone unappreciated."

Still, hepatitis C is the most common blood-borne disease across the nation, and can cause cirrhosis, liver cancer and death. Cases have increased in Washington every single year since 2012, exacerbated by intravenous drug use in the opioid epidemic.

On Wednesday, HEP will be in Centralia with a big tour bus trying to combat that. Partnering with Gather Church, drug manufacturer Abbvie and the Washington state Health Care Authority as part of the ElimiNATION Awareness Tour, the public will be offered screening, care coordination and hepatitis C-related counseling.

And the care won't stop when the bus pulls away. The event is a de facto kickoff for Gather's own hepatitis C and HIV testing, which will add to its harm reduction work and new, low-barrier substance use disorder clinic.

All of it plays into the Hep C Free Washington initiative. Implemented in 2018 by Gov. Jay Inslee, the goal is to eliminate the virus by 2030. According to the state Health Care Authority, about 60,000 Washingtonians are living with hepatitis C, which can fly under the radar for decades.

By some estimates, nearly half of Americans with hepatitis C are undiagnosed. In Washington, that number is lower, but "the remaining undiagnosed cases will be challenging to identify without an active screening campaign," according to the Hep C Free Washington plan.

With cases now increasing, the Centers for Disease Control and Prevention last year changed its recommendation for who should get tested for the disease. While the agency used to emphasize Baby Boomers, who were more likely to have contracted hepatitis C, it now recommends all people over 18 get a one-time screening.

Lewis County has seen anywhere from 100 to 144 new cases each year for the last five years, according to Lewis County Public Health and Social Services Deputy Director John Abplanalp.

The ElimiNATION tour bus has already made a few stops in Washington. Lewis County was a good choice, Ninburg said, because Gather Church already convenes a "critical mass" of folks less likely to access traditional health care. The church atrium offers food, clothing, community and medication-assisted treatment, and a large swath of its clientele are homeless or struggling with substance use disorder.

People with substance use disorder using intravenous drugs are at higher risk, as well as those living unsheltered with less access to health care. It's one reason why there's so much stigma around hepatitis C, said Gather Church Pastor Cole Meckle. But the virus knows no bounds.

"It doesn't care if you're homeless or housed or affluent or not or an IV drug user or not," he said. "It's going to be happy to find a host wherever it can."

Still, he said people who have absorbed those stereotypes, who may be uncomfortable discussing screening with their primary care provider, are welcome to get tested at Gather instead.

Before screening became regular, Ninburg said the virus was more prevalent in the medical blood supply — one reason why health organizations specifically targeted Baby Boomers.

According to the state Department of Health, individuals in jails and prisons, those living with HIV, African Americans and Native Americans are also disproportionately impacted by the virus.

And there are multiple forces working against those trying to eradicate it, including funding. Compared to federal dollars for HIV, Ninburg described hepatitis C treatment and prevention "woefully underfunded."

He points to the success in global efforts to prevent and test for HIV.

"That was the result of advocacy and billions and billions of dollars poured into research for treatment and the public health response to HIV. We do not have that for hepatitis C," he said. "It's really shocking the disparity that exists."

Since the late '90s, the nonprofit has been sending a message to the state Capitol, summarized by Ninburg as "wake up, this silent epidemic is killing Washingtonians."

"And finally, after decades, we got Gov. Inslee to commit to elimination of hepatitis C by 2030," he said.

The date mirrors the World Health Organization's own goal. According to the World Hepatitis Alliance, only one in four high-income countries are on-track to reach that goal, and the United States' elimination of the virus will likely include huge disparities across the country.

Some still associate hepatitis C treatment with the old, painful methods. Meckle said it's important for folks to know that isn't the case anymore. People he knows who've been cured "just can't believe how much better they feel, and how much more energy they have."

The ElimiNATION Awareness Tour will be at Riverside ParkSept. 15 from 10 a.m. to 7 p.m. In addition to hepatitis C screening, counseling and care coordination, free box lunches, backpacks and hygiene products will be distributed.

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