The strenuous process of care and lack of awareness keep patients away from complete remission, specialists develop.
Dr. Humberto Guiot, president of the Society for Infectious Diseases of Puerto Rico (SEIPR) and Dr. Juan Carlos Lemos, infectologist specialized in transplantation attached to the Comprehensive Cancer Center. Photo: Journal of Medicine and Public Health.
Hepatitis is inflammation in the liver, that inflammation occurs due to different viruses; of which several are preventable, others treatable and curable. But there is a very high number of people who do not know they have the disease and others who, even knowing their diagnosis, cannot access treatment.
The Hepatitis Cis “one of the infections, with a new paradigm that is curable, when I was studying medicine it was treatable, but not curable, not many years ago, in this short time there is a new paradigm that is a curable infection, up to 95% or more of the patients respond well to treatment”, says Dr. Humerto Guiot, President of the Society of Infectious Diseases of Puerto Rico (SEIPR),
The specialist also highlights the importance of a topic that is not talked about much and it is those patients who, with the diagnosis, cannot access treatment, “however, many of them cannot access it, we have to talk about what What can we do?, to improve the percentage of patients who can access treatment and eradicate the condition”.
This virus that affects the liver, has two phases: many of the patients in the first, after the infection the first months the body can eliminate this virus by itself; but it is not something generalized, since some patients develop chronic phase, without presenting a specific symptomatology.
“It is quite silent, it will not give symptoms that you are going to say are characteristic of this condition, and it continues to progress,” said Dr. Juan Carlos Lemos, Infectologist Specialized in Transplantation attached to the Comprehensive Cancer Center, also maintains that if it is not diagnosed early, “if we do not know our status, it can lead to cirrhosis, which is a progressive failure of the liverand later it can have two consequences, or it gives you a carcinoma or cancer of the liveror end up needing an organ transplant.”
Who is at risk of getting infected? Hepatitis C?
Mainly, it is necessary to reach a diagnosis, raise awareness about the presence of this type of viral disease in society, and recognize the risk factors that can expose us to the virus, specifically hepatitis Cand more considering the percentage of patients who are not part of the risk factor groups, as Dr. Guiot postulates, “we have always had a group of patients with Hepatitis Cin which we could never identify a risk factor, that is why it is necessary to create more openness, at one point the test was recommended only for those people who had a risk factor, additional ones already appeared because they were tested for another reason ” .
Currently, the Centers for Disease Control and Prevention, CDC, and the American Society for Infectious Diseases recommend that all adults have at least one hepatitis test, at least once in their lifetime, and if they have risk factors risk periodically.
“The doctors who have a group of patients that they have been following and realize that they do not have a test in their file, that they carry it out, and realize that since there is a group of people who do not have a risk factor, it is like all infectious diseases, they should not be a reason for stigmatization or reduction”, emphasized Dr. Guiot.
Barriers to diagnosis and treatment
Dr. Carlos Lemus shares that, based on his experience in the Puerto Rican and US territory, reaching a diagnosis is currently one of the main barriers that delays care and puts patients at risk, so it is necessary first to “raise awareness to the primary doctor as well as to the patient, that anyone is at risk, and that it is necessary to do the test, not be afraid to know the status, if you are positive or negative.
This is due to the general lack of knowledge, and the association of Hepatitis C with a chronic disease, which can happen in some cases, but it must be kept in mind that there is currently a treatment of which remission is a high percentage, as well as removing the stigmatization of the group of people who face this disease.
The specialist reiterates that, “following the diagnosis, primary care physicians have a role, to start the full workout, which is extensive, because between the time you have the diagnosis and the start of treatment, there are a number of discernment tests, as it has been, to know if it is exposed with other chronic infections, many times there are co-infections with what has been HIV, Hepatitis B, Hepatitis A if you are not vaccinated”, in this case the patient should be vaccinated, to avoid other infections and evaluate all the battery of laboratories to be carried out.
But it must be taken into account that another barrier is the time that passes between the performance of the battery of laboratories, until the delivery of results, which can take from 4 to 6 weeks, at which point we can determine an effective treatment, “we are speaking that we are already two months since we know the state”.
Then comes the work on the part of the medical plan, between authorizations, requested paperwork, adjustment of the treatment to the characteristics of the medical plan, “there the process can be delayed, both exhausting for the patient and also for the doctor, and after the treatment, there are some that last 8 weeks, but they need follow-up of many appointments, even once the treatment is finished, a test is needed, 12 weeks later, to know that the therapy was effective, we are talking about the whole process of cure the Hepatitis Cit can take basically a full year.”
Added to this barrier is the cost of the process, because “this battery of tests, depending on the patient’s coverage, could have deductibles or copayments, and the studies are sophisticated, specialized; not necessarily all laboratories have them, you have to send the patient to other laboratories, the co-payments can be high, the patient sometimes requires help, from his family or savings, to take out these payments and all this is delaying and paying for the obstacles current”, confirmed Dr. Guiot.
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