High-risk groups should be screened for hepatitis C and treated, Knesset told

It is the moral obligation of all doctors whose patients are in high-risk groups to inform them that they need to undergo screening tests.

By JUDY SIEGEL-ITZKOVICH
Petri dish [Illustrative] (photo credit: REUTERS)
Petri dish [Illustrative]
(photo credit: REUTERS)
Although drugs to cure hepatitis C have been added to the basket of health services provided by the health funds, and plans for a national campaign to wipe out the infectious disease have been in place for two years, little has been done, according to speakers at a joint meeting of the Knesset Labor, Social Welfare and Health and Immigration and Absorption committees.
Hepatitis C is caused by the HCV virus and is spread mostly by blood-to-blood contact resulting from intravenous drug use, poorly sterilized medical equipment, needle- stick injuries in healthcare and transfusions.
Because of poorly sterilized medical equipment in previous decades, there are many hepatitis C carriers among former immigrants from Eastern Europe and the former Soviet Union. Carriers are also more common among immigrants from Africa, including Ethiopia.
It may also be spread from an infected mother to her baby during birth.
It is estimated that there are more than 100,000 carriers in Israel, or 2 percent of the entire population.
The condition can require a liver transplant to save the patient. There is no vaccine against hepatitis C, even though there are vaccines against hepatitis A and B which are given to children.
But as there are effective but expensive drugs to prevent the condition from turning into serious complications, the government has invested large sums in prescription medication against HCV.
During the initial infection, people often have mild or no symptoms. Occasionally, the individual has fever, dark urine, abdominal pain and yellow-tinged skin. The virus persists in the liver in between 75% and 85% of those initially infected. Initially, there are no symptoms if it becomes a chronic infection. Over many years, however, it often leads to cirrhosis, liver failure and liver cancer.
The national program for fighting hepatitis C has still not launched an effort to identify all carriers, said Bayit Yehudi MK Shuli Moalem-Refaeli (acting chairman of the health committee).
“As many immigrants are in high-risk groups, we must make information about hepatitis C accessible in their languages,” said Likud MK Avraham Neguise.

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Yesh Atid MK Yoel Razbozov said that many cases of infection can be prevented, thus saving huge amounts of money in treating the disease.
Dr. Emilia Anis of the Health Ministry’s epidemiology department said that information about hepatitis C will be translated into numerous languages and, within six months, priorities will be set for screening various sectors for the virus.
Dr. Ian Miskin, a member of the Family Physicians Society, urged that carriers should not be told of their status before they can all get the drugs. “If 100,000 people are told they are carriers but only 2,000 get the drugs quickly because of the shortage, it will be very frustrating,” he said. But Moalem-Refaeli said society “doesn’t have the right not to inform a person that he is a carrier. Informing him can prevent the disease from breaking out and the costs of treating [more people].”
Prof. Ziv Ben-Ari, director of the liver unit at Sheba Medical Center at Tel Hashomer and president of the voluntary organization Hetz, which promotes awareness of hepatitis C, said that if all carriers are not identified, there will be serious results. “Carriers often get to medical care too late, and they can’t be saved.”
Hetz chairman Julio Borman said that people have the right to know if they’re carriers.
“Screening must begin immediately. Tens of thousands of people are walking about with a ticking bomb in their bodies. Many can be saved merely with lifestyle changes, without immediately receiving medications.  It is the moral obligation of all doctors whose patients are in high-risk groups to inform them that they need to undergo screening tests,” he said.