Although formal recommendations have been issued by CDC for preventing progression of liver disease and treatment for patients with chronic hepatitis C infection (HCV), little is known about the needs of HCV-infected persons in King County . In 2004, Public Health-Seattle & King County performed a needs assessment of persons who were reported with chronic HCV to identify priority areas for public health interventions.

Between January 1, 2002 and July 1, 2003, 2,475 persons diagnosed with chronic HCV were reported to Public Health. A standardized questionnaire was administered to a random sample (906) of this group, and to a convenience sample of 21 adults incar-cerated in the King County Jail during the same time period.

A total of 197 persons completed the questionnaire (180/906 non-incarcerated and 17/21 incarcerated).  Ninety-two percent were aware of their HCV infection. Of those, 12 percent were tested in a public clinic, 55 percent in a private clinic or office, 9 percent in a blood bank, and 6 percent in jail or prison. The most common reasons for being tested for HCV were abnormal liver function tests or symptoms (34 percent), and participation in a program that routinely screens for HCV (19 percent). The remaining 47 percent were screened for other reasons, including routine physicals, life insurance exams, a known exposure, or high risk behavior.

Eighty-four percent of persons diagnosed with HCV visited a health care professional after diagnosis. Of these:

• 58 percent reported being counseled to avoid hepatotoxic medications
• 54 percent recalled being offered vaccination for hepatitis A or B
• 47 percent were told to avoid alcohol; and,
• 35 percent were treated for their HCV infection.

Thirty-one percent of persons reported that they had not received adequate information about chronic HCV in order to make decisions about managing their condition. Incarcerated persons were more likely than non-incarcerated persons to report being told that nothing could be done for their HCV infection (35 percent vs. 6 percent).

On the basis of these data, we conclude that persons with chronic HCV infection need improved access to information about their disease including measures to prevent progression of disease (including vac-cination for hepatitis B and C), and treatment considerations.

The Hepatitis Education Project is a good local resource where healthcare professionals can refer persons with hepatitis C and their families. The mission of the Hepatitis Education Project is to educate patients, medical personnel and the public about hepatitis C and to provide resources to help those living with HCV disease. In addition to providing educational materials, they also sponsor support groups, publish a newsletter, and provide a drop-in center in Seattle. For more information about the Hepatitis Education project, see their website at www.hepeducation.org, or call (206) 732-0311.

Additional information about hepatitis C can be found at:

www.metrokc.gov/health/prevcont/hepcfactsheet.htm
www.cdc.gov/ncidod/diseases/hepatitis/c