Monday is National Hepatitis Testing Day, and the Department of Health is using it to generate greater awareness of a virus that afflicts thousands of residents, many of whom have no knowledge that they’re infected. The state agency is also promoting its ongoing free testing and its latest partnership with Walgreens to provide no-cost risk assessments.
Hepatitis means “inflammation of the liver.” Viral hepatitis is a collection of viruses that attack the liver and may lead to liver disease and cancer. Many types of viral hepatitis exist, but hepatitis B and C often become chronic, long-term infections and are the most common causes of liver cancer in the state, according to Hep Free Hawaii, a grassroots campaign to bring attention to the epidemic in Hawaii.
Hawaii has the highest rate of liver cancer in the United States. The Department of Health’s Immunization Branch estimates 1 to 3 percent of people in Hawaii have hepatitis B and approximately 23,000 are living with hepatitis C.
Hepatitis B and C typically have no symptoms and can remain dormant for 20 to 30 years, said Thaddeus Pham, the department’s viral hepatitis prevention coordinator.
“Most people with hepatitis B or C don’t know that they have it,” he said. “With better insurance coverage under the Affordable Care Act and more effective hepatitis treatments available, people with hepatitis B and C now have better options to take care of themselves before they become ill. The earlier people know they have hepatitis, the better the outcome.”
Year-round, uninsured residents have the opportunity to be assessed for hepatitis B and C, as the department continues to partner with community groups and health clinics to offer free tests. On Monday, Walgreens will begin providing free risk assessments and referral information for anyone to take to their primary care provider. Such collaboration is key in not only combating viral hepatitis, but also in “helping empower communities to stay healthy and take care of each other,” Pham said.
On Hawaii Island, hepatitis B and C testing is offered by appointment at the Waiakea Health Center on Kuawa Street in Hilo and those interested can call 974-4247. Hepatitis C testing is also offered from 9 a.m. to 3 p.m. at the Hawaii Island HIV/AIDS Foundation on Nani Kailua Drive in Kailua-Kona and on Melekahiwa Place in Keaau. The foundation can be reached at 331-8177 or 982-8800. In addition, individuals without insurance may call Aloha United Way at 211 or visit hepfreehawaii.org to find the nearest free screening location.
Hepatitis B and C are spread through contact with blood and body fluids. The U.S. Centers for Disease Control and Prevention recommends anyone who has been exposed to blood through needle use, blood transfusion, nonsterile equipment or tattooing should be tested for both hepatitis B and C. Anyone born in a country with high rates of hepatitis B, especially countries in Asia and the Pacific, should be screened for hepatitis B. Baby boomers, anyone born from 1945-65, should also get a one-time test for hepatitis C, regardless of any known risk.
Baby boomers are more likely to have hepatitis C than other age groups because of the high rates of experimental drug use in the 1960s and ’70s, as well as the lack of oversight given to the blood supply used in all transfusions before 1992, Pham said.
A finger stick test is used to detect hepatitis C and patients can expect the testing to take roughly 20 to 30 minutes. Hepatitis B, on the other hand, is diagnosed with a blood test, Pham said.
As for the risk assessments, individuals with insurance can go to a Walgreens pharmacy or their primary care provider. The only Walgreens on the island is at 301 East Makaala St. in Hilo and can be reached at 961-1001. The assessment conducted by Walgreens pharmacists is “a short conversation,” consisting of a handful of questions. Anyone considered at-risk will be referred to a primary care provider for testing, Pham said. The reasoning behind not offering testing at Walgreens pharmacies is to ensure linkage of care, which includes maintaining relationships with their doctor and navigating the health care system to get access to treatment if needed, he added.
Having Walgreens participate in this effort to provide free risk assessments is of great benefit to residents because such pharmacies are typically open outside normal business hours and on the weekends, Pham said.
There are no cures for these diseases. Nevertheless, vaccines and medications are available to prevent hepatitis B infection. Hawaii’s students have been required to be vaccinated against hepatitis B since 1997. Hepatitis C, on the other hand, has no vaccines for public use and research into the development of one is underway. Hepatitis C can also be treated with medications.
Pham recommends the public take advantage of the free testing and screening, saying it will bring peace of mind and also keep Hawaii’s communities healthy.
“I often tell people when thinking about viral hepatitis to not focus on the percentages or numbers. Instead they should visualize two people they know and love,” he said. “By learning about hepatitis B and C together, getting tested or screened, and following up with your doctor, these simple things allow us to take care of each other and save lives.”